Objective To investigate the expression of human telomerase RNA component (hTERC)gene in cervical scraping samples, and the relationship between hTERC gene and cervical lesions. Methods The fluorescent in situ hybridization (FISH) was used to detect the expression of hTERC oncogene in cervical scraping samples in 100 cases, including 76 cases with cervical intraepithelial neoplasia, meanwhile, high risk human papillomavirus (HR-HPV) were detected by Hybrid Capture 2 (HC2) . The other 24 cases were negative for intraepithelial lesion (NILM). Results The positive expression rates of the hTERC gene in NILM,ASCUS, ASC-H, LSIL, HSIL and cervical cancer were 0, 32.25 %, 75.00 %, 35.71 %, 81.81 % and 100.00 % respectively. hTERC gene positive expression in normal group was less significantly than that in abnormal groups (P <0.05). There was a significantly difference between HSIL and ASCUS, LSIL (x2 = 6.1736, x2 =5.0004, P <0.05). The positive expression rates of the HR-HPV in ASCUS, ASC-H, LSIL and HSIL or higher lesions were 54.80 %, 75.00 %, 60.70 %, 90.90 % and 100.00 % respectively. HR-HPV positive expression in HSIL or higher lesions were more significantly than that in ASCUS group (x2=4.1767, P<0.05). Conclusion The overexpression of hTERC gene may play an important role in cervical carcinogenesis, therefore it can be used as a better tumor marker for prospective in early cervical cancer progresses.

Objective To evaluate the effects of thrombus aspiration on postoperative clinical prognosis of acute ST-segment elevation myocardial infarction (STEMI) patients with emergency percutaneous coronary intervention(PCI).Methods From September 2009 to January 2012,a total of 239 patients with STEMI undergoing emergency PCI (thrombus aspiration + PCI (n =118) and PCI (n =121)) were enrolled in this study.The angiographic and clinical results were retrospectively analyzed and compared between the two groups of patients.Results There were significant differences between the thrombns aspiration group and the PCI group on instant blood flow TIMI3 grade (106 (89.8％) vs.96 (79.3％) ; x2 =5.026,P ＜ 0.05),ST-segment depression rate at two hours after surgery (101 (85.6％) vs.90 (75.2％) ; x2 =5.500,P ＜ 0.05),ejection fraction within one week after surgery (68 (57.6％) vs.52 (43.0％) ; x2 =5.130,P ＜ 0.05),incidence of reinfarction during hospitalization (0 (0) vs.5 (4.1％) ; x2 =4.980,P ＜ 0.05).There were no significant statistical difference between the two groups on the average length of stay ((10.05 ± 5.40) d vs.(10.40 ± 5.03) d; t =-0.525,P ＞ 0.05),incidence of ventricular fibrillation during surgery (4 (3.4％) vs.3 (2.5 ％ ; x2 =0.174,P ＞ 0.05),heart failure during hospitalization (15 (12.7％) vs.18 (14.9％) ; x2 =0.235,P ＞0.05),Malignant arrhythmias (12 (10.2％) vs.15 (12.4％) ; x2 =0.296,P ＞ 0.05),and mortality rate (2 (1.7％) vs.5(4.1％);x2 =1.248,P ＞0.05).Conclusion Application of thrombus aspiration,which is a safe and effective way,may improve the clinical outcomes in acute ST-segment elevation myocardial infarction patients with emergency PCI.

To establish a method to detect cardiac troponin I by using time-resolved fluoroimmunoassay ( TRFIA) and apply to the clinic.Methods:The assay were measured by TRIFA and double antibody sandwich method .Standard protocols were evaluated with the standard curve , the limit of detection , stability, precision and cross reaction .Healthy reference populations and clinical serum specimens were measured to established the reference interval and evaluated the perspective of the clinical application . Results:The standard curve was Y=7485 .878+1400.924 X with a correlation coefficient of 0.999.The limit of detection was 0.052 ng/ml.The intra-and inter-assay coefficients of variation ( CV) were all <10%.Reference values was <0.14 μg/L.The AUC of ROC curve was 0.971 while the sensitivity was 96.45%,the specificity was 91.43% and the accuracy was 95.69%, with 98.45% of positive predictive value and 82.05%of negative predictive value.The correlation coefficient was 0.993 between our proposed method and the commercially available CLIA kits.There was no significant difference in statistics compared with ECG , CK-MB and cTnT ( P>0.05 ).There was significant difference in statistics compared before and after treatment with AMI ( P<0.001 ) .Conclusion: The TRFIA method for detecting cTnI achieves clinical application standards and may be used for the diagnosis and serosurveillance of acute myocardial infarction patients.

Objective:to investigate clinical significance of serum and urine NGAL (Neutrophil gelatinase-associated lipocalin) in the early kidney damage with primary hypertension.Methods:According to UAER ( urinary microalbumin excreting rate ) ,we divided 90 patients with primary hypertension into three groups (<30 mg/24 h,30-300 mg/24 h and >300 mg/24h),and selected 30 healthy people as the control group.Serum and urine NGAL and cystatin C ,serum creatinine,urea nitrogen,high sensitive C reactive protein , transferrin,and basis of blood pressure were detected and followed up one year.Results:Compared with healthy group ,GFR( glomerular filtration rate ) and serum NGAL were decreased significantly in medium and severe proteinuria groups , while urine NGAL was increased.Conclusion:Serum and urine NGAL have been a clear trend changes in kidney damage ,which could be used as a reliable indicator in monitoring renal function of patients with primary hypertension.

Objective To investigate the application of magnetic resonance imaging (MRI) fluid-attenuated inversion recovery vascular hyperintensities (FVH) for the diagnosis of transient ischemic attack (TIA). Methods Consecutive 218 inpatients for TIA from May 2011 to July 2013 were reviewed with gender, age, cardiovascular risk factors, TIA or a history of stroke, TIA duration, and calculate the ABCD2 scores. All patients accepted MRI and MRA within 24 hours of symptom onset. FVH positive patients would follow up MRI and MRA within 7 days. All the patients were followed up in 90 days. Results FVH was identified in 45 patients (21%), 15 cases of them was found diffusion weighted imaging (DWI) hyperintensities on the same sides. The prevalence of atrial fibrillation (AF, P<0.001), DWI positive (P= 0.010) and arterial occlusive lesions (AOL, P=0.003) were more in the FVH positive patients than in the negative ones, while the duration of symptoms was shorter (P=0.010). Multivariate Logistic regression analysis showed that AF (OR=7.17, 95% CI: 2.71-18.4), AOL (OR=4.93, 95% CI: 3.53-12.6) and hemiplegic (OR=2.84, 95% CI: 1.21-7.42) independently associated with FVH. 7 days after the onset, FVH was not found in 15 patients (65%, transient FVH), in whom the prevalence of AF was more (P=0.020), and AOL was less (P<0.001). A total of 197 patients (90%) were successfully followed up. In the FVH-positive patients, 5 cases developed into recurrent TIA and 6 into ischemic stroke (IS), focused on the the same sides of FVH; while the FVH-negative patients, 2 cases developed into recurrent TIA and 5 into IS. COX proportional hazard analysis showed that FVH (HR=3.64, 95% CI: 1.08-12.6) and AOL (HR=3.82, 95% CI: 1.07-15.8) independently associated with the recurrence of TIA or IS. Conclusion FVH can be helpful for the diagnosis of TIA and predictions for recurrent TIA or IS after a TIA.

ObjectiveTo study the application of magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) in brain metastases, and the relationship between DWI results and the primary tumor pathology. Methods76 cases with brain metastases were grouped according to the primary cancer pathology. The apparent diffusion coefficient (ADC) of tumor parenchyma, capsule area, edema around tumors and normal parenchyma were determined; the ratio of high signal on the DWI were calculated (namely diffusion limited) in different tumor. ResultsThe ADC was (1.1364±0.310)×10-3 mm2/s in tumor parenchyma, (2.167±0.472)×10-3 mm2/s in capsule, (1.597±0.238)×10-3 mm2/s in edema and (0.812±0.158)×10-3 mm2/s in normal parenchyma (P<0.05). 15 cases appeared diffusion limited (19.7%), in which the primary tumors were lung cancer in 10 patients (66.6%) (including 5 cases with small cell lung cancer, 5 cases with none small cell lung cancer), breast cancer in 3 cases, and the other 2 cases were colon cancer and teratocarcinoma of testis (P>0.05). The minimum ADC were (0.72±0.16)×10-3 mm2/s in tumor parenchyma with diffuse limited metastases and (0.78±0.21)×10-3 mm2/s without diffuse limited (P=0.325). ConclusionDWI can respond to brain metastases to the microstructure change, but diffusion limited may not be related with the primary histopathology.

Objective To Compare postoperative complications between patients with varicose veins of the lower limbs treated with foam sclerotherapy or endovenous laser.Method From 2011 to 2015,simple varicosis of great saphenous vein patients (grade C3-6) in 2 542 cases,3 468 limbs were divided into 2 groups.Combined with high ligation of great saphenous vein plus stripping,foam sclerotherapy group (1 355 cases) underwent calf foam sclerotherapy (1％ polidocanol),endovenous laser group (1 187 cases) underwent endovenous laser therapy.All postoperative patients were treated with stretch socks for 3 months.Postoperative pain (calf),deep vein thrombosis,pulmonary embolism,superficial thrombophlebitis,saphenous nerve injury,ecchymoma,migraine,allergic dermatitis,pigmentation in 2 groups were compared.Result During the follow-up,28 cases in foam sclerotherapy group had saphenous nerve injury (2％),1 071 (79.1％) cases had subcutaneous ecchymosis,613 cases (51.6％) in endovenous laser group had saphenous nerve injury,979 cases (82.5％) had subcutaneous ecchymosis,8 cases (1.0％) had skin burns (x2 =824.660,4.786,9.161,P ＜ 0.05).Endovenous laser group (23.8％) was significantly better than that of foam sclerotherapy group (30.8％) in pigmentation (x2 =15.243,P ＜0.05).Conclusion Treatment of varicose veins of the lower leg with foam sclerotherapy has less postoperative complications compared with endovenous laser.

Objective To report the primary experience of open placement of triple-branched stent graft for acute Stanford type A aortic dissection. Methods Between June 2008 and September 2009, 20 well-selected patients with acute Stanford type A aortic dissection underwent open placement of triple-branched stent graft for total arch reconstruction. When core cooling to a 20℃ nasophageal temperature, perfusion to the lower body was discontinued and the ascending aorta was transected at the base of the innominate artery. Through a transverse incision, the triple-branched stent graft was inserted into the true lumen of the arch and descending aorta, and each side arm of the stent graft was positioned one by one into the arch branches.The transected stump of the ascending aorta was reconstructed by inner proximal stent-free dacron tube of the main graft and outer teflon felt, and subsequently continuous anastomosis to the 1-branched dacron tube graft was made. Results Open placement of triple-branched stent graft was technically successful in all patients. The mean cardiopulmonary bypass time, aortic cross-clamp time and lower body arrest time were (163.2 ±19.2) min, (89.4 ±10.0) min and (32. 7 ±6. 6)min, respectively. Transient postoperative neurological dysfunction was observed in 1 patient and acute renal failure in 1 patient. All patients were discharged from the hospital. Their computed tomographic scans at 3 months postoperatively showed that all stent grafts were fully opened without distortion. In the vascular stent implantation site the dissected false lumen was eliminated. The false lumen of the descending aorta distal to the stent graft was closed with thrombus in 16 cases. Conclusion Open placement of triple-branched stent graft is a new effective technique for total arch reconstruction in acute type A aortic dissection. Patients have the indications of the extensive primary repair of the thoracic aorta without primary intimal tears in the arch may be the best candidates for this new technique. The size of the stent graft, the distances between two neighboring side arm grafts and the prevention of the intimal trauma during the placement are crucial for successful open placement of triple-branched stent graft.

Objective : To assess the impact of inclusion of hepatitis A vaccine in Expanded Program on Immunization（EPI）on hepatitis A incidence. Methods : The data of patients with hepatitis A from 1998 to 2017 in Huzhou were collected through Huzhou Infectious Diseases Yearbook and China Disease Prevention and Control Information System. Interrupted time-series models were constructed using the year 2008 when hepatitis A vaccine was included in EPI as the intervention time point. The influence of hepatitis A vaccine into EPI on the hepatitis A incidence was evaluated by analyzing the changes in the level and slope of incidence before and after hepatitis A vaccine into EPI. Results : Before the inclusion of hepatitis A vaccine in EPI,the average annual incidence rate of hepatitis A was 10.228/100 000 and the incidence of hepatitis A showed a significant descending trend with an annual decrement of 1.558/100 000. After the inclusion of hepatitis A vaccine in EPI,the average annual incidence rate of hepatitis A was 1.721/100 000 and the incidence of hepatitis A showed a significant descending trend with an annual decrement of 0.263/100 000. The average annual rate of decline in the hepatitis A incidence decreased by 1.295/100 000 after the inclusion of hepatitis A vaccine in EPI. Conclusion The incidence of hepatitis A significantly reduced after inclusion of hepatitis A vaccine in EPI,and the EPI strategy had a continuous effect on the decreasing trend of hepatitis A incidence.

Objective: To monitor the adverse events following immunization (AEFI) with combined attenuated live measles, mumps and rubella vaccines (MMR) in Huzhou City from 2015 to 2021, so as to provide insights into the implementation of the MMR immunization strategy. Methods: All AEFI caused by MMR immunization in Huzhou City from 2015 to 2021 were captured from the AEFI Monitoring Information Management System of the Immunization Planning System of Chinese Disease Control and Prevention Information System, and the incidence, clinical features and epidemiological features of AEFI were analyzed descriptively. Results: The reported incidence of AEFI caused by MMR immunization appeared a tendency towards a rise in Huzhou City from 2015 to 2021 (χ2trend=124.126, P<0.001). Totally 324 386 doses of MMR vaccines were immunized, and 317 cases with AEFI were reported, with an reported incidence rate of 9.77/104 doses. Following two-dose immunization, the reported incidence of AEFI caused by two-dose MMR immunization was significantly lower than by one-dose immunization (6.01/104 doses vs. 25.43/104 doses; χ2=113.692, P<0.001). The incidence rates of general reactions, abnormal reactions and coincidental events were 6.20/104 doses, 3.42/104 dose and 0.15/104 doses, respectively. Fever and allergic rash were predominant clinical manifestations of AEFI, and no vaccine quality accident, inoculation accident or psychogenic reaction were reported. There were 246 (77.60%) cases with AEFI within 24 hours following vaccination, and among children with AEFI, there were 173 boys (54.57%), and 200 children (63.09%) age ages of less than one year (63.09%). AEFI was reported in each quarter, and 99 cases (31.23%) were reported in the fourth quarter. The largest number of children with AEFI was reported in Wuxing District (78 cases, 24.61%). Conclusions The safety of MMR vaccination is high in Huzhou City. General reaction is the predominant AEFI, which mainly occurs within 24 hours following vaccination. Two-dose MMR vaccination does not increase the risk of AEFI.