Objective To investigate the vaginal microbilme characterization in women with human papillomavirus(HPV)16 and 18 infection and high-grade cervical intraepithelial neoplasia(CIN).Methods Three groups were set,including control group(without HPV infection and with colpitis),low-grade CIN group(with HPV 16 or/and 18 infection),and high-grade CIN group(with HPV 16 or/and 18 infection).Virginal microbial composition was determined by using 16S rRNA amplication sequencing and hierarchical clustering analysis among three groups was applied.Rank sum test was used to determine statistical significance.Results Diversity and complexity of bacteria was significantly elevated in high-grade group.Compared with the control,the growth of Lactobacillus crispatus(L.crispatus) and Lactobacillus casei(L.casei) was significantly decreased,while Lactobacillus iners(L.iners) was significantly increased in low-grade CIN group and high-grade CIN group,and both were proportionally correlated to the grade of the disease.Brucella canis(B.canis),as colonized bacteria,was significantly decreased in both low-grade and high-grade CIN groups,and the changes were proportional to the grade of disease.The growth of Dialistersuccinatiphilus(D.succinatiphilus),Gardnerella vaginalis(G.vaginalis) and Prevotellabivia(P.bivia) were significantly elevated and proportional to the grade of disease.Conclusion The diversity and complexity of virginal microbial composition could be significantly expanded in women with HPV infection and high-grade CIN.In contrast to the important role of lactobacillus in virginal health,L.inners could be pathogenic.The colonization of B.canis,D.succinatiphilus,G.vaginalis and P.bivia might be highly correlated with HPV chronic infection and further development of CIN.

Objective To evaluate the effect of recombinant human annexin A5 on the expression of phosphorylated protein kinase C alpha (p-PKCα) and p120-catenin during endotoxin-induced damage to cardiomyocytes.Methods H9c2 cells cultured in vitro were randomly divided into 3 groups (n=18 each) using a random number table:control group (group C),endotoxin group (group L),and recombinant human annexin A5 group (group A).Recombinant human annexin A5 (final concentration 5 ng/ml) was added,and the cells were incubated for 2 h in group A,and then lipopolysaccharide (final concentration 1 μg/ml) was added,and the cells were incubated for 4 h in L and A groups.At 4 h of incubation,cell apoptosis was detected using the cell apoptosis detection kit,the intercellular space was measured using the confocal microscopy,and the expression of p-PKCα and p120-catenin was determined by Western blot.The apoptosis rate was calculated.Results Compared with group C,the apoptosis rate was significantly increased,the intercellular space was significantly widened,the expression of p120-catenin was significantly down-regulated,and the expression of p-PKCα was significantly up-regulated in group L (P＜0.05).Compared with group L,the apoptosis rate and intercellular space were significantly decreased,the expression of p120-catenin was significantly up-regulated,and the expression of p-PKCα was significantly down-regulated in group A (P＜0.05).Conclusion Recombinant human annexin A5 can inhibit phosphorylation of PKCα and up-regulate the expression of p120-catenin,thus attenuating endotoxin-induced damage to cardiomyocytes.

Objective To explore the influence of different injection techniques on the quality of bolus in 99mTc-DTPA renal dynamic imaging.Methods 395 patients accepted 99mTc-DTPA renal dynamic imaging were retrospectively analyzed.All patients were divided into three groups according to injection techniques:direct injection group (187 cases),intravenous route injection group (84 cases)and venous indwelling needle injection group (124 cases).The three groups were injected by each technique.Areas of interest (ROI) were drawn on abdominal aorta by Xeleris workstation in blood flow perfusion imaging.The time-radioactivity curves of ROI were got.The patients whose ROI curve formed a peak was successfully injected,and did not formed was unsuccessfully injected.The number of patients in three groups who were successfully or unsuccessfully injected was respectively calculated.The data of three groups was taken Chisquare test by SPSS17.0 software.Results 174 patients of the direct injection group,46 of the intravenous route injection group and 115 of the venous indwelling needle injection group were injected successfully.The successful rate respectively was 93.0％,54.8％ and 92.7％.The successful rate of the direct injection group and venous indwelling needle injection group were higher than intravenous route injection group.The difference had statistical significance.The successful rate of the direct injection group and venous indwelling needle injection group hadn't statistical significance.Conclusions The successful rates of the direct injection group and venous indwelling needle injection group were similar.The venous indwelling needle injection technique can be chosen.The successful rate of the intravenous route injection group was lower than the other two groups.The intravenous route injection technique should be chosen prudently.

Objective To investigate the clinical value and experience of transperitoneal and retroperitoneal robot-assisted partial nephrectomy for renal hi1 ar tumors.Methods We evaluated 48 patients who had partial nephrectomy for renal hilar tumor by robotic surgical syestem from January 2013 to March 2017.In those cases,35 were male and 13 were female,with an average age of 57.3 (range from 41 to 75 ),27 cases were ventral tumor and 21 cases were dorsal tumor.3 cases were totally confined to the renal parenchyma,the other 45 cases were partially confined to the renal parenchyma.18 cases were performed surgery by retroperitoneal route,the rest 30 cases were performed by peritoneal route.Results A total of 48 patients underwent successful robotic partial nephrectomy for renal hilar tumors.The mean warm ischemia time was 22 minutes (range from 16 to 33 minutes) and the mean estimated blood loss was 88 md (range from 50 to 350 ml).No bleeding-related complications were found.Histopathology confirmed 39 cases of ccRCC,7 cases of angioleiomyolipoma,2 cases of renal oncocytoma.There was one case in this review was positive surgical margin (2.1％) and found no sign of recurrence during the short term post-operation follow-up.All cases in this review are following up after surgery to date from 2 months to 4 years,no cases of tumor recurrence or metastasis were found.Conclusions The application of transperitoneal and retroperitoneal RAPN is the effective and safe way for renal hilar tumor resection,and it has a clear advantage of renal surgical incision stitching and tumor complete resection.The choice of surgical approaches depends on the size and location of tumor and the clinical experience of the surgeon.

Objective To evaluate the relationship between the expression of Nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) in nerve tissues and mitochondrial function during mechanical stretch-induced damage to mouse alveolar epithelial cells.Methods Alveolar epithelial type Ⅱ cell line MLE-12 cells were divided into 3 groups (n=13 each) using a random number table:control group (group C),cyclic stretch group (group CS) and cyclic stretch plus NLRP3 inhibitor TAK-242 group (group CS+T).MLE-12 cells underwent 20％ cyclic stretch at a frequency of 0.5 Hz (stretch ∶ intermittence =1 ∶ 1) for 4 h in group CS.In group CS+T,after being incubated for 1 h with 1 μ mol/L TAK-242,MLE-12 cells underwent 20％ cyclic stretch for 4 h,and the parameters were similar to those previously described in group CS.The reactive oxygen species (ROS) content and mitochondrial membrane potential (△ΨM) were measured using chemiluminescence assay.Enzyme-linked immunosorbent assay was used to determine the concentration of interleukin-1 beta (IL-1β) in the supernatant.The expression of NLRP3 in MLE-12 cells was detected using Western blot.Results Compared with group C,the △ΨM of cells was significantly decreased,the ROS content and IL-1β concentration were increased,and the expression of NLRP3 was up-regulated in group CS,and the △ΨM of cells was significantly decreased,the ROS content was increased,and the expression of NLRP3 was up-regulated in group CS+T (P＜0.05).Compared with group CS,the △ΨM of cells was significantly increased,the ROS content and IL-1β concentration were decreased,and the expression of NLRP3 was down-regulated in group CS+T (P＜ 0.05).Conclusion Mechanical stretch induces damage to mitochondria through up-regulating the expression of NLRP3,thus leading to damage to mouse alveolar epithelial cells.

Objective:To observe the pathological changes of levator palpebrae superiors muscle in patients with different severities of simple congenital ptosis (SCP).Methods:Levator palpebrae superiors muscle specimens from 102 eyes of 68 patients with SCP who received levator palpebrae superiors muscle shortening surgery at Wuhan Aier Hankou Eye Hospital from August 2018 to October 2019 were collected as the observation group.According to the severity of ptosis, the specimens were divided into three groups, coverage ≤4 mm group (n=35), coverage >4 mm to ≤6 mm group (n=30), and coverage >6 mm group (n=37). Fresh levator palpebrae superiors muscle tissues from 8 normal donors in Aier Eye Bank of Wuhan Red Cross were selected as the control group.All specimens were performed with Masson trichrome staining and immunohistochemical staining for α-smooth muscle actin (α-SMA), and ImageJ software was used to measure the collagen fiber area ratio, skeletal muscle fiber area ratio and the integrated absorbance (IA) value of α-SMA.Seventeen specimens (2 from the control group, 5 from coverage ≤4 mm group/coverage >4 mm to ≤6 mm group/coverage >6 mm group) were observed with a transmission electron microscope (TEM). This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Wuhan Aier Hankou Eye Hospital (No.HKAIER2018IRB-005-01). All patients and their legal guardians were well informed about the treatment method and the purpose of sampling and voluntarily signed informed consent.Results:Compared with the control group, the skeletal muscle fiber was reduced in number and was in disordered arrangement, and the striation of some muscle fibers disappeared, and hyperplastic fibrous connective tissue was found in intercellular substances in the observation group.The collagen fiber area ratio of the coverage ≤4 mm group, coverage >4 mm to ≤6 mm group, coverage >6 mm group were significantly higher than that of the control group, and the skeletal muscle fiber area ratio of the three groups was significantly lower than that of the control group (all at P<0.008 3). There were more smooth muscle fibers and positive expression of α-SMA found in the specimens of the observation group.The IA value of α-SMA of the coverage ≤4 mm group, coverage >4 mm to ≤6 mm group, coverage >6 mm group was 7 195.28(5 935.69, 14 058.29), 55 584.18(33 861.88, 80 419.32), 166 507.76(119 121.95, 187 890.86), respectively, which were all higher than 5 543.03(4 867.67, 8 312.02) of the control group, among which, there were statistically significant differences between the control group and the coverage >4 mm to ≤6 mm group, coverage >6 mm group (both at P<0.008 3). Abundant organelles and some damaged mitochondria were found in smooth muscle cytoplasm in the observation group with a TEM.But no characteristic structure of smooth muscle cells such as dense patch and dense body was detected.Conclusions:There are abnormal smooth muscle cells in the levator palpebrae superiors muscle of SCP patients, and the dysgenesis of the levator palpebrae superiors muscle may be related to this abnormal muscle cell.

Objective To provide the clinical evidences for intervening the depression and anxiety in patients with chronic subdural hematoma, we investigated the incidence and the influencing factors of anxiety and depression in these patients.Methods Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to investigate 100 patients with chronic subdural hematoma in Department of Neurosurgery, Beijing Tian Tan Hospital of Capital Medical University from October 2015 to May 2016 at admission and discharged. Results The score of SAS was (45.16±8.423) and the detection rate of anxiety was 25% on admission; the score of SDS was (38.86±7.906) and the detection rate of anxiety was 29%; the scores of SAS and SDS both were higher than the national norm (t=17.227, 4.891;P<0.05). The detection rate of anxiety was 10% and the detection rate of depression was 12% at discharged; the scores of SAS (38.86±7.906) and SDS (44.15±6.772) both were also higher than the national norm (t=10.756,3.047;P<0.05).Conclusions Patients with chronic subdural hematoma have high detection rates of anxiety and depression, so we should pay sufficient attention. The doctors and nurses should regard the psychological problems when implement diagnosis and treatment of the physical diseases in patients with chronic subdural hematoma, and promptly provide clinical intervention to against anxiety, depression and other psychological problems for promoting the physical and mental health of patients.

Objective? To explore the effects of closed sputum suction, open-closed sputum suction and open sputum suction on intracranial pressure levels in patients with severe craniocerebral injury and mechanical ventilation when the head of bed elevated by 30°. Methods? Totally 36 patients who were admitted in Beijing Tiantan Hospital, Capital Medical University from October 2016 to December 2017 and conformed to the inclusion and exclusion criteria were selected consecutively by convenient sampling. The patients received closed suction (CS), open-closed suction (OCS) and closed suction (OS) as needed. The intracranial pressure (ICP) values shown on the intracranial pressure monitor were recorded at 2 min before, during and after suction as well as 5 min and 15 min after suction. Arterial blood was collected for blood gas analysis at 15 min before and after suction. The patients' partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) were also recorded. Results? The patients intracranial pressure increased when the three different suction methods were used. ICP values for OS, OCS and CS were (20.02±4.93), (16.00±4.82) and (16.08±4.42) mmHg, respectively (F=8.523,P＜0.01). There was statistical difference in ICP values at 2 min after suction between the patients received CS, OCS and OS (F=4.082,P＜ 0.05), but there was no statistical difference in ICP values at other time points between these patients (P＞ 0.05). There was no statistical difference in PaO2 and PaO2 values before and after suction using different methods (P＞0.05). Conclusions? When the head of bed is elevated by 30°, OCS and CS show small effects on ICP values in patients with severe craniocerebral injury and mechanical ventilation and do not affect the effects of sputum suction.

Objective? To explore the pressed abdominal belt on promoting restore of brain organization structure among chronic subdural hematoma (CSDH) patients with trepanation and drainage. Methods? From January to November 2017, we selected 72 CSDH patients of neurosurgery in Beijing Tiantan Hospital, Capital Medical University. All of the patients were divided into experimental group and control group with the random number table, 36 cases in each group. Control group carried out routine treatment and nursing care. On the basis of that in control group, experimental group applied pressed abdominal belt until discharge. We compared the restore distance of brain organization structure of patients between two groups three days after surgery. Results? Three days after surgery, the restore distance of brain organization structure by imaging of CT was (17.19±7.18)mm in patients of experimental group and (12.83±8.42)mm in patients of control group with a statistical difference (t=2.26, P＜0.05). Conclusions? Pressed abdominal belt as a simple and effective adjunctive therapy can promote restore of brain organization structure among CSDH patients with trepanation and drainage.

Objective To discuss the effects of different postoperative position care on the recurrence of chronic subdural hematoma (CSH).Methods By convenience sampling method,102 patients with CSH were recruited in this study. These patients were admitted to the department of neurosurgery of Beijing Tiantan Hospital from November 2013 to October 2015,and they were divided into two groups by using random digits table method. In one group,52 patients were in the horizontal position without pillow,while in the other group, 50 patients lay in beds with their heads elevated. All patients received burr hole drainage,and were asked to keep the position that required for three days. Afterwards,specific adjustments were made according to the situations of drainage tubes. CT scans of brains were taken 12 hours,one week and three months respectively after operation. The degree of comfort,pulmonary complications,and recurrence rate were investigated during the period of hospitalization and the three-month′s follow-up.Results The recurrence rates were 7.7% and 20.0% respectively (χ2=2.304,P>0.05) for patients in horizontal position without pillow and patients lay in bed with elevation;the score of comfort were (51.6±3.7) and (62.7±3.3) respectively (t=1.919,P>0.05);and the incidences of pulmonary complications in two groups were 7.7% and 4.0%,the rates of venous thrombosis were 1.9% and 2.0% (χ2=0.138,0.471;P>0.05).Conclusions Compared with patients lying in beds with elevation,horizontal position without pillow can help to decrease the risk of recurrence for patients with CSH, but it may lead to more discomfort. Hence,specific postures should be considered for patients with horizontal position.