Objective To evaluate the high-risk human papillomavirus(HR-HPV)detection and thinprep cell test(TCT)in the diagnosis of cervical lesion by comparison with pathological findings.Methods The data collected from Dec.2004 to Dec.2006 from 690 patients who had undergone HR-HPV detection,TCT and pathology examination with electronic colposcopy in the Department of Obstetrics and Gynecology,General Hospital of PLA were analyzed retraspactively.Results Among the 690 patients,the coincidence between the findings of TCT and pathology was 22.34%(42/188)for low-grade squamous intraepithelial lesion(LSIL),58.33%(56/96)for high-grade squamous intraepithelial lesion(HSIL)and 100%(16/16)for cervical cancer.The number of patients with the cytological diagnosis of abnormal squamous cells(ASC),LSIL,HSIL and cervical cancer was 315,188,96 and 16,respectively.Among them,the positive rate of HR-HPV of ASC,LSIL,HSIL and cervical cancer was 53.96%(170/315),77.12%(134/188),80.21%(77/96)and 100%(16/16),respectively.Pathologic examination through electronic colposcopy revealed the number of patients with the diagnosis of inflammation,CINⅠ/HPV,CINⅡ/CINⅢ and invasive cancer was 425,81,157 and 27,respectively.Among them,the positive rate of HR-HPV in inflammation was 43.29%(184/425),CINⅠ/HPV 74.93%(60/81),CINⅡ/CINⅢ 91.72%(144/157)and invasive cancer 92.5%(25/27).Among the 690 cases,413 were HR-HPV positive,55.45%(229/413)of which showed CINⅠ/HPV or higher.277 cases were HR-HPV negative,and 87.01%(241/277)of which showed inflammation,12.99%(36/277)of which showed CINⅠ/HPV or higher,and 5.42%(15/277)of which showed CINⅡ/CINⅢ and invasive cervical cancer.Among 315 cases with ASC,170 cases were HR-HPV positive,41.76%(71/170)of which showed CINⅠ/HPV or higher,including 69.01%(49/71)CINⅡ/CINⅢ and invasive cervical cancer.145 cases were HR-HPV negative,only 4.83%(7/145)of which was CINⅡ/CINⅢ and invasive cervical cancer,and 90.34%(131/145)of which was inflammation.Conclusion HR-HPV detection and TCT are feasible for cervical lesion screening.Cytology combined HR-HPV test is favorable for shunting management in cervical lesions.

Objective To discuss the clinical significance of human papilloma virus (HPV) infection in cervical cancer and to explore the feasibility of detecting the infection with microarray from paraffin-embedded specimens of cervical cancer. Methods From May 2005 to February 2007, 48 patients with cervical carcinoma, including 37 cases with cervical squamous cell carcinoma and 11 cases with cervical adenocarcinoma, were analyzed retrospectively. After DNA extraction from the paraffin-embedded tissues, 23 HPV subtypes were detected by the use of microarray after amplification by polymerase chain reaction (PCR) and hybridization. Results 44 cases of cervical cancer were found to be high-risk HPV positive genotypes. The HPV infection rate was 91.7%. The HPV infection rate in cervical squamous cell carcinoma was 94.6% (35/37), and in cervical adenocarcinoma was 81.8% (9/11). Among them, 33 cases were found to have single infection, accounting for 75.0% of the infection rate. There were 11 cases of mixed infection, among them 9 cases were found to have double infection and 2 cases with multiple infection, accounting for 20.5% and 4.6%, respectively, of the infection rate. The infection rate of HPV16, the main genotype, was 90.9% (40/44). The infection rate of HPV18, the second ranking subtype, was 27.3% (12/44). Infection with HPV52, 33, 59, and 68 genotypes was lower in incidence. Among 35 cases of cervical squamous cell carcinoma, the infection rates of HPV16 and HPV18 were 91.4% (32/35) and 22.9% (8/35), respectively. Among 9 cases of cervical adenocarcinoma, the infection rate of HPV16 and HPV18 were 88.9% (8/9) and 44.4% (4/9), respectively. Conclusion Multiple HPV genotypes can be detected from paraffin-embedded tissues with microarray technique in high sensitivity and specificity, and it is useful to study the pathogenesis and prevention of cervical cancer.

Objective To observe the effect of the operation and application value of encircling constriction of superficial femoral vein with electrocoagulation in the varicose veins of lower extremity.Methods 271 cases were divided into the research group(n=166)with encircling constriction of superficial femoral vein with electro-coagulation and the control group(n=105)with traditional encircling constriction of superficial femoral vein with electrocoagulation.The degrees of the venous reflux,velocities of blood flow,CEAP classification and clinical scoring of the two groups were compared.Results The research group was better than the control group on decrease in de- grees of the venous reflux.increase in velocities of blood flow and decrease in clinical scores(P<0.01).Conclu- sions The encircling constriction of superficial femoral vein with electrocoagulation is the desirable method in the treatment of varicose veins of the lower extremity.

Objective To study the clinical efficacy of robotic sacral hysteropexy in treatment of uterine prolapse.Methods From January 2012 to December 2013,3 patients undergoing robotic sacral hysteropexy in treatment of uterine prolapse in General Hospital of People's Liberation Army were studied retrospectively.Operation time,blood loss and postoperative recovery exhaust time and pelvic organ prolapse quantification (POP-Q) staging were evaluated.Results Three patients were treated by robotic sacral hysteropexy successfully.The mean operation time was 221 minutes (210-240 minutes),mean blood loss was 45 ml.One case with Ⅱ degree perineal laceration patients simultaneously perineal repair,neither intranor post-operative complications occurred.The mean postoperative recovery exhaust time was 16 hours.At three months of follow-up,all 3 patients got satisfaction.Although one patient at the first six months of postoperation had leakage of urine when coughing,instruct exercise pelvic floor muscle function and acupuncture one month their symptoms disappear.Conclusion Robotic sacral hysteropexy pave the way for an effective option in the management of uterine prolapse.

Objective:To investigate the in vitro effect of arsenic trioxide (As2O3) alone and in combination with dexamethasone (DXM), etoposide (VP-16), methotrexate (MTX), bortezomib (BTZ), and suberoylanilide hydroxamic acid (SAHA) on the growth of human cutaneous T cell lymphoma (CTCL) cells Hut-78 and Hut-102. Methods:Hut-78 and Hut-102 cells were cultured with different concentrations of As2O3, DXM, VP-16, MTX, BTZ, and SAHA alone and As2O3 in combination with DXM, VP-16, MTX, BTZ, or SAHA for 48 h. The effects of the different samples on Hut-78 and Hut-102 cell proliferation were determined by MTT assay. Analyses using CalcuSyn software were performed to determine whether the combination of As2O3 with DXM, VP-16, MTX, BTZ, or SAHA in-duced synergistic cytoxicity. Results:As2O3, DXM, VP-16, MTX, BTZ, and SAHA alone significantly inhibited the growth of Hut-78 and Hut-102 cells in a dose-dependent manner, with a 50%inhibiting concentration of 5μmol/L, 500μg/mL, 2.5μg/mL, 1μg/mL, 10μmol/L, and 2.5μmol/L individually after 48 h of culture. As2O3 with DXM, VP-16, MTX, BTZ, or SAHA showed remarkable antitu-mor efficacy compared with that of individual applications. Conclusion:As2O3 alone or combined with DXM, VP-16, MTX, BTZ, or SAHA significantly inhibited Hut-78 and Hut-102 cell growth in vitro. This study demonstrated that As2O3 with DXM, VP-16, MTX, BTZ, or SAHA presents synergistic antitumor effects on CTCL cells and may be an optimal regimen in clinical trials of CTCL.

Objective To explore the reasonable radiologic nodal size criterion of retropharyngeal lymph node (RLN) metastasis in patients with nasopharyngeal cancer (NPC).Methods Imaging and clinical data of 817 NPC patients were analyzed retrospectively.The patients with RLN metastasis were classified into two groups according to the nodal size of 5 mm or 6 mm as standard in diagnosis.Overall survival (OS),distant metastasis-free survival (DMFS) and the local-relapse-free survival (LRFS) were assessed between the two groups taking 5 mm or 6 mm as standard in diagnosis of RLN.Results No significant difference was found for OS,DMFS,LRFS between nodal size ＜5 mm group and ≥5 mm group.Difference of OS (P＜0.001),DMFS (P=0.001) were significant statistical and difference of LRFS (P=0.380) had no significant statistical between nodal size ＜6 mm group and ≥6 mm group.OS,DMFS,LRFS were not an independent prognostic factor for NPC.Conclusion Using the minimal axial diameter of 6 mm as the nodal size criterion in diagosis of RLN metastasis in patients with NPC may be more reasonable.

Objective To apply robotic surgery of early ovarian malignancy tumors clinically and evaluate its feasibility in management for early ovarian cancer. Methods Using the da Vinci robotic surgical system, seven patients with early ovarian malignancy tumors (stage Ⅰ) underwent robotic surgery from April 2012 to September 2013. The average age was 45.7 years. Robotic surgeries approaches contained salpingo-oophorectomy,para-aortic lymphadenectomy, pelvic lymphadenectomy, omentectomy and appendectomy. Perioperative and follow-up clinical data were recorded. Results All robotic surgeries were successfully completed without the conversion to laparotomy. The mean operative time was 225 minutes (100-330 minutes). The average estimated blood loss was 171 ml (20-600 ml). No patients received blood transfusions. No intraoperative and postoperative complications were observed. The average number of pelvic lymph node dissected were 18.3 (11-34). The average number of para-aortic lymph node dissected were 3.7 (3-4). The mean follow-up time was 26.0 months after surgery (20-36 months). Currently, all patients had no tumor recurrence and survived. Conclusion Robotic surgery is feasible as a novel alternative approach in the treatment of early ovarian malignancy tumors.

Objective To explore the clinical significance of PET-CT in evaluating distant metastasis and M staging of nasopharyngeal carcinoma(NPC). Methods 257 NPC patients with no prior treatment were investigated with PET-CT and conventional imaging (chest X-ray, abdominal ultrasound, and bone scan). The findings of PET-CT in diagnosing distant metastasis and M staging were compared with those of conventional imaging according to the results of biopsy and follow-up. Results PET-CT disclosed 34 of 39 patients with distant malignancy compared with 22 patients disclosed by conventional imaging. The false positive rate of PET-CT was 12.8 %. On region-based analyses, PET-CT was more effective than bone scan and chest X-ray for detecting mediastinum metastasis (x2=4.063, P =0.041) and bone metastasis (x2=5.939, P=0.015), respectively. Compared with conventional imaging, PET-CT had an impact on the M staging of 19 patients (7.4 %), of which 15 patients were truly staged and 4 patients incorrectly staged. Conclusion PET-CT is superior to MRI in evaluating distant metastasis and M staging of NPC.

ObjectiveToevaluatethefeasibilityandresultsof transorallaparoscopic thyroidectomy. MethodThyroidectomy was attempted in 5 cases,including 4 females and 1 male with the average age of 42 years( range 35 -60 years).All patients was diagnosed as single nodule of the thyroid gland confirmed by B-mode ultrasound examination before the operation.The average diameter of nodule was 2.5 cm (range 2 - 3.4 cm). ResultTransoral laparoscopic thyroidectomy was perfoormed successfully in all 5 patients.The operation time was 120 - 210 min,averaging 170 min,blood loss during the operation was 15-60 ml,the postoperative hospitalization was 4 days. There was no conversion to open surgery,no recurrent laryngeal nerve injury,nor parathyroid glands dysfunction. ConclusionsTransoral laparoscopic thyroidectomy is feasible and safe,giving excellent cosmetic results.

To investigate physicians' knowledge about chronic obstructive pulmonary disease (COPD) in tertiary hospitals in northeast China.Physicians from 77 tertiary hospitals in northeast China were surveyed with a questionnaire,which included questions such as risk factors,symptoms,exacerbations,comorbidities and diagnostic criteria of COPD.Besides cigarette smoking,air pollution and pulmonary infections,only 22.5％ (40/178) physicians recognized that the biomass fuels may induce COPD.Totally 59.0％ (105/178) physicians recognized the importance of spirometry to the diagnosis of COPD.Besides dyspnea,cough,sputum production,wheezing and chest tightness,only 23.7％ (42/177)of physicians considered that limitation of activity was an important symptom of COPD.65.5％ (116/177)physicians believed that recurrent lung infections was one of the most important comorbidities of COPD.However,less than 30％ [20.9％ (37/177)-28.8％ (51/177)] physicians were aware of the other important comorbidities.The physicians of tertiary hospitals in northeast China need to be systematically educated on COPD to meet the new guideline.