Objective To evaluate the values of visual inspection with acetic acid( VIA) and human papillomavirus( HPV) and thinprep cytology test( TCT) in the screening of cervical cancer.Methods VIA,HPV test and TCT in 946 women was conducted.Cervical biopsy or endocenical curettage( ECC) was performed in VIA positive women or HPV positive women or TCT positive women. The pathologic outcome was as the gold standard,and the out come more and equal to cervical intraepithelial neoplasia( CIN) Ⅱ were identified as positive.Results There was no significant difference among three groups in sensitivity rate( 73.l％,96.2,88.5％ ) and negative predictive value ( 99. 1％ ,99.9％ ,99.7％ ) ( all P ＞ 0.05 ).The specificity rate (97.5％ ) and positive predictive value ( 50.O％ ) of TCT was better than those of HPV ( 93.5％,29.4％ ),and HPV was better than those of VIA( 87.0％,13.7％ ),and the difference had statistifical significance among three groups ( x2 =71.34,26.00,22.17,8.28,all P ＜ 0.05 ).Conclusion Although the rate of missed diagnosis and misdiagnosis rate was higher than that of HPV and TCT,but VIA seems to be appropriate methods in the screening of cervical cancer owing to its low price.

10.3969/j.issn.2095-4344.2013.24.003

[Objective] To assess the changes in bone marrow microenvironment in patients with psoriasis by determining the level of transforming growth factor β1 (TGF-β1),stem cell factor (SCF),keratinocyte growth factor (KGF) and tumor necrosis factor-α (TNF-α) secreted by bone marrow stromal cells(BMSCs).[Methods] This study recruited 20 healthy controls with normal bone marrow picture and 20 patients with psoriasis vulgaris,including 10 at progressive stage and 10 at resting stage.The psoriasis area and severity index (PASI) score varied from 0.6 to 22.8 and averaged 10.97 in these patients.Bone marrow mononuclear cells were isolated by density-gradient centrifugation from bone marrow of these subjects,and BMSCs were cultured with adherent method.After three passages,the BMSCs were subjected to a 72-hour culture followed by the identification of cell phenotypes via flow cytometry and determination of TGF-β1,SCF,KGF and TNF-α levels in the culture supernatant via enzyme linked immunosorbent assay (ELISA).The parameters were compared by two independent samples t test between the two groups,and the correlation of eytokines with PASI was assessed by Pearson correlation analysis.[Results] Inverted microscopy revealed no obvious difference in the morphology of BMSCs between the patients and controls.CD29 was expressed by more than 90％ of the BMSCs,but no expression of CD45,CD34 or HLA-DR was observed in them.The BMSCs from patients showed a significantly lower level of supematant TNF-α ((22.93 ± 10.1 1 ) μg/L vs.(35.73 ± 15.15) μg/L,t =3.14,P ＜ 0.05),a higher level of supernatant SCF ((76.80 + 16.19) μg/L vs.(59.86 + 22.41) μg/L,t =2.74,P＜ 0.05),and asimilar level of supernatant KGF and TGF-β1 (both P＞ 0.05) compared with those from the controls.The PASI score was uncorrelated with the levels of SCF,TNF-α,KGF or TGF-β1 secreted by BMSCs in patients with psoriasis (all P＞ 0.05).[Conclusion]s The levels of SCF and TNF-α secreted by BMSCs are aberrant in patients with psoriasis,hinting an abnormal bone marrow microenvironment in these patients.

Objective To determine the prevalence and risk factors of Epstein-Barr virus (EBV) infection after pediatric liver transplantation for patients with biliary atresia. Methods Clinical data of 65 pediatric patients with biliary atresia, who underwent liver transplantation, were retrospectively analyzed. Patients were divided into EBV infection group
(n=30) and non-EBV infection group (n=35). The univariate analysis was used to analyse the preoperative, intraoperative and postoperative data of patients included. The variables with a P <0.1 were included in the multivariate Logistic regression analysis of EBV infections after pediatric liver transplantation for patients with biliary atresia. Results A total of 30 cases (46.15%) of pediatric recipients showed EBV infection in 65 cases, of which 23 cases (76.67%) occurred within 3 months after operation. The univariate analysis showed that there were significant differences in the ratio of patients younger than 1 year preoperation, EBV serology D+/R-, acute rejection, the usage of mycophenolate mofetil and supratheraputic tacrolimus level between two groups (P<0.05) . The type of graft (P=0.060), input quantity of red blood cell intraoperation (P=0.063) and factors mentioned above were included in the multivariate Logistic regression analysis. It revealed that donor EBV serology positive but recipient negative, acute rejection and supratheraputic tacrolimus level were risk factors of EBV infection for pediatric liver transplantation recipients with biliary atresia. Conclusion Donor EBV serology positive but recipient negative, acute rejection, supratheraputic tacrolimus level are closely related to EBV infection in pediatric recipients with biliary atresia after liver transplantation. Appropriate antiviral drugs should be adopted to prevent EBV infection in high risk patients.

Objective To summarize the clinical characteristics and treatment of rotavirus infection after liver transplantation in children.Methods Thirty nine children undergoing liver transplantation in Beijing Friendship Hospital affiliated to Capital Medical University from October to December 201 4 were retrospectively analyzed.And 6 cases were infected with rotavirus after liver transplantation.Characteristics of clinical symptoms,complications,treatments and prognosis in these six children were retrospectively analyzed.Results Six cases were diagnosed with rotavirus infection at 8-1 97 d after liver transplantation with a median time of 22 d,3 cases of whom mainly manifested as high fever,diarrhea and vomiting and the remaining 3 presenting with diarrhea.The longer interval time between rotavirus infection and liver transplantation was,the slighter degree of rotavirus infection-related symptoms was.Among 6 cases,5 cases were complicated with EB virus,cytomegalovirus or respiratory syncytial virus,and 2 cases were complicated with abnormal liver or heart function.The main treatment was decreasing the dose of FK506.Gamma globulin was administered in partial affected children to enhance immunity.Effective therapy was delivered to regulate intestinal tract bacterial colony and relieve diarrhea.All children recovered after oral use of antibiotics and supporting therapy using fluid infusion.Two cases complicated with severe cardiac and liver function abnormality were healed after expectant treatment.Conclusions Rotavirus infection-related symptoms are relatively severe after liver transplantation in children,occasionally complicated with cardiac and liver function injury,which can gradually return to normal after efficacious therapy.

Objective:To discuss the efficacy and safety of stereotactic electroencephalography (SEEG) in epileptogenic foci excision in pediatric patients with drug-resistant epilepsy.Methods:A total of 126 pediatric patients (<18 years old) with drug-refractory epilepsy who received SEEG-guided epileptogenic foci excision in Epilepsy Center, Aviation General Hospital from January 2015 to March 2022 were selected. The clinical data and efficacy were retrospectively analyzed, and prognoses of these pediatric patients were evaluated by Engel grading 1 year after resection.Results:(1) A total of 1289 electrodes were implanted, with a mean of (10.09±2.92) electrodes per pediatric patient; 55 pediatric patients had unilateral implant and 71 had bilateral implant. Mean EEG monitoring time was (8.69±5.71) d, ranged 3-28 d. Epileptogenic focus could be located in 114 pediatric patients (90.5%) after initial implantation under SEEG monitoring, and secondary implantation for accurate positioning was given in 12 pediatric patients (9.5%). (2) Lobectomy was performed in 27 pediatric patients (21.4%), multi-lobectomy or tailored cortical resection in 36 (28.6%), tailored cortical resection on single lobe in 60 (47.6%), and tailored cortical resections on single lobe or hippocampal amygdala resection combined with corpus callosotomy in 3 (2.4%). Minimally invasive exploring hemostasis under SEEG was performed in 13 pediatric patients (17 electrodes) and postoperative CT was normal. A little asymptomatic epidural, subdural or cerebral parenchymal hematoma spontaneously absorbed was noted in 4 pediatric patients after implantation under SEEG monitoring. No perioperative infection, CSF leakage, death or severe disability was noted. (3) Mean follow-up was performed for (26.1±7.26) months; 66 (52.3%) pediatric patients reached Engel grading I, 33 (26.2%) reached Engel grading II, 21 reached Engel grading III (16.7%), and 6 (4.8%) reached Engel grading IV. Thirteen pediatric patients with failed resection received SEEG-guided epileptogenic foci excision for the second time: 8 (76.9%) had Engel grading I and 2 had Engel grading II 1 year after follow-up, accounting for 76.9% totally.Conclusion:SEEG-guided epileptogenic foci excision is safe and effective in drug-refractory epilepsy; for pediatric patients with poor initial results, SEEG can be used to relocate the epileptogenic focus, and a second resection of epileptogenic focus can also obtain good results.

Objective To analyze the donor specific antibody (DSA) in liver transplantation,and discuss the therapeutic schemes.Methods We retrospectively analyzed prospectively collected samples from 139 cases of liver transplantation from September 1,2013 to July 1,2015.Luminex assays were applied to determine human leukocyte antigen,panel reactive antibody (PRA).For PRA positive cases,DSA,C1q and C4d were detected,and liver biopsy was done.Results Of 139 cases enrolled,there were 12 cases positive for DSAs,including 2 cases of PreDSA:1 case of Ⅰ DSA (HLA-A mismatch),and 1 case of Ⅱ DSA (HLA-DQ mismatch).Ten cases of de novo DSA (including 1 case of PreDSA) all were HLA-DQ mismatch.The liver biopsy on 5 cases showed hepatic fibrosis,early rejection and intrahepatic cholestasis,and only 2 cases showed positive C4d.Of 6 cases of DSA,5 cases showed positive C1q.In the patients positive for DSA,tacrolimus dose was adjusted postoperatively,adding mycophenolatemofetil or increasing its dose,or methylprednisolone and immunoglobulin given.Conclusion DSAs are important indicators of sensitized recipients in liver transplantation,associated with trends toward worse outcomes in patients or allografts.The monitoring of DSA is requisite in order to adjust the immunosuppressant.

Aquilaria sinensis, a kind of typically wounding-induced medicinal plant with a great economical value, is widely used in the production of traditional Chinese medicine, perfume and incense. Coronatine-insensitive protein 1 (COI1) acts as a receptor in jasmonate (JA) signaling pathway, and regulates the expression of JA-responsive genes in plant defense. However, little is known about the COI1 gene in A. sinensis. Here, based on the transcriptome data, a full-length cDNA sequence of COI1 (termed as AsCOI1) was firstly cloned by RT-PCR and rapid-amplification of cDNA ends (RACE) strategies. AsCOI1 is 2330 bp in length (GenBank accession No. KM189194), and contains a complete open frame (ORF) of 1839 bp. The deduced protein was composed of 612 amino acids, with a predicted molecular weight of 68.93 kDa and an isoelectric point of 6.56, and was predicted to possess F-box and LRRs domains. Combining bioinformatics prediction with subcellular localization experiment analysis, AsCOI1 was appeared to locate in nucleus. AsCOI1 gene was highly expressed in roots and stems, the major organs of agarwood formation. Methyl jasmonate (MeJA), mechanical wounding and heat stress could significantly induce the expression level of AsCOI1 gene. AsCOI1 is an early wound-responsive gene, and it likely plays some role in agarwood formation.