Objective To investigate the clinical significance of combined detection of human papillomavirus (HPV) L1 capsid protein,thinprep cytoligic test (TCT) and HPV genotyping on the early diagnosis of cervical cancer.Methods A total of 1 260 patients with sexual life history and cervical lesions were detected of HPV genotyping and TCT,then one or both in the two indicators was tested by biopsy.Meanwhile the expression of HPV L1 capsid protein was detected in patients with abnormal TCT.Contrasted TCT,HPV genotyping,HPV L1 capsid protein and histopathological diagnosis.Results The positive rate of cervical intraepithelial neoplasia (CIN) and more gradually of no definitive diagnosis significance of atypical squamous cells (ASCUS),low-grade squamous epithelial cell lesions (LSIL),the height of squamousintraepithelial lesion (HSIL),squamous cell carcinoma (SCC) was respectively 19.0％ (11/58),63.4％ (26/41),84.6％ (22/26) and 7/7,which increased with TCT-level rise,and there was significant difference (P ＜ 0.01).Low risk HPV-positive were mainly seen in low-grade lesions,with the TCT-level rise,high risk HPV-positive rate was significantly higher,which was respectively 36.2％ (21/58),56.1％ (23/41),73.1％(19/26) and 7/7,and there was significant difference (P＜0.05).The rate ofinflammation,CIN Ⅰ in HPV L1 capsid protein-positive was higher than HPV L1 capsid protein-negative [59.2％ (42/71) vs.39.3％ (24/61),29.6％(21/71) vs.14.8％(9/61)],pathological diagnosis of SCC were negative in HPV L1 capsid protein expression.With the increased level of pathology,the positive rate of HPV L1 capsid protein decreased.Conclusions That TCT liquid-based cytology and HPV genotyping can significantly reduce high-risk groups and significantly improve the detection rate of cervical cancer,and to detect HPV L1 capsid protein of HPV infection may provide the basis for the status and prognosis.Combination of the three indicators can provide the basis for early diagnosis of cervical cancer.

Objective To determine the degree of C 4 changes at precede or coincide with changes in systemic lupus erythematosus (SLE) activity by 5 global activity indices(PGA, M-SLEDAI, M-LAI, SLAM, and M-BILAG), and to evaluate the correlation between changes in C 4 levels and SLE activity in individual organ systems.Methods 53 lupus patients were observed monthly for 1 year in a longitudinal study. Lupus disease activity rate and complement levels were measured at each visit. Disease activity rates were calculated for subgroups defined by previous or concurrent changes in C 4 levels. Logistic regression models were used to determine the significance of the correlation between recent changes in complement levels and disease activity, and between changes in C 4 levels and SLE activity increased in specific organ systems.Results Lupus disease activity occurred at 12%,25%,13% and 12% respectively on PGA,M-SLEDAI,M-LAI,SLAM and M-BILAG. Disease activity by the M-LAI were more frequent when there was a concurrent decrease in C 4. Higher disease activity rates by the SLAM were correlated with previous increases in C 4. Decreases in C 4 were correlated with a concurrent increase in renal disease activity,or related to a concurrent decrease in the hematocrit levels and platelet count.Conclusions Reducing serum in C 4 levels were not consistently correlated with SLE disease activity, decrease in C 4 was correlated with a concurrent increases in renal and hematologic SLE activity.

Objective To demonstrate that SLE T cells primary function disordor was related to abnormal [Ca 2+ ]i responses,and to investigate the reason of abnormal [Ca 2+ ]i responses.Methods After cross-linking of anti-CD 3 mAb to sheep anti-mouse IgG and stimulating T cells,the changes of free calciumion [Ca 2+ ]i within T cells under interference of Thapsigarain and EGTA was observed respectively successively for 10 minutes by an adhesion cytometry.The relation between [Ca 2+ ]i responses in SLE T cells and InsP 3 levels was evaluated .Results The basic [Ca 2+ ]i response in T cells from SLE patients was similar to that from normal control(P=0 105),peak and plateau [Ca 2+ ]i responses were significantly higher in the group of SLE patients(P

Objective To understand teicoplanin concentration in cerebrospinal fluid (CSF)during intravenous in-fusion in patients following neurosurgery operation,and evaluate whether drug concentration can be increased if blood-brain barrier was damaged, and effect of continuous pump of drug on drug concentration in CSF. Methods The post-neurosurgical surgery patients with surgical site/ventricular drainage were enrolled in the study, patients were divided into routine administration group(a dose of teicoplanin of 400 mg/12 h was administered for 30 min)and continuous administration group (a dose of 400 mg teicoplanin was administered for 30 min followed by a continuous infusion of 200 mg/6 h).CSF specimens were collected at respective time points of administration, teicoplanin concentration in specimens was measured.Results For routine administration group,drug concentration in CSF was (0.004 ± 0.0123 )mg/L immediately after teicoplanin was bumped,the peak concentration was (0.712 ± 1.028)mg/L after 1-hour bumping,then concentration decreased gradually,which were (0.254 ±0.222),(0.173 ± 0.152),and (0.355±0.207)mg/L at 12,18,and 24 hours of bumping respectively.For continuous administration group, drug concentration in CSF was(0.017±0.020))mg/L immediately after teicoplanin was bumped,the peak concentration reached (0.587±0.255)mg/L after 4-hour bumping,then concentration were (0.429±0.416),(0.325±0.254),(0.476 ±0.686),and (0.318 ±0.464)mg/L at 6,12,18,and 24 hours of bumping respectively,teicoplanin concentration was relatively stable 6 hours later,which were (0.318±0.464)mg/L-(0.476±0.686)mg/L.The area under the curve during 24 hours (AUC0-24 )in routine administration group and continuous administration group were 5.590 mg/L·h and 9.082 mg/L·h respectively.For two groups of patients,teicoplanin concentration only at the area near peak value a-chieved 50% minimum inhibitory concentration(MIC50 )for coagulase negative staphylococcus (CNS),but the time for a-chieving concentration higher than CNS MIC50 was far less than 50% of total administration time;teicoplanin concentration in CSF of both groups of patients didn’t achieve MIC50 for Staphylococcus aureus .Conclusion After continuous infusion of teicoplanin,drug concentration in CSF can be increased compared with routine administration group,but still can’t achieve the effective MIC;the increase of blood drug concentration is benefit to drug concentration in CSF,it is necessary to in-crease the dose appropriately to achieve clinical effectiveness.

BACKGROUND: Appropriate anastomosis materials can improve success rate of trachea and bronchus reconstruction.Common domestic suture materials include silk suture, dacron and synthesized absorbable suture. However, the suture with best effects in preventing and lightening scar granulation hyperplasia and luminal stenosis remains Uncertain.OBJECTIVE: To compare the influence of three kinds of suture materials on histopathological changes of anastomotic stoma and transforming growth factor-β_1 (TGF-β_1) expression in rabbits following tracheotomy.DESIGN, TIME AND SETTING: A randomized, controlled animal experiment and histopathological observation were performed at the Animal Experimental Department, Nanhua University from September 2005 to October 2006.MATERIALS: Artificial absorbable suture was purchased from Brazil Johnson & Johnson Professional Products; silk suture and dacron were purchased from Hangzhou Fuyang Medical Suture Factory and Hangzhou Huawei Medical Products Co., Ltd.METHODS: A total of 36 New Zealand healthy adult rabbits, regardless of gender, weighing 1.6-2.0 kg, were randomly divided into silk, dacron and artificial absorbable suture groups with 12 animals in each group. The end-to-end anastomosis following tracheotomy was performed using silk, dacron and artificial absorbable suture, respectively.MAIN OUTCOME MEASURES: The pathological changes and TGF-β_1 level around the sutures 1, 2, 4 weeks post operation were observed.RESULTS: A total of 36 rats were included in final analysis. There were no difference in anastomotic healing between three groups 1 and 2 weeks postoperatively, with a great amount of inflammatory cell infiltration, mainly neutrophil, around the sutures.Moreover, bleeding in the focus and foreign body grannuloma were found. At 4 weeks postoperatively, foreign body grannuloma formed accompanied with obvious firboplasia in silk and dacron groups, and the sutures in the artificial absorbable suture group were absorbed. Compared with 1 and 2 weeks postoperatively, the expression of TGF-β_1 was slightly decreased in silk and dacron groups at 4 weeks (P > 0.05), but the absorbable suture group significantly decreased (P < 0.05).CONCLUSION: Of three kinds of suture materials, artificial absorbable suture exhibited good histocompatibility, effectively reducing inflammatory reaction and benefiting the prevention and lightening of formation of pathological scar after tracheal surgery.

Objective To investigate the isolation and drug resistance change trend of pathogens isolated from ce-rebrospinal fluid (CSF)of neurosurgical patients in Beijing Tian Tan Hospital.Methods Pathogens and antimicro-bial susceptibility of pathogens from CSF specimens of neurosurgical patients from August 1997 to August 2013 were analyzed.Results A total of 2 732 isolates of pathogens were detected,gram-positive and gram-negative bacte-ria accounted for 71 .23% (n = 1 946 )and 28.77% (n =786 )respectively.The top three isolated bacteria were Staphylococcus spp .(n =1 751 ,64.09%),Acinetobacter spp .(n =254,9.30%),and Enterococcus spp .(n =172,6.30%).Gram-positive bacteria were the major isolated pathogens,detection rate of methicillin-resistant Staphylococcus aureus (MRSA ) and methicillin-resistant coagulase-negative Staphylococcus (MRCNS ) was 74.34% and 80.73% respectively;gram-negative bacteria increased gradually in recent years.All Staphylococcus spp .isolates were highly sensitive to vancomycin and linezolid(>90%).The overall antimicrobial susceptibility rate of gram-negative bacteria decreased,susceptibility rates of Acinetobacter spp .to imipenem and meropenem was 51 % and 44% respectively.Conclusion The major pathogens causing intracranial infection in neurosurgical patients are gram-positive bacteria,the detection rates of MRSA and MRCNS are high;gram-negative bacteria,especially extensively drug-resistant Acinetobacter spp .shows an increasing tendency in recent years.

Objective To explore rapamycin's inhibitory effect on proliferation of H_(22) hepatic cancer in mice. Methods In vitro study: H_(22) hepatic cancer cell lines were cultured with rapamycin, CsA, FK506, and proliferation was determined through MTT. The influences of different agents on the H_(22) hepatic cancer cell cycle were observed by flow cytometry. The vascular endothelial growth factor (VEGF) concentration of the supernatant fluid of the cultured H_(22) hepatic cancer cell was detected by ELISA. In vivo study: C57BL/6 to Balb/c mice allogenic skin transplant was established, and the H_(22) hepatic cancer cell was implanted under skin. Rapamycin, CsA, FK506 and 5-FU were fed to the mice, respectively. The effect of different immunosuppressors on the survival of skin graft was observed while the proliferation of the transplant tumor was investigated. VEGF concentration of treated mice serum was examined by ELISA. The microvessel density of the transplanted tumor was observed through immunohistochemistry staining of CD34. Results The proliferation of the H_(22) hepatic cancer cells was inhibited by rapamycin at the concentration different dose of rapamycin, the VEGF concentration of the supernatant fluid decreased significantly (P<0.05). The number of S phase cells decreased significantly compared to that of other agents (P<0.05). When rapamycin, the lengthened survival time of the skin grafts was similar to that in CsA and FK506 groups. But the tumor volume was smaller than that in CsA and FK506 groups (P<0.05). Compared to that in the control group, the VEGF concentration of mice serum decreased in rapamycin group (P<0.05), and the microvessel density of the transplant tumor was reduced greatly (P<0.05). Conclusion Rapamycin, as an immunosuppressor, significantly resists immunologic rejection and inhibits the proliferation of H_(22) hepatic cancer, thus having its advantage in treating malignant hepatic cancer with liver transplantation.

The authors described two cases with primitive trigeminal artery. Case 1 was a 32-year-old woman who suffered dizziness and a serious pulsatile intracranial bruit on the left ear, and sometimes associated with pulsatile intracranial bearing-pain on the left temporal side six months before she was admitted to the hospital. She also suffered from obvious diplopia on left lateral gaze for the last 5 months. She had suffered no recent trauma. Magnetic resonance imaging(MRI) demonstrated a suspected intracranial aneurysm located in left cavernous sinus. Digital subtraction angiography (DSA) was performed and a primitive trigeminal artery-cavernous sinus fistula in left side was found. Intraluminal occlusion of the fistula was successfully performed immediately after angiography using 6 Guglielmi detachable coils (GDC), and the patient was cured finally. Case 2 was a 28-year-old woman who suffered a serious intermittent cephalodynia associated with soreness on the left body two years before she was admitted to the hospital. She had suffered no recent trauma. Magnetic resonance angiography(MRA) demonstrated a suspected intracavernous aneurysm of the right internal carotid artery, Digital subtraction angiography (DSA) was performed. Right internal carotid angiography showed a primitive trigeminal artery (PTA) run between the cavernous segment of the internal carotid artery and the distal portion of the basilar artery. On initiation of PTA of R-ICA a small wide-necked saccular aneurysm was incidentally visualized. The aneurysm was successfully embolized after angiography using 2 Stent (Neuroform, 4.5mmm × 20mmm)-assisted detachable coils (Matrix), the ICA and PTA were preserved, and the patient was cured finally.

Objective To analyze the clinicopathologic features of primary cutaneous CD30 positive lymphoproliferative disorders. Methods A clinical, pathological and immunohistochemical analysis was carried out in 4 cases of lymphomatoid papulosis and 5 cases of primary cutaneous anaplastic large cell lymphoma. Results Lymphomatoid papulosis was divided into 3 subtypes, A, B and C. The lymphomatoid papulosis of subtype A was pathologically characterized by pleomorphic anaplastic large cells or Steinberg-reed cells scattered or patchly distributed among many inflammatory cells; subtype B showed pathological changes characteristic of granuloma fungoides, and manifested as a broad infiltration zone of lymphocytes in dermis with scattered small- to middle-sized atypical gyrus-like lymphocytes; subtype C was characterized by a diffuse distribution of anaplastic large cells and could clinically subside spontaneously. Primary cutaneous anaplastic large cell lymphoma clinically manifested as subcutaneous nodules or papules, and was pathologically characterized by large, pleomorphic, round or ellipse cells with plentiful, eosinophilic or bicolor cytoplasm, large nuclei and obvious nucleoli. The neoplastic cells characteristically expressed CD30 antigen in both lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma, and all the cases showed a favorable prognosis.Conclusions Primary cutaneous CD30 positive lymphoproliferative disorders are a spectrum of cutaneous T cell lymphoma with favorable prognosis, and a synthetic analysis of clinical, histopathological and immunohistochemical findings is beneficial to the diagnosis of these entities.

Objective To discuss the TARP (transoral pharyngeal atlanto axioal reduction plate,TARP) stress distribution under the condition of atlantoaxial dislocation treatment with the TARP system and explore the possible suggestion for the further innovation of the TARP system.Methods A fixed Finite Element model was constructed for transoral atlantoaxial reduction plate system based on the CT digital data of the China Digital Human NO.1.The internal structure changes and the stress distribution of TARP system under different loads were imitated and analyzed.Results The results showed that,after the fixation of the TARP system,different parts of the atlantoaxial had different stress under anteflexion,extension,lateral bending and rotation,the internal fixation parts located mainly at the mid-part of the TARP(0.159 × 108 ～0.732 × 108 Pa) and the root of the screw(0.214 × 109 ～0.958 × 109 Pa).Beside that,when using anteflexion,the stress mainly focused on the articular surface of the atlantoaxial(0.512 × 107 Pa).As for extension,the stress mainly focused on the part between the lateral mass and anterior arch (0.582 × 107 Pa).While lateral bending or rotation,the stress mainly focused on the axial screw nailing path (0.287 × 109 Pa and 0.241 × 109 Pa).Conclusions Although different parts of the TARP plate have different stress,its maximum stress lied in the root of the screw.The stress of plate mainly focused on the mid - part,no matter in what state of motion,therefore,the root of the screw and the mid-part of the plate bore the biggest stress,their strength decided the fatigue property of the TARP system.