OBJECTIVETo explore the distribution the tyes- of human papillomavirus (HPV) in cervical biopsy tissue or exfoliated cell specimen of Chinese women and to estimate the perspective of HPV prophylactic vaccine in China.

METHODSA total of 18 studies using polymerase chain reaction to detect HPV types were included in this Meta-analysis. There were 1335, 394, 381 and 2584 cases included in invasive cervical cancer (ICC), high-grade squamous intraepithelial lesions (HSIL), low-grade squamous intraepithelial lesions (LSIL) and normal group respectively. The overall HPV prevalence was estimated by adjusting the variables using unconditional multiple logistic regression model. HPV type-specific HPV prevalence rates of 18 types including HPV6, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 70, 73 and 82 were estimated, after stratified by cervical lesion of Chinese women.

RESULTSIn ICC, HSIL, LSIL and normal group, the overall HPV prevalence rates were 82.7%, 88.5%, 69.3% and 13.1% respectively, and the HPV16 type-specific prevalence were 61.9%, 46.7%, 21.0% and 3.1%. HIPV16 was the predominant type in all cervical lesion specimen followed by HPV18 and 58 in ICC group, then HPV58 and 52 in HSIL, LSIL and normal. The estimated HPV16/18-positive fractions were 69.6%, 59.1%, 32.3% and 4.4% respectively in ICC, HSIL and normal. Data from the Meta-analysis showed that the top five common HPV types in ICC women were HPV16, 18, 58, 52 and 31 which contributed for 82.9% of the ICC. Thus the HPV16, 18, 31, 33, 35, 45, 52 and 58 were accounted for 87.7% ICC in China mainland.

CONCLUSIONThe proportional impact of HPV16/18 vaccine on ICC was estimated as high as 69.6% in China. HPV58 seemed the priority HPV type and should be emphasized enough to be included in the development of new generation HPV vaccine. However, more uniform standardized multi center studies were necessary to get more exact figure about HPV distribution in China.

Cervical Intraepithelial Neoplasia ; epidemiology ; prevention & control ; virology ; Cervix Uteri ; virology ; China ; epidemiology ; Female ; Humans ; Logistic Models ; Papillomaviridae ; classification ; isolation & purification ; Papillomavirus Infections ; epidemiology ; Papillomavirus Vaccines ; administration & dosage ; Prevalence ; Uterine Cervical Neoplasms ; epidemiology ; virology

OBJECTIVETo evaluate visual inspection with Lugol's iodine (VILI) in cervical cancer screening program and to provide evidence for designing a cervical cancer screening algorithm in high risk areas of existing low-resource settings to reduce the incidence and mortality of cervical cancer.

METHODSWomen in Yangcheng county, Shanxi province were screened with VILI, colposcopy, liquid-based cytology test and human papilloma virus (HPV) DNA test. The efficacy of different screening tests was compared by Youden's index based on the pathology as the gold standard.

RESULTSIn the population being screened, the mean age was 40.80 +/- 10.75 years old. Based on pathological findings, 4.35% (32/735) of the subjects had >or= CIN (cervical intraepithelial neoplasia) II. The sensitivity and specificity for the VILI test (>or= positive) were 53.13 and 82.19, while 56.25 and 79.09 were for colposcopy (>or= low grade dysplasia) respectively. Comparing by the Youden's indexs, there was no statistically significant difference (P > 0.05) between VILI and colposcopy. However, statistical significant difference (P < 0.05) was found between VILI and liquid-based cytology test and HPV DNA test. In addition, there was no statistically significant difference (P > 0.05) found between the experienced doctors and the newly-trained doctors working in the field station.

CONCLUSIONWith low sensitivity when using microscope but low cost of equipments, VILI can be one of the primary screening tests in China's rural area with low-resource settings if the screening frequency is to be increased.

Adult ; Cervical Intraepithelial Neoplasia ; diagnosis ; epidemiology ; China ; epidemiology ; Early Detection of Cancer ; economics ; methods ; Female ; Health Resources ; Humans ; Incidence ; Iodides ; Program Evaluation ; Rural Health ; Sensitivity and Specificity ; Socioeconomic Factors ; Uterine Cervical Neoplasms ; diagnosis ; epidemiology

OBJECTIVETo evaluate the application value and feasibility of various cervical screening methods and to explore a rapid and efficient cervical cancer screening program for the women in the rural areas of China.

METHODSWe sequentially conducted human papillomavirus (HPV) DNA test by hybrid capture-2 (hc2) with cervical cells, liquid-based thinprep cytology test (TCT), visual inspection with acetic acid (VIA), visual inspection with iodine (VILI), colposcopy respectively for the 2499 married women between 30 and 49 years from Xiushui county of Jiangxi province. All the detection methods were performed independently under double-blind design. Women who were diagnosed positive for having any VIA,VILI and colposcopy inspection or for those women who were diagnosed negative for VIA, VILI and colposcopy but with positive result of HPV or TCT test underwent cervical biopsy directly and endocervical curettage (ECC)when necessary. We performed cervical biopsy endocervical curettage within two weeks to observe the sensitive (SE), specificity (SP), negative predict value (NPV) and positive predict value (PPV) of these detection methods when used alone or combined each other, including HPV test, TCT inspection, VIA, VILI, and colposcopy, the pathological diagnosises of cervical tissue were confirmed by IARC (International Agency for Research on Cancer) while the cytological findings were underegone through the updated program of TBS (The Bethesda System) in 2001.

RESULTSA total of 2499 women underwent the screening and found 443 women who were diagnosed as HPV positive, 337 women with abnormal cervical cytology and 27 women with ASC-H, 157 cases with ASCUS; 103 cases with HSIL, 49 cases with LSIL and 1 cervical cancer. According to the pathological findings. There were 181 women diagnosed as cervical intraepithelial neoplasia (CIN) or cervical cancer, including 81 cases with CIN1 37 cases with CIN2,60 case cervical cancer. The sensitivity rates of HPV, TCT, HPV+ TCT, VIA, VILI, VIA+VILI and colposcopy were 96.67%, 89.47%, 97.98%, 56.57%, 36.36%, 63.64% and 39.39%, and the specificity rates were 85.00%, 96.91%, 86.97%, 94.60%, 96.23%, 92.97% and 98.14% respectively.

CONCLUSIONHPV + TCT seemed to be more sensitive than other screening methods in the cervical cancer screening program.

Adult ; China ; epidemiology ; Early Detection of Cancer ; methods ; Female ; Humans ; Mass Screening ; methods ; Middle Aged ; Papillomavirus Infections ; diagnosis ; epidemiology ; Predictive Value of Tests ; Rural Population ; Sensitivity and Specificity ; Uterine Cervical Neoplasms ; diagnosis ; epidemiology ; virology

OBJECTIVETo investigate the occupational stressors and modifiers of pediatricians and nurses in order to find the measurements for control of the job stress.

METHODS427 pediatricians and nurses working in five hospitals of a city served as subjects. Of them, the staff in section of pharmacy and toll offices in each hospital mentioned above served as control group. The General Job Stress Questionnaire was used to investigate the job stress by self-assessment.

RESULTSThe scores of job demand, job risk, drug using, daily job stress, positive feelings, patient A behavior, physical environment and feeling balance in pediatricians and nurses were higher than those of control group, but the scores of job-person conflict, environmental control, technology utility, mental health, responsibility on things were lower than those of control group (P<0.05). The points of job future, job locus of control, self-esteem, job satisfaction, job load variance, depression in nurses were higher than those of pediatricians, and non-work activities, job risk and daily life stress were lower than those of doctors (P<0.05). The main affecting factors on job strain of pediatric staff included job monotony, higher job demand, more non-work job, lower job control, more job risk, job future ambiguous, poorer social support, lower job locus control and lower self-esteem.

CONCLUSIONThe stress degree of pediatric staff is higher than that of controls. The pediatricians have more job stress than that of nurses. The main stressors of pediatric staff are job monotony, higher job demand, more non-worker activity, lower job control, higher job risk and ambiguous job future. The main modifiers are good social support, external job locus of control and higher self-esteem.

Adult ; Burnout, Professional ; Female ; Humans ; Male ; Medical Staff, Hospital ; psychology ; Nursing Staff, Hospital ; psychology ; Pediatrics ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo clone the urea membrane channel gene (ureI) from Helicobacter pylori (Hp) for its expression in E. coli, and evaluate the expression conditions and immunological features of the fusion protein.

METHODSureI gene cloned by PCR from Hp was inserted into the plasmid pET32a (+) to construct the recombinant plasmid pET32a/ureI, followed by identification by BglII and HindIII digestion and sequencing. E. coli BL-21+(DE3) was transformed with pET32a/ureI to obtain the engineered bacterium BL21+/UreI, which was cultured at different temperatures and induced with 1.0 mmol/L IPTG for expression of the recombinant protein. The expressed proteins were identified by SDS-PAGE and analyzed by Pro-gel analyzer 4.0. Western blotting was performed to evaluate the immunogenicity of the expressed protein.

RESULTSThe cloned gene fragment was about 650 bp in length, and BglII and HindIII digestion of pET32a/ureI yielded a 650-bp band. Sequence analysis revealed that the cloned ureI gene contained 646 bp without reading frame alterations. Comparison against GenBank indicated a homology of 100% of the cloned gene with ureI gene of the corresponding Hp strains, and also one no less than 98.5% with ureI gene from other strains. The engineered E. coli BL21+/UreI could express recombinant UreI (rUreI) with His tag, and the target protein accounted for 20.2% of the total bacterial proteins after 1.0 mmol/L IPTG induction of the bacterium at 37 degrees C for 14 h. SDS-PAGE and Western blotting showed that the recombinant UreI protein was produced mainly in the inclusion bodies and fused with his-tag (rUreI/his), which could react with human anti-Hp and mAb to his tag but not with mAb to Hp UreB.

CONCLUSIONSWe have successfully cloned ureI gene and constructed the prokaryotic expression plasmid for efficient rUreI expression, and the fusion protein rUreI/his expressed in the inclusion bodies can react specifically with both Hp antibody and his-tag antibody.

Bacterial Proteins ; genetics ; metabolism ; Blotting, Western ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; genetics ; Helicobacter pylori ; genetics ; Humans ; Membrane Transport Proteins ; genetics ; metabolism ; Plasmids ; genetics ; Recombinant Fusion Proteins ; genetics ; isolation & purification ; metabolism

AIMTo study the effect of thyroid hormone on protein kinase C activity and isoprotein expressions in cardiac myocytes and fibroblasts of rats in vitro.

METHODSCardiac myocytes and fibroblasts were cultured according to the method of Simpson. Cells were pretreated with 1% newborn calf serum (NCS) or Angiotensin II (Ang II) for 24 hours, then Triiodothyronine (T3) was added to the culture medium and the culture was kept for another 48 hours. The protein kinase C activation were measured by PepTaga non-radioactive PKC assay, and the expressions of PKC alpha and PKC epsilon were detected by Western blot method.

RESULTSAt the condition of 1% NCS culture medium, T3 could inhibit PKC activity and PKC epsilon expression in cardiac myocytes significantly, but the expression of PKC alpha in cardiac myocytes was not influenced by T3. In cardiac fibroblasts, neither PKC activity nor PKC alpha and PKC epsilon expressions was influenced by T3. When cells were pretreated with Ang II for 24 hours, PKC activities in cardiac myocytes and fibroblasts were increased significantly, and PKC epsilon expressions in cardiac myocytes were also markedly increased. Following a T3 treatment, PKC activity and PKC epsilon expression in cardiac myocytes were markedly decreased, but PKC activity in cardiac fibroblasts was not changed.

CONCLUSIONWhether at the condition of 1% NCS medium or in a pretreatment with Ang II, thyroid hormone could inhibit the PKC activity and PKC epsilon expression in cardiac myocytes. The influence of thyroid hormone on the PKC signal pathway in cardiac myocyte may be involved in many pathophysiological progress of myocardium.

Animals ; Cells, Cultured ; Myoblasts, Cardiac ; drug effects ; metabolism ; Myocytes, Cardiac ; drug effects ; metabolism ; Protein Kinase C ; metabolism ; Rats ; Rats, Wistar ; Signal Transduction ; drug effects ; Thyroid Hormones ; pharmacology

OBJECTIVETo evaluate the technique of C1-C2 transarticular screw fixation for atlantoaxial instability or dislocation.

METHODSAmong 14 patients with atlantoaxial instability, 10 were male and 4 patients were female, with an average age of 38.6 years ranging from 17 to 62 years. All patients were treated by internal fixation with transarticular screws.

RESULTSThere were 28 screws applied in 14 patients. All patients were followed up. The average follow-up period was 16 months (range, 9 to 35 months). The postoperative JOA score was ranging from 13.8 to 15.8 with the average score of (14.50 +/- 0.66) and the improved rate of (76.12 +/- 4.94)%. No spinal injury and vertical artery injury was found and osseous fusion was completed in all patients.

CONCLUSIONThe technique of C1-C2 transarticular screw fixation is one of the best treatments for atlantoaxial instability. Without the help of structural bone graft and aided internal fixation, morselized cancellous bone graft can acquire effective osseous fusion.

Adolescent ; Adult ; Atlanto-Axial Joint ; pathology ; surgery ; Bone Screws ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Joint Instability ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Male ; Middle Aged ; Radiography ; Tomography Scanners, X-Ray Computed ; Treatment Outcome ; Young Adult

OBJECTIVETo analyze the clinical characteristics of 267 cases with occupational chronic carbon disulfide (CS(2)) poisoning and to provide the basis for revising the items of periodical medical examination of workers occupationally exposed to CS(2).

METHODSThe subjects of present study were 267 patients with mild CS(2) poisoning diagnosed according to "Diagnostic Criteria of Occupational Chronic Carbon Disulfide Poisoning (GBZ4-2002)" from April in 2006 to May in 2010. All patients were from the same chemical fiber factory. When a subject was diagnosed as patient with CS(2) poisoning, who should interview with questionnaire which included the illness and occupational history, symptoms, individual habits. The physical examination, nervous test, cardiovascular test, biochemical test and electromyogram were performed.

RESULTSThe rate of decreased motor conduction velocity was 87.3% (233/267 roots). The highest detection rate of slowing conduction velocity was the common peroneal motor nerve which was 48.6% (138/248 roots) and the second was median motor nerve with delay rate of 37% (155/419 roots). The main symptoms of the patients were neurasthenia, numbness and paresthesia. The rates of abnormal achilles tendon reflex and knee jerk reflex in patients were were 79.4% and 49.8%, respectively. The detected rates of patients with ST-segment changes and hypertension were 19.1% and 27.5%, respectively. The rates of hypertension, systolic pressure and diastolic pressure were 27.3%, 22.5% and 21.1%, respectively. The rates of lactate dehydrogenase (LDH), triglycerides (TG) and low density lipoprotein (LDL) were high. The detected rates of urine acid, indirect bilirubin and total bilirubin in male patients were higher than those in female patients. In addition, the abnormal detected rate of urea nitrogen and indirect bilirubin increased with exposure years.

CONCLUSIONOccupational chronic CS(2) poisoning mainly affects the nervous system, as well as liver and kidney function. Detecting the median and common peroneal motor nerve conduction velocities could be the screening indicators for the peripheral nerve injury induced by CS(2) in the occupational exposure population during the periodical occupational medical examinations.

Adult ; Aged ; Carbon Disulfide ; poisoning ; Chemical Industry ; Female ; Humans ; Kidney ; drug effects ; physiopathology ; Liver ; drug effects ; physiopathology ; Male ; Middle Aged ; Multiphasic Screening ; Nervous System ; drug effects ; physiopathology ; Neural Conduction ; Occupational Exposure

OBJECTIVETo verify the clinical efficacy of acupuncture on motor dysfunction in ischemic stroke of subacute stage.

METHODSThe multi-central randomized controlled trial was adopted. One hundred and twenty-six cases of ischemic stroke of subacute stage were randomized into an acupuncture group (61 cases) and a conventional treatment group (65 cases). The basic treatment of western internal medicine and rehabilitation training were applied to the patients of the two groups. In the acupuncture group, acupuncture was supplemented at the body points located on the extensor of the upper limbs and the flexor of the lower limbs. In combination, scalp acupuncture was applied to NS5, MS6 and MS6 on the affected side. The treatment was given 5 times a week and totally 8 weeks were required. The follow-up observation lasted for 3 months. The scores in Fugl-Meyer scale and NIHSS scale and Barthel index were compared between the two groups before treatment, in 4 and 8 weeks of treatment and the 3-month follow-up observation after treatment separately.

RESULTSIn 4 and 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score was improved obviously in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score in the acupuncture groupwas im proved much apparently as compared with that in the conventional treatment group [68. 0 (43. 0,86. 5) vs 52. 5 (30.3, 77.0), 77.0 (49.5, 89.0) vs 63. 0 (33.0, 84.0), both P<0. 05]. Except that NIHSS scale score was not reduced apparently in 4 weeks of treatment in the conventional treatment group (P>0.05), the results of NIHSS scale at the other time points were all decreased obviously as compared with those before treatment in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, the results in the acupuncture group were reduced much apparently as compared with those in the conventional treatment group [5. 0 (3.0,8.0) vs 7. 0 (3.0,13.8), 4. 0 (1.5,7.0) vs 6.0 (2.0,11.7) ,both P<0. 05]. In 8 weeks of treatment and the follow-up observation, Barthel index was improved obviously as compared with that before treatment in the patients of the two groups (all P<0. 05). The improvement in the acupuncture group was much more significant as compared with the conventional treatment group [75. 0 (60. 0,87. 5) vs 65. O (36. 3, 87. 5), P<0. 051.

CONCLUSIONBased on the conventional treatment, Acupuncture achieves the satisfactory clinical efficacy on motor dysfunction in ischemic stroke of subacute stage.

Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Motor Activity ; Stroke ; physiopathology ; therapy ; Treatment Outcome

OBJECTIVETo establish an assessment index system to objectively evaluate the implementation of health promotion in enterprises.

METHODSMulti-methods, which include the reviewing references, the summarizing results of preliminary studies, the interview with experts and employers, were used in developing attentative index framework and working out the consultative questionnaires. Then the improved Delphi Method was adopted in collecting ideas from 20 experts in China, and they scored the importance of every single index by two rounds of consultation. On the basis of these data, the indicators were added , deleted or modified according to concentration and distraction levels of expert ideas. The method of the percentile weighted coefficient was conducted to decide the weighing of assessment index.

RESULTSThe responding rates to the two rounds of questionnaires were 90.91% and 100.00% respectively. The overall specialist authoritative coefficient was 0.69, the coordination coefficient of all indicators was 0.623 (P <0.01),and the coordination coefficient of the four kinds of first-ranking indicators was 0.313, 0.625, 0.390, 0.563, respectively (P<0.01).Eventually, an assessment index system consisting of 4 first-ranking indicators and 10 sub-indicators which were further divided into 52 grade-three indicators was set up.

CONCLUSIONThe assessment index system possesses good content validity, and the liability and typicality were recognized by experts. However, it should be applied and validated in practice.

Adult ; China ; Delphi Technique ; Health Promotion ; Humans ; Middle Aged ; Occupational Health Services