ABSTRACT:Objective To investigate the clinical value and application indications of the second biopsy-cervical conization in the diagnosis and treatment of cervical lesions.Methods We selected 413 patients from Department of Gynecology and Obstetrics,General Hospital of Jinan Military Command,who received cervical multi-point biopsy pathology IA for cervical cancer and cervical conization (LEEP knife)of the second biopsy between January 2012 and October 2015.Their data were retrospectively analyzed.Results Compared with cervical multi-point biopsy, the second biopsy-cervical conization after operation had pathological upgrade in 10.65% (44/413),agreement in 73.37% (303/413),and reverse (pathological levels drop and overcast)in 15.98%(66/413).Cervical multi-point biopsy and the second biopsy-cervical conization significantly differed in the diagnosis of cervical low-level intraepithelial lesion,high-grade intraepithelial lesions,and early invasive cancer (IA)(T=21.740,v=3-1=2,P<0.05).Before conization high-risk type HPV infection positive rate was 71.91%(297/413);after operation it was 86.36% (38/44)in upgrade pathology and 70.20% (259/369)in non-upgrade one.And thin prep cytologic test (TCT)showed that the positive rate (ASC-US and above)was about 87.89% (363/413), of which about 11.85% (43/363)was pathological upgrade after conization.The positive rates of high-risk type HPV infection and TCT result (ASC-US and above)in cervical lesions differed significantly between pathological upgrade and non-upgrade after conization (χ2=5.092,P<0.05,χ2=4.476,P<0.05).Conclusion The second biopsy-cervical conization technique as a means of reevaluation of cervical pathological changes in diagnosis and treatment of cervical biopsy under colposcopy can significantly improve diagnosis rate,reduce misdiagnosis and occult cervical cancer,but its clinical application has some indications.

Objective The modified Blalock-Taussig shunt (MBTS) is considered a low-risk management option for palliation in patients with severely cyanotic heart anomalies in advanced heart centers in western countries.But the morbidity and mortality associated with MBTS remains challenge in developing countries.Methods 106 patients with severely cyanotic complex heart anomalies underwent 110 modified Blalock-Taussig shunts(B-T shunts) between October 2000 and August 2012.The mean age was (3.8 ± 1.1) months (1 day-37.2 months).The mean weight of the babies was (5.0 ± 2.1) kg (2.3 kg-12.0 k g).The cardiac anatomy was as follows:pulmonary atresia with intact ventricular septum in 25,pulmonary atresia with ventricular septum defects in 45,tricuspid atresia in 11,tetralogy of Fallot in 7,complex single ventricle physiology in 18.All patients were deeply cyanotic,and preoperative prostaglandin E1 was needed in 78 patients to ensure ductus patent and maintain oxygen saturations prior to the shunt operation.The shunts were accomplished with 3.0 mm polytetrafluoroethylene grafts in 8 patients,3.5 mm in 11,4 mm in 65,5mm in 26.Results The duration of mechanical ventilation was 4 hours-7 days,cardiac intensive care unit stay was 1-12 days,hospital stay after operation was 1-18 days.There were 3 deaths (2.6％),immediate post-operative shunt block in 1,severe hypoxidosis in 1 and heart failure in 1.Oxygen saturation increased from 68.5％ preoperatively to 79.2％ postoperatively.Four patients had shunt block,additional shunt was created respectively.There was 2 late death.Follow-up of 94 patients revealed satisfactory systemic oxygen saturation of 0.81 ± 0.10 (0.63-0.92).86 cases received further operations,including 7 in TOF radical operation,31 in Rastelli,25 in Glenn,18 in Fontan.Conclusion With an encouraging early shunt patent rate and oxygen saturation increasing,we can now adopt MBTS as an alternative in patients with severely cyanotic heart anomalies.Modified B-T shunt is a good palliation for patients with cyanoti cheart anomalies,which can increase pulmonary blood flow.Excellent surgical skills and perioperative treatment contribute to good operation results,and to low morbidity and low mortality.

Humans ; Periapical Periodontitis ; diagnosis ; etiology ; therapy ; Root Canal Therapy ; adverse effects

Humans ; Root Canal Obturation

Humans ; Root Canal Therapy ; instrumentation ; methods

Cholestasis ; etiology ; physiopathology ; therapy ; Female ; Humans ; Liver Diseases ; drug therapy ; etiology ; physiopathology ; Male ; Neonatology ; Parenteral Nutrition, Total ; adverse effects ; S-Adenosylmethionine ; therapeutic use ; Ursodeoxycholic Acid ; therapeutic use

Adult ; Cardiac Catheterization ; adverse effects ; Female ; Heart Septal Defects, Atrial ; therapy ; Hemolysis ; Humans

Dental Pulp Cavity ; anatomy & histology ; Humans ; Root Canal Preparation ; methods

Dental Pulp Cavity ; abnormalities ; pathology ; Humans ; Root Canal Therapy ; methods

Objective To explore the morbidity, manifestation, pathogenesis and diagnosis of acquired immune deficiency syndrome( AIDS)-related lesions in digestive system. Methods The complete history interview, physical examination and diagnostic test were made in a total of 1000 heroin addictors with intravenous injection. Seventy-two of them were selected as AIDS based on the diagnosis criteria on HIV/AIDS of Centers for Disease Control(CDC) (CD4+ T cell count lower than 400/?l and human immunodeficiency virus ( HIV) load higher than 400 copies/ml). Results Main clinical manifestations of AIDS were persistent low fever, diarrhea, progressive exhaustion, opportunistic infection, tumorgenesis and multiple organ impairment. The morbidity of AIDS-related lesions in digestive system ranged from 1.4% to 98. 6%. Oropharyngeal and gastrointestinal lesions occurred in 71 cases (98.6%), while hepatic, biliary and pancreatic impairment occurred in 59 cases (81. 9%). Conclusions AIDS-related lesions in digestive system are common in AIDS patients which are mainly caused by HIV invasion, opportunistic infection, tumorgensis and immune system impairment.