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.

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

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

Objective To evaluate the safety and efficiency of the treatment with autologous cytokine-induced killer (CIK) cell in patients with hepatocellular carcinoma (HCC). Methods Peripheral blood mononuclear cells (PBMC) were isolated from blood from patients with HCC, then augmented by priming with interferon-gamma (IFN-?) followed by monoclonal antibody (mAb) against CD3 and interleukin-2 (IL-2). The autologous CIK cells thus obtained were infused back to individual patients. Altogether 30 patients undertook such treatment. The changes in subsets of lymphocytes and dendritic cells (DC1, DC2) in peripheral blood were assessed by using flow cytometry. Results The percentages of CD3 +, CD3 + CD8 + , CD3 + CD56 + , and CD25 + were increased significantly, and the proportions of DC1 and DC2 subsets were also increased after autologous CIK cells transfusion. Most (23 of 30) patients developed a fever 1-2 hours after CIK cells transfusion and the body temperature ranged from 37℃ to 40℃, lasting for 2-8 hours. Most (20 of 23) febrile patients recovered without any treatment, antipyretic medicine was given to 3 patients to allay the fever. The HCC symptoms were markedly relieved in most patients. No major side effects were found. Conclusion Our observation indicates that the treatment with autologous CIK cells for HCC patients is safe and efficacious.

Objective To study the expression and its significance of Platelet-derived growth factor(PDGF) and Collagen type Ⅰ (Col- Ⅰ) mRNA in hepatic tissue in mice exposed to arsenic in drinking water. Methods Fifty mice were divided into control group, sodium arsenite group(iAs3+ group, 300 mg/L) and sodium arsenate group (iAs5+ group, 300mg/L) at random. The mice were sacrificed after 10 months for liver function test (ALT, AST and GLB examined by automatic biochemical analyzer) and pathologic examinations. Masson staining and immunohistochemical SABC methods were used. Through the result of Masson staining fibrosis semi-quantitative analysis of the fibrosis number was carried out in the per unit area. Using immuonhistochemical SABC methods, the expression of PDGF and Col- Ⅰ was detected. Results ①Serum ALT was statistically significant among control group [(36.67±3.51) U/L], iAs3+ group[(61.46±13.85) U/L] and iAs5+ group[(43.31±4.21) U/L, F= 6.56, P < 0.05], especially between the control and iAs3+ group (P < 0.05) ;Serum AST had a statistical significance among control group [(135.00 ± 20.42)U/L], iA3+ group [(510.86 ± 59.01)U/L] and iAs5+ group[(258.93 ± 22.40) U/L, F= 83.36, P < 0.05] ;Serum GLB had no statistical significance among control group [(20.86 ± 0.61)g/L], iAs3+ group [(26.94± 3.73)g/L] and iAs5+ group[(24.59 ± 5.27)g/L, F = 2.80, P < 0.05]. ②Masson staining revealed notable liver cell necrosis, regeneration, infiltration of inflammatory cells in portal area. Masson staining Semi-quantitative results showed significantly increasing size of fibrosis in model group. Compared with control group(0.069 ± 0.013) and iAs5+ group(0.143 ± 0.122), fiber hyperplasia of iAs3+ group(0.192 ± 0.108) had statistical significance (F = 1.91, P < 0.05). ③Immunohistochemistry results showed higher expression of PDGF in the portal area, sepetal and preisinus cells in model group. The heavy expression of Col- Ⅰ distributed in the surrounding of blood vessels and bile duet and along portal wall extensting to the liver in model group. Semi-quantitative results showed that PDGF among control group(202.79 ± 7.46), iAs3+ group(174.38 ± 7.71) and iAs5+ group(177.64 ± 7.81) had a statistical significance(F= 102.91, P < 0.05);Col-Ⅰ had a statistical significance among control group(200.11 ± 7.46), iAs3+ group (176.47±10.20) and iAs5+ group (177.378 ±7.948, F = 78.51, P < 0.05). Conclusions Exposed in oral drinking arsenic, mice can develop hepatic injury and hepatic fibrosis. The PDGF and Col-Ⅰ play significant effects on the process of hepatic fibrosis caused by oral drinking arsenic exposed mice.

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.

Objective Evaluation of the benefit and safety of combined thrombolysis and precutaneous coronary intervention in acute myocardial infarction by retrospective analysis. Methods Precutaneous coronary intervention were performed in 45 patients with acute myocardial infarction immediately after thrombolysis. The clinical and angiographic data were compared with that of 31 patients with thrombolysis alone and 74 patients with primary precutaneous coronary intervention in the same period. Results Angiographic data showed that patients with PCI plus thrombolysis had more frequency of TIMI 3 flow than patients with thrombolysis alone (88.9% vs. 74.2%, P=0.087). Patients with PCI plus thrombolysis and with primary PCI had similar frequency of TIMI 3 flow (88.9% vs. 91.9% P=0.404). Clinical data showed that patients with PCI plus thrombolysis had less major adverse cardiovascular events in hospital than patients with thrombolysis alone (4.4% vs. 12.9%, P=0.181). Patients with PCI plus thrombolysis and with primary PCI had similar major adverse cardiovascular events (4.4% vs. 1.4%, P=0.319). Patients with three strategies of treatment had similar mortality (4.4% vs. 6.5% vs. 4.1%). Patients with three strategies of treatment had similar major bleeding events (4.4% vs. 3.2% vs. 1.4%) in hospital. Conclusion Combined thrombolysis and precutaneous coronary intervention maybe surpass thrombolysis alone, at least similar to primary PCI. This strategy of treatment is safe.

Objective To observe the relationship between the intima media thickness(IMT) and the level of serum uric acid in elderly female patients with hypertension Methods Eighty elderly female patients with hypertension were measured for carotid artery average IMT and the level of serum uric acid They were divided into the normal group, intima thicking group ,the plaque shaping group and the vascular stenosis group. In the abnormal groups, probable risk factors were analysed by multiple stepwise regression Results There were significantly differentces among these groups ( P

Objective To investigate the biofilm formation,the alginate biosynthetic gene ex- pression and analyze the mucA gene sequence of mucoid Pseudomonas aeruginosa PA17 and nonmu- cold Pseudomonas aeruginosa PA01.Methods The modified plate culture method was used to estab lish the biofilm model in vitro.Semi-quantitative RT-PCR was used to determine the expression level of algD in planktonic condition and during the formation of biofilm.The mucA gene of PA17 and PA01 was amplified and the products were sequenced.Results PA17 biofilm was mature at 6th day, and PA01 biofilm was mature at 3rd day.The structures of the biofilms were both like pellicle.In planktonic condition,the algD expression of PAl7 was higher than PA01;in biofilm formation,the algD expression was maximal when the biofilm was mature.There was a 166～333 deletion mutation and 342A→G in mueA gene of PA17,the mucA gene of PA01 was the same with the sequence of Genbank.Conclusions The mucA gene mutation of PA17 was a new type,which maybe the reason for the little expression difference of algD between PA17 and PA01 during the biofilm formation than it in planctonic condition and the same structure of PA17 and PA01 biofilm.

Objective To observe the change of serum TG in elderly diabetic patients after fatty meal.Methods The diabetic patients and non-diabetic patients of fasting normotriglyceridemia ate the fatty test meal after having been fasting for 12h.Serum lipid were measured at 0,2,4 and 6h after the meal.Results The serum TG level increased in the two groups after the meal,the diabetic patients had a higher TG-AUC than the non-diabetic patients (P