Objective To discuss the clinical value of the "three-step" diagnostic routine in the diagnosis of cervical high-grade lesions. Method The women with the abnormal thinprep cytology test (TCT) underwent colposcopy and biopsy,the pathobiology result was the diagnostic standard. The sensitivity and specificity of the cervical high-grade lesions was calculated. Results The identify rate of the cervical high-grade lesions from the abnormal TCT was 22.3% (340/1524), the sensitivity was 27.1% (92/340), the specificity was 97.5% (1154/1184). The sensitivity of colposcopy was 47.9% (163/340), the specificity of colposcopy was 96.4% (1141/1184). Conclusion TCT with high sensitivity is used for preliminary screening, the colposcopic examination is used to pinpoint and evaluate the lesions,the detection rate and accuracy of cervical high-grade lesions can be improved.

Objective: To evaluate biological materials tanned with a compound method for clinical performance of biovalves. Methods: The tissue calcium concentration was compared between biological materials tanned simply with amylic aldehyde and those compoundly tanned with amylic aldehyde, cation fat, chromium trioxide and glycerol. The histological morphology, the ultra-structure and tensile strength of the biological materials were tested and the content of hydroxyls in the materials was measured with the Fourier infrared spectrum detector. The prosthetic biological cardiac valves made of the materials were tested with an accelerated wearing device extracorporeally. Results: The tissue calcium concentration was lower in the compoundly tanned materials. In these materials, the collagenous fibers were dense and lined up in order. The cellular structure was maintained. The materials were pliable at the contracting temperature of 86℃ to 90℃. The tensile strength of the materials was 19.9 to 25.9 N/mm 2 and the extension rate was 43.4% to 46.0%. The peak of the hydroxyls decreased significantly at the wave length of 1741.11 cm -1 in the Fourier infrared spectrum. The swine aortic valve experienced 3.892?10 8 cycles in the accelerated wearing tests, and the bovine pericardial valve, 3.888?10 8 cycles. By estimation, the biovalves will last for about ten years. Conclusion: Compound tanning can increase firmness and softness of the materials and may play an important role in anticalcification of the biovalves.

Objective To analyze the clinical management of women with atypital squamous cells(ASC).Methods During Sep 2003 to Sep 2008,a totle of 956 women in our department were diagnosed with ASC by cytological test,they were further biopsied under the colposcope.The result of TCT,colposcopic test,biopsy and the highrisk factor were recorded and analysed;the based the biopsy were analyzed by the X~2-test;the high-risk factors and the odds Ratio(OR) were counted by SPSS10.0.Results Among the women with ASC,the rate of cervical intraepithelial neoplasia(CIN) diagnosed by the biopsy under the colposcope was 50.7% ,the rate of the high-grade lesion over CINII Was 13.3% ;if the colposcopic test were low-grade lesion,the rate of the cases which biopsys were the highgrade lesion over CINII,was 8.3% ;the high-risk factors which caused the cervical high-grade lesion were the number of sex-partners over 3,the age less than 20 yearold when the sex were made,the cervical erosion,the result of TCT with ASC-H.Conclusion Among the women with ASC,the biopsy shows multiformity;the rate of CIN and the highgrade lesion is also high;if TCT is ASC,the colposcopie test is advised;if the woman who has the high-risk factors,biopsy is advised.

ObjectivesTo discuss the value of the three kinds of surgical management to treat high-grade cervical intraepithelial neoplasia. MethodsThe study was conducted on 136 patients who underwent LEEP、CKC 、hysterectomy ,to compare the change of the postoperative biopsy result,the rate of cure and pregnancy. ResultAmong the postoperative biopsy result,66. 4% was consitent with pretreating histopathology,but 3.6% was upgrade,30.0% was downgrade; there were no statistical difference in the rate of cure of the three kinds of surgical management and in the rate of pregnancy of the two kinds of conization. ConclusionThe three kinds of surgical management to treat high-grade cervical intraepithelial neoplasia were effective,while LEEP was the best way.

Objective To investigate the riskf actors associated with sepsis following surgery of con-genital heart disease in children, for early-recognizing and diagnosing, improving prognosis and decreasing mortality.Methods Retrospective study wa s employed,52 patients of sepsis and 104 patients of non-sepsis with similar age,sex,na d the same diseases were enrolled during Jan 2012 to Apr 2015 in cardiac intensive care unit.Variables such as age,sex,preoperative infection,delayed sternum closure,diaphragmatic paralysis, exploraot ry chest,cardiopulmonaryb ypass time, placed invasive catheter were included in the research fac-tors.The Logistic regression model was set up,OR and 95%CI were calculta ed.Results In sepsis group,the more shock and dysfunction organs,longre hospital stays,longer ICU stays and higher mortality were found compared to the non-sepsis group[25.32%vs.6.73%,3.5 ±1.1 vs.1.1 ±0.7,(35.1 ±11.2)d vs.(11.3 ±3.1)d,(21.3 ±7.1)d vs.(7.1 ±2.3)d,19.23%vs.4.81%,P<0.05].In the Logistic regres ion mod-e l,variables significantly associated with sepsisw ere preoperative infection,deal yed sternal closure,explorato-ry chest,and placed more invais ve duct,diahp ragmatic paralysis(P<0.05).OR value (95%CI) were 10.53 (1.73,64.2),26.66(2.69,263.83),19.47(1.87,203.02),4.99(1.36,18.31),8.32 (0.12,16.46 ), respectively.Conclusion Preoperative infection,delayed sternal closure,exploratory chest,placed more inva-sive duct,diaphragmatic paralysis are the risk factors of sepsis.Children with sepsis had poor clinical outcome compared to those without sepsis.

Objective The purpose of this study was to evaluate the value of contrast-enhanced ultrasound in diagnosis of renal cell carcinoma subtyping.Methods 206 cases with renal tumors were confirmed by pathology and surgery from June 2012 to June 2014,including 113 male cases and 93 female cases.The mean age was 54 years (range 23-80 years).The subtype of renal tumor included clear cell carcinoma in 147 cases,papillary cell carcinoma in 32 cases,chromophobe cell carcinoma in 27 cases.All patients were received the CEUS before operation.The enhancement patterns,degree of enhancement,the appearance of necrosis and the time-intensity curve by contrast-enhanced ultrasound were analyzed.Results Enhancement patterns of CEUS were showed by fast in and fast out in 63.9％ (94/147)cases with clear cell carcinoma,59.4％ (19/32) cases with papillary cell carcinoma,51.9％ (14/27) cases with chromophobe cell carcinoma.Statistical significant diference was shown among those subtype groups (P ＜ 0.05).Most of the clear cell carcinomas (127/147,86.4％) showed hyperenhancing.While,the papillary renal cell carcinoma (22/32,68.8％) and chromophobe cell carcinoma (15/27,55.6％) showed hypoenhancing (P ＜ 0.05).The rate of necrosis in clear renal cell carcinoma was 62.6％ (92/147),and 59.4％ (19/32) in papillary cell carcinoma.necrosis area accounted for only 18.5％ (5/27)in chromophobe cell carcinoma (P ＜ 0.05).In the time-intensity curve analysis,the initial time,the average arrival time,the time to peak and area under the curve in renal cortex was (11.06 ± 2.75) s,(23.42 ± 2.79) s,(27.47 ± 3.02) dB,(35.01 ± 2.94)dB,respectively.Significant differences in those items were found in clear cell carcinoma,which was(8.01 ± 1.89) s,(20.05 ± 3.01) s,(30.03 ± 2.98) dB,(37.64 ± 4.01) dB respectively,compared with those in cortex (P ＜ 0.05).The arrival time,time to peak,peak intensity and area under the curve in papillary cell carcinoma were (1 1.12 ± 2.43) s,(27.29 ± 3.54) s,(20.13 ± 2.67) dB,(34.67 ±3.24) dB,respectively.The curve showed the time to peak was higher and the peak intensity were lower than those of renal cortex (P ＜0.05).The arrival time,time to peak,peak intensity and area under the curve in chromophobe cell carcinoma were (11.32 ± 2.90) s,(22.21 ± 3.62) s,(22.02 ± 2.52) dB,(28.67 ± 3.65) dB,respectively.The curve demonstrated peak intensity and area under the curve were lower than those of surrounding renal cortex (P ＜ 0.05).The increase of tumor diameter after contrast-enhanced ultrasound in clear cell carcinoma was about (0.35 ± 0.11)cm and in nonclear cell carcinoma was about (0.23 ± 0.10) cm (P ＜ 0.05).Conclusion The contrast-enhanced ultrasound played an important role in diagnosis and subtype renal cell carcinoma.

Objective To explore the distribution and antimicrobial resistance of pathogens causing healthcare-associated infection(HAI) in a hospital,and provide theoretical basis for rational use of antimicrobial agents and control of HAL Methods HAI occurred in patients in this hospital between 2011 and 2015 were chosen,distribution of major pathogens causing HAI and antimicrobial resistance were analyzed.Results A total of 852 pathogenic strains were isolated,including 458 (53.75 ％) strains of gram-negative bacteria,259 (30.40 ％) fungi,and 135 (15.85 ％) gram-positive bacteria,the top 4 pathogens were Klebsiella pneumoniae (n =159,18.66 ％),Candida albicans (n =119,13.97％),Acinetobacter baumannii (n =81,9.51％),and Escherichia coli (n =74,8.69 ％).Isolation rate of gram-negative bacteria increased from 47.41 ％ in 2012 to 61.57％ in 2015,fungi increased from 24.78％ in 2011 to 34.45％ in 2014 (2015 was 27.95％),gram-positive bacteria decreased from 26.55％ in 2011 to 10.48％ in 2015.Resistance rates of Escherichia coli and Klebsiella pneumoniae to imipenem and meropenem were 8.11％-12.58％;Acinetobacter baumannii had the lowest resistance rate to cefoperazone/sulbactam(23.46％),resistance rate of Candida albicans to fluconazole was up to 59.66％,vancomycin-resistant gram-positive bacteria was not found.Conclusion The major pathogens causing HAI are opportunistic pathogens,antimicrobial resistance is serious,the species and distribution varies with different years,it is necessary to enhance specimen detection rate,strengthen the monitoring on pathogen resistance,and use antimicrobial agents rationally.

Objective To explore the expression of interleukin -17A(IL-17A),interleukin-10(IL-10), interleukin-6 ( IL-6 ) in the maternal plasma , umbilical plasma , neonatal plasma from the pregnant women who accepted the Telbivudine for the prevention of perinatal transmission of hepatitis B virus infection .Methods 85 preg-nant women who were delivered in the hospital were chosen [ Telbivudine group 25 cases,HBVDNA high viral level group,HBVDNA negative group,non-infection group(health pregnant),each group included 20 cases].The level of the serum of IL-17A,IL-10,IL-6 in the maternal plasma,umbilical plasma,neonatal plasma from the different group was prospectively analyzed by the CBA method .Results The levels of IL-17A in the maternal plasma,um-bilical plasma,neonatal plasma of the Telbivudine group [(15.29 ±4.80)pg/mL,(19.45 ±4.80)pg/mL,(17.32 ± 4.18)pg/mL]were lower than the HBVDNA high viral level group [(26.03 ±4.88)pg/mL,(34.07 ±5.59)pg/mL, (24.12 ±4.76)pg/mL],there were significant differences(P=0.000,0.001,0.019);The level of IL -10 in the maternal plasma,umbilical plasma,neonatal plasma of the Telbivudine group [(6.08 ±1.32) pg/mL,(2.33 ± 0.68)pg/mL,(3.74 ±0.61)pg/mL]were higher than the HBVDNA high viral level group [(3.95 ±1.21)pg/mL, (1.71 ±0.53)pg/mL,(2.22 ±0.55)pg/mL],there were significant differences(P=0.023,0.015,0.012);The level of IL-6 in the maternal plasma ,umbilical plasma ,neonatal plasma of the Telbivudine group were lower than the HBVDNA high viral level group,there were significant differences (all P <0.05).Conclusion Telbivudine can cause the inhibition of the replication of HBV virus , partially reverse the immunologic dissonance of the pregnant women with HBV virus ,which is conducive to maintaining pregnancy .

AIM: To explore the differentiation and the functional behavior of marrow mesenchymal stem cells (MSC) transplanted into the cerebral infarction area after cerebral middle artery ischemia in rats. METHODS: MSC were isolated from human rib marrow and cultured in L DMEM medium in vitro. The model of rat cerebral infarction by cerebra middle artery occlusion was established, and the identified MSC were transplanted intracerebrally 10 days later. Immunohistochemistry technique was used to identify the cell survivor and its differentiation to the neurogenesis in the transplantation site, and at 2 weeks and 6 weeks after transplantation, the functional tests were comparatively studied. RESULTS: The results showed that the survivor of transplanted MSC was differentiated to neural phenotype cells, and the functional behavior of the injury rats was recovered significantly after MSC transplantation (P