Cervical intraepithelial neoplasia is a preinvasive lesion of cervical carcinoma associated with HPV infection.It can be classified as low or high grade according to the degree of the lesion.Low grade lesion includes HPV infection and CIN1,and high grade lesion includes CIN2～3.HPV infection and CIN have become very common among fertile women,so more and more attention has been paid to the influence that HPV infection,cervical lesion and their treatments would have on pregnancy.HPV infection may increase during pregnancy period.Tough there will be more chances for the vaginal delivery infants to be exposed to HPV,it is not proper to draw a conclusion that cesarean must be performed for all HPV infected pregant women.If CIN1 is found during pregnancy,observation and close follow-up post partum should be advised.Pregnancy may not deteriorate CIN2～3,but clear diagnosis should be made during pregnancy if colposcopy examination result is not satisfactory or great doubt for invasive cancer exits.In this case,conization during the second semester of the pregancy is advised,which may increase the cesarean rate.Conservative therapy for CIN has not significant influnce on fertility,while cold knife conization and LEEP conization may increase the premature delivery rate,which may be associated with premature ruption of fetal membrane.

Objective To evaluate the quality of observational studies on pelvic organ prolapse in China.Methods The checklist of strengthening the reporting of observational studies in epidemiology (STROBE) statement was applied to evaluate the observational studies.The articles were searched in the SinoMed database using the terms:prolapse,uterine prolapse,cystocele,rectal prolapse and pelvic floor;limited to Chinese core journals in obstetrics and gynecology from January 1996 to December 2015.With two 10-year groups (1996-2005 and 2006-2015),the x2 test was used to evaluate inter-group differences.Results (1) A total of 386 observational studies were selected,including 15.5％(60/386) of case-control studies,80.6％(311/386) of cohort studies and 3.9％ (15/386) of cross-sectional studies.(2) There were totally 22 items including 34 sub-items in the checklist.There were 17 sub-items (50.0％,17/34) had a reporting ratio less than 50％ in all of aticles,including:1a (study's design) 3.9％ (15/386),6a (participants) 24.6％(95/386),6b (matched studies) 0 (0/386),9 (bias) 8.3％ (32/386),10 (study size) 3.9％,11 (quantitative variables) 41.2％ (159/386),12b-12e (statistical methods in detail) 0-2.6％ (10/386),13a (numbers of individuals at each stage of study) 18.9％ (73/386),13b (reasons for non-participation at each stage) 18.9％,13c (flow diagram) 0,16b and 16c (results of category boundaries and relative risk) 9.6％ (37/386) and 0,19 (limitations) 31.6％ (122/386),22 (funding) 20.5％ (79/386).(3) The quality of articles published in the two decades (1996-2005 and 2006-2015) were compared,and 38.2％ (13/34) of sub-items had been significantly improved in the second 10-year (all P＜0.05).The improved items were as follows:1b (integrity of abstract),2 (background/rationale),6a (participants),7 (variables),8 (data sources/measurement),9 (bias),11 (quantitative variables),12a (statistical methods),17 (other analyses),18 (key results),19 (limitations),21 (generalisability),22 (funding).Conclusions The quality of observational studies on POP in China is suboptimal in half of evaluation items.However,the quality of articles published in the second 10-year have significantly improved.

Aim To study the reversal effect of CPUC1 on multidrug resistance in K562/A02 cells. Methods MTT assay was used to detect the cytotoxicity of vincristine. Intracellular accumulation of rhodamine123 was measured by flow cytometry to evaluate the function of P glycoprotein(Pgp). The apoptotic cells induced by vincristine were detected by flow cytometry using DNA content analysis and Annexin V/PI double staining. Results CPUC1 significantly reversed the resistance of K562/A02 cells to vincristine. CPUC1 increased intracellular accumulation of rhodamine123 in K562/A02 cells in a concentration dependent manner. CPUC1 increased the apoptosis induced by vincristine. Conclusion CPUC1 reversed multidrug resistance by inhibiting function of P gp in K562/A02 cells, suggesting that CPUC1 merits further study.

0.05).Among the 26 pregnancies,there occurred one ectopic pregnancy and four cases of spontaneous abortion.In the 13 delivery cases,there were one premature delivery,two cases of premature rupture of the membrane,and ten cases of cesarean section.The sample height of the cone was less than 2.0 cm in the nine delivery cases,and the mean width of the cone was over 2.5 cm.Conclusion No evidence of secondary infertility caused by cervical conization was found.There was also no significant increase in the number of either premature delivery cases or low birth weight infants. The sample height of the cone might play a more important role in the pregnancy outcome than the width, which still needs to be further verified by larger studies.

Objective:To analyze associations of sedentary behavior and physical activity with dyslipidemia among residents in Wuhai city.Methods: Data about social demographic characteristics, life style, health status and other covariate required for analysis in this study was obtained from a cross-sectional study on a total of 11 497 18-79 years old residents in Wuhai City by questionnaire, body mea-surement and laboratory examination.In this study, sedentary behavior and physical activity were evaluated using international physical activity questionnaire long version (IPAQ).IPAQ is widely used all over the world, and its reliability and validity have been tested in Chinese population.2016 Chinese Guideline for the Management of Dyslipidemia in Adults was used to define dyslipidemia in this study.Results: According to IPAQ scoring protocol, 124 participants were excluded as a result of reporting more than 960 min of physical activity per day.50.58% of 11 373 participants included in the analysis reported more than 4 hours of sedentary behavior per day in this study, thus 49.42% participants reported no more than 4 hours of sedentary behavior per day;the proportions of these 11 373 participants who reached Low level physical activity, Moderate level physical activity and high level physical activity were 23.43%, 37.29% and 39.28% respectively;and the detection ratios of new cases and prevalent cases of dyslipidemia in Wuhai City were 20.46% and 16.13% respectively.After controlling for confounders in this study, we found out that sedentary behavior increased the risk of new cases of dyslipidemia in women (OR=1.17, 95% CI: 1.00-1.36), and increased the risk of prevalent cases of dyslipidemia in both men (OR=1.21, 95% CI: 1.02-1.44) and women (OR=1.24, 95% CI: 1.04-1.48);as for association of physical activity with dyslipidemia, association was found between high level physical activity and prevalent cases of dyslipidemia in men in this study (OR=0.78, 95% CI: 0.62-0.98), suggested that high level physical activity may help to reduce the risk of prevalent cases of dyslipidemia in men.Conclusion: Our results from this cross-sectional study in Wuhai City suggested that sedentary behavior increased the risk of dyslipidemia;by contrast, physical activity may help to reduce the risk of dyslipidemia.

Objective:To investigate the correlation between the expression level of serum exosome miR-29C and postoperative cognitive dysfunction (POCD) in elderly patients undergoing surgery.Methods:A total of 119 elderly patients who underwent elective spinal surgery in the Second Hospital of Shanxi Medical University from January 2021 to January 2022 were selected and scored on the Montreal Cognitive Assessment (MoCA) Scale 1 day before surgery and 1, 7 and 21 days after surgery. The selected patients were divided into POCD group (51 cases) and non-POCD group (68 cases) according to whether the MoCA Scale score decreased ≥2 points 1 day before surgery and 1 day after surgery. S100-β, neuron-specific enolase (NSE) levels and serum exosome miR-29C expression levels were detected and analyzed in all patients 1 day before and 1 day after surgery. Pearson correlation analysis showed the correlation between MoCA Scale score and S100-β, NSE and miR-29C. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of S100-β, NSE and miR-29C for POCD occurrence in elderly patients undergoing surgery.Results:The score of MoCA Scale in POCD group were significantly decreased 1, 7 and 21 days after surgery compared with 1 day before surgery (all P<0.05), while the score of MoCA Scale in non-POCD group were significantly decreased only 1 day after surgery compared with 1 day before surgery ( P<0.05). The levels of S100-β and NSE and the expression level of serum exosome miR-29C in 2 groups were significantly increased 1 day after surgery compared with 1 day before surgery (all P<0.05). Moreover, the levels of S100-β and NSE and the expression level of serum exosome miR-29C in POCD group were significantly higher than those in non-POCD group 1 day after surgery (all P<0.05). There was a negative correlation between the MoCA Scale score and the expression level of serum exosome miR-29C 1 day after surgery in the POCD group ( P<0.05). ROC curve analysis showed that the expression levels of NSE, S100-β and exosome miR-29C 1 day after surgery predicted the risk of POCD in elderly surgical patients with area under the curve (AUC) of 0.891, 0.908 and 0.918, respectively. Conclusions:The occurrence of POCD in elderly patients with surgery is related to the increase of the expression level of serum exosome miR-29C, and the expression level of serum exosome miR-29C is negatively correlated with MoCA Scale score. Early monitoring of the miR-29C expression level can provide a basis for the occurrence and development of postoperative POCD in elderly patients, disease diagnosis and clinical intervention.

Objective To compare the clinical significance of peripheral blood neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in predicting prognosis of patients with hepatocellular carcinoma (HCC).Methods The clinical data of 661 patients with HCC were retrospectively analyzed.Routine peripheral blood test results were used to calculate the NLR and PLR,and the receiver operating characteristic (ROC) curves were drawn.Using the thresholds of NLR and PLR,the patients were divided into the low NLR group and the high NLR group,and the low PLR group and the high PLR group.Overall survival (OS) and disease free survival (DFS) were evaluated by the Kaplan-Meier method.Independent prognostic predictors were determined by the Cox proportional hazard model.Results The NLR and PLR thresholds were 2.790 and 99,respectively.Analysis of the ROC curves showed higher NLR and PLR were significantly associated with poorer OS and DFS (all P ＜ 0.05).Multivariate analysis showed that NLR was an independent risk factor of OS and DFS (both P ＜ 0.05).The results remained unchanged when the NLR was further analyzed by applying different cut-off values of 2.810 and 3.In subgroup analysis,NLR remained an independent factor of Barcelona Clinical Liver Cancer staging system (BCLC) 0/A/B (P ＜ 0.05 for all measurements).Conclusion An elevated preoperative NLR could be a better prognostic predictor for HCC patients in comparison with PLR,especially for BCLC 0/A/B patients.

Objective To investigate the significance of albumin-bilirubin (ALBI) score in predicting prognosis of hepatocellular carcinoma (HCC).Methods The clinical data of 644 HCC patients were retrospectively analyzed from May 2010 to May 2013 in the First People's Hospital of Changde City and the Affiliated Tumor Hospital of Guangxi Medical University.Peripheral blood test results were used to calculate ALBI score,and ALBI score was categorized into the following 3 groups:grade 1,grade 2,grade 3.Overall survival(OS) and disease free survival(DFS) were evaluated by the Kaplan-Meier method.And independent prognostic predictors were determined by the Cox proportional hazard model.Results Multivariate analysis showed that ALBI grade 2 was an independent risk factor for OS(P＜0.05).The ALBI grade stratified patients into at least two distinct overall survival cohorts (P＜0.05),whereas the CP grade did not.The ALBI grade also classified patients with CP grade A patients into two distinct overall survival cohorts (P＜0.05).In the subgroup analysis,the ALBI grade seemed to be an independent factor in terms of Barcelona Clinical Liver Cancer staging system(BCLC) 0-C.Conclusion For patients with HCC who underwent R0 resection,the ALBI grade is a good predictor of OS in HCC patients,and the above conclusions is true in patients with BCLC stage 0-C.

Objective To understand the status of infection and epidemic trend of Dengue fever and Chikungunya in Guangdong.Methods Retrospective survey and literature review were used to obtain data on the incidence,etiology of Dengue and Chikungunya.Serological survey was conducted to detect the specific-antibodies in healthy individuals for both Dengue virus (DENV) and Chikungunya virus (CHIKV).Results Three epidemics of Dengue fever were observed during 1990-2012,with the annual incidence rates as 9.75/100 000 in 1995,1.76/100 000 in 2002 and 1.25/100 000 in 2006,respectively.The predominant epidemic strains appeared to be DENV-2 and DENV-4 during 1990-1994.Since 1995,DENV-1 had become the predominant transmission strain which lasted for almost 13 years.Co-existence of multiple serotypes of DENV started in 2009.Of the 7 718 sera from healthy population during 2003-2012,180 specimens were detected positive for specific DENV-IgG antibody,ended with a sero-prevalence rate of 2.33％.All 2 132 sera in 2012 were detected negative for CHIKV-IgG antibody.Conclusion The overall exposure level to Dengue was considered to be low in Guangdong province.However,the predominant transmission mode caused by DENV-1 had been gradually changed into the co-existence of multiple serotypes with the endemic signs appeared in some part of the areas.Chikungunya was a newly emerging disease in Guangdong since local people were lack of basic immunity barrier.Surveillance and control programs thus seemed important.

Objective: To evaluate the efficacy of reinforcement on duodenal stump using single purse-string suture during laparoscopic radical gastrectomy for gastric cancer in preventing duodenal stump leakage. Methods: A descriptive cohort study was conducted to retrospectively collect clinical data of 211 patients with gastric adenocarcinoma who underwent laparoscopic radical gastrectomy with Roux-en-Y or Billroth Ⅱ reconstruction and reinforcement on duodenal stump using laparoscopic single purse-string suture in Zhongshan Hospital of Fudan University between January 2013 and December 2016. Of 211 patients, 136 were male and 75 were female with mean age of (57.5±11.1)(24 to 87) years. Tumors locating at gastric upper 1/3, middle 1/3 and low 1/3 were found in 62, 68 and 81 patients respectively. Eighty-three cases underwent total gastrectomy, 128 underwent distal subtotal gastrectomy, 107 underwent Roux-en-Y reconstruction and 104 underwent Billroth II reconstruction. The procedure of reinforcement on duodenal stump using single purse-string suture during laparoscopic radical gastrectomy was as follows: (1) after cutting the duodenal stump to about 2.0 cm in length, use a 3-0 single-strand absorbable suture to make a muscle layer purse at a distance of 1.0 to 1.5 cm from the duodenal stump; (2) use the purse line to make a slipknot; (3) push the duodenum stump into the purse with a needle holder or grasper; (4) tighten the knot of the purse string, and then make 4 to 5 knots for reinforcement. Postoperative complications were defined and graded according to the Clavien-Dindo grading criteria, and the incidence of early complications was recorded. Clinicopathologic features and postoperative outcomes were analyzed. Results: All patients completed operations successfully. The mean time of laparoscopic single purse-string suture was (5.1±1.6) (3.6 to 10.2) minutes. Postoperative early complication occurred in 31 cases (14.7%), of whom 27 cases developed surgery-related complications (12.8%), including 7 cases (3.3%) of peritoneal infection, 6 (2.8%) of pancreatic leakage, 4 (1.9%) of wound infection, 4 (1.9%) of gastroplegia, 2 (0.9%) of peritoneal hemorrhage, 2 (0.9%) of intestinal obstruction, 2 (0.9%) of lymphatic leakage, and no duodenal stump leakage; while 4 cases (1.9%) developed internal non-surgical complication, including 3 cases (1.4%) of pulmonary infection and 1 (0.5%) of cardiovascular event. The patient with peritoneal hemorrhage was healed after re-operation and all other patients were discharged uneventfully after conservative treatment. Four cases (1.9%) developed complications beyond grade III a of Clavien-Dindo criteria. Conclusion Reinforcement on duodenal stump using laparoscopic single purse-string suture during laparoscopic radical gastrectomy with Roux-en-Y or Billroth II reconstruction is simple and effective, and can prevent the risk of development of duodenal stump leakage.