Objective To understand the prevalence and sub‐genotypes distribution situation of high risk human papillomavirus (HPV) infection in the gynecological outpatient department in Beijing area in order to provide the reference basis for the prevention and treatment of HPV infection and cervical cancer .Methods The detection results of 13 kinds of high risk HPV genotypes among 1 294 women in the gynecological outpatient department of this hospital from January 2013 to May 2014 were performed the retro‐spective analysis for comparing the epidemiological characteristics of different HPV genotypes .The SPSS17 .0 software was adopted to perform the statistical analysis .Results Among 1 294 detected women ,HPV‐58 ,HPV‐16 and HPV‐52 were most common ,the detection rates were 10 .5% ,9 .2% and 8 .2% respectively .Among various age groups ,the 30 - < 40 years group had the highest HPV detection rate(39 .9% ) ,followed by the 40 - < 50 years group and the ≥ 60 years group ,but the difference among them had no statistically significance (P> 0 .05) .Conclusion The women going to the local outpatient department have the higher prevalence of high risk HPV infection .The intensity of HPV screening should be strengthened in order to provide the fundamental basis for the prevention and treatment of HPV related diseases .

Objective To investigate the clinical significance and the content of soluble P selection in the patients with ischemic cerebrovascular disease(ICVD)Methods Using the means of an enzyme linked immunosorbent assay,the contents of soluble P selectin (sP selection) were measured in 28 patients with ICVD,45 patients with stroke and 33 health persons.We observed its content changes form atherosclerosis to different stages of ICVD,and the effect of M ASA.Results sP selection in different stages of ICVD group was higher than in the patients with atherosclerosis( P

Objective To explore the effect of tetramethylpyrazine (TMP) on serum cytokines and cardiac function in patients with sepsis myocardial injury.Methods Fifty patients with sepsis myocardial injury were admitted in Hangzhou First People's Hospital from June 2015 to September 2016,and according to the computer generated random number,they were divided into conventional treatment group and TMP treatment group,25 cases in each group.The patients in the conventional treatment group were treated with antimicrobial agents,vasoactive drugs,fluid resuscitation and organ function support,etc.;TMP treatment group was treated with traditional Chinese medicine (TCM) TMP on the basis of routine treatment.TMP 120 mg was added to 250 mL normal saline (NS) for intravenous drip once a day for a therapeutic course of 10 days.Plasma N-terminal pro-B type natriuretic peptidec (NT-proBNP) and serum tmnor necrosis factor-oα (TNF-α) levels were measured before treatment and on 1,5 and 10 days after treatment.Left ventricular internal systolic dimension (LVIDs),fractional shortening (FS) and left ventricular ejection fraction (LVEF) were measured by cardiac ultrasound,3 cardiac cycles were measured and the average results were taken.The intensive care unit (ICU) hospital stay and mortality were calculated in the two groups.Results The levels of NT-proBNP and TNF-α in the two groups after treatment were lower than those before treatment,the differences in the levels were statistically significant between those before treatment and 5 days after treatment in the conventional treatment group [NT-proBNP (ng/L):334.25 ± 36.46 vs.577.72 ± 60.34,TNF-α (ng/L):388.48 ± 43.38 vs.507.74-± 31.63,both P ＜ 0.05],and in TMP treatment group,the levels from 1 day after treatment compared with those before treatment,there were statistical significant differences [NT-proBNP (ng/L):387.44 ± 36.39 vs.571.67-± 56.34,TNF-α(ng/L):403.79 ± 23.20 vs.505.82 ± 31.31,both P ＜ 0.05];the degrees of decrease in TMP treatment group were more obvious than those in conventional treatment group (all P ＜ 0.01).After treatment in the two groups,the LVIDs was decreased gradually,FS and LVEF were increased gradually,reaching the lowest or highest level on 10 days after treatment,and the changes of TMP treatment group were more significant than those in the conventional treatment group,LVIDs and LVEF of the two groups showed statistically significant differences on 5 days after treatment [LVIDs (mm):43.23 ± 5.57vs.48.21 ± 2.29,LVEF:0.47 ± 0.02 vs.0.41 ± 0.02,both P ＜ 0.05],FS on 1 day after treatment showed a statistically significant difference [FS:(23.92 ± 1.81)％ vs.(22.84 ± 1.79)％,P ＜ 0.05].The ICU stay in the TMP group was shorter than that in the conventional treatment group (days:13.16 ± 2.67 vs.16.48-± 3.08,P ＜ 0.05),and the mortality was lower than that of conventional treatment group [20％ (5/25) vs.36％ (9/25)],the difference being not statistically significant (P ＞ 0.05).Conclusions In septic myocardial injury,TNF-α plays an important role;after TMP treatment in patients with myocardial injury caused by viral myocarditis,the serum TNF-α level is decreased showing it has antagonizing TNF-α activity,thus it has protective effect on sepsis myocarditis,improves heart function and the disease prognosis.

Objective Toexplorethecorrelationbetween MRIcharacteristicsandaxillarylymphnode metastasisofmass-type breastcancer.Methods MRIcharacteristicsandpathologicalresultsofpostoperativeaxillarylymphnode metastasisin187cases withmass-typebreastcancerwereanalyzedretrospectively.Accordingtothenumberoflymphnodemetastases,allofthepatients weredividedintothefourgroups:pN0,pN1,pN2andpN3.Thecorrelationbetween MRIsignsand N pathologicalstagesineach groupwereanalyzed.Results Therewere108casesinpN0group,33casesinpN1group,22casesinpN2groupand24casesinpN3 groupI.nthedifferentgroups,therewere15,5,1and1casewithroundmassrespectively;8,1,1and0casewithlobularmasserespectively;85, 27,20and23caseswithirregularmasserespectively.Theshapeswerenotsignificantlydifferentamongthedifferentgroups(P>0.05)I.nthe differentgroups,therewere7,0,1and0casewithclearmarginrespectively;69,14,7and8caseswithirregularmarginrespectively;32,19,14and16caseswithspiculatedmarginrespectively.Themarginsweresignificantlydifferentamongthedifferentgroups(P<0.05)I.nthe differentgroups,therewere55,16,14and18caseswithheterogenousenhancementrespectively;43,14,5and6caseswithringenhancement respectively;3,1,1and0casewithcentralenhancementrespectively;7,2,2and0casewithseptumenhancement.Theenhancement patternswerenotsignificantlydifferentamongthedifferentgroups (P>0.05).ThenumbersofthemasswithtypeⅠ,ⅡandⅢtime-signalcurvesandtheADCvalueswerenotsignificantlydifferentamongthedifferentgroups(P>0.05).Conclusion MRIfeaturesof mass-typebreastcancershavelimitedvalueindeterminingaxillarylymphnodemetastasis.However,thespiculatedmarginofmassis valuableindeterminingaxillarylymphnodemetastasis.

ObjectiveTo establish rabbit knee joint cartilage injury models to evaluate effects of the type Ⅱ collagen sponge in repair of the articular cartilage.MethodsThe type Ⅱ collagen sponge was prepared according to previous method and the pore size of the sponges was measured based on the collagen autofluorescence characteristics.The type Ⅱ collagen sponge was transplanted into the injury lesions of the animal model for experimental study.The regeneration of the cartilage defects was observed by using MRI, histologic HE staining, Safranin O, sirius red polarized light staining, areas determination of the newly grown cartilage and immunohistochemistry of type Ⅱ collagen.ResultsAutofluorescent images of confocal microscope layer scanning showed that the pore size was (93.26 + 38.40) μm in diameter, suitable for chondrocyte growth.Comparison between MRI and H&E staining results showed quicker effusion absorption in the treatment groups than that in the control group, while the level of inflammatory response in the treatment group was lower than that in the control group.The sporadic cartilage signals first appeared at the 6th week.The newly formed cartilage with the expression of glycosaminoglycan and type Ⅱ collagen matrix was confirmed by Safranin O staining and immunohistochemical analysis.The sirius red polarized light staining showed that areas of the newly formed cartilage were significantly larger in the treatment group than that in the control group (P ＜ 0.01).Conclusion The type Ⅱ collagen sponge developed from purification can effectively repair the damaged cartilage tissues of the rabbit knee joints, as has been verified either by MRI or histology.

Background:Esophagogastric variceal bleeding is a severe and commonly seen complication of portal hypertension in patients with liver cirrhosis. Prevention of rebleeding remains an important issue in the management of patients suffered from the disease. Aims:To evaluate the efficacy and safety of percutaneous transhepatic variceal embolization(PTVE) combined with partial splenic embolization(PSE)for treatment of esophagogastric variceal bleeding in patients with liver cirrhosis. Methods:Ten liver cirrhosis patients with esophagogastric variceal bleeding were prospectively selected and treated by PTVE combined with PSE. The blood flow of portal system was measured by Doppler ultrasonography pre- and post-operatively;meanwhile peripheral blood cells were counted. A 1-2-year follow-up was carried out and the rebleeding and procedure-related complications were recorded. Results:The postoperative inner diameter of main portal vein,as well as the blood flow velocity of main portal vein and splenic vein were significantly reduced as compared with those before operation(P < 0. 05). Three months after operation,the peripheral white blood cell and platelet were still significantly higher than those before operation(P < 0. 05). During 1-year follow-up,rebleeding appeared in 2 patients,one of them was found having main portal vein thrombosis developed,and was treated by endoscopic esophageal variceal ligation because the gastric varices was not as evident as ever. The rebleeding rate and incidence of portal system thrombosis after the PTVE-PSE procedure was 20. 0% and 10. 0%,respectively. Conclusions:PTVE combined with PSE seemed efficient for alleviating portal hypertension,and might be recommended as a safe and effective interventional therapy for liver cirrhosis patients with esophagogastric variceal bleeding.

Objective To investigate the influence of preoperative splenectomy on the prognosis after liver transplantation.Methods The retrospective cohort study was conducted.The clinical data of 95 patients who underwent liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University between January 2004 and January 2014 were collected.Thirty-five patients undergoing preoperative splenectomy and pericardial devascularization and 60 undergoing spleen-preserving liver transplantation were allocated into the study group and control group,respectively.All patients received modified piggyback liver transplantation by the same team.Observation indicators:(1) intra-and post-operative situations;(2) follow-up and survival.The follow-up using telephone interview and outpatient examination was performed once every a week within 3 months postoperatively,once every one month within 6 months postoperatively and once every 3 months after 1 year postoperatively up to January 2016,including routine blood test,plasma-drug concentration of immunosuppressive agent and function of liver and kidney.Ultrasound and abdominal CT were used to monitor the long-term complication and survival.The measurement data with normal distribution were represented as (x)±s,and comparison between groups was done by the t test.Comparison of count data was done by the chi-square test.Results (1) Intra-and post-operative situations:all patients underwent successful liver transplantation.The operation time,volumes of intraoperative blood loss and blood transfusion were (483 ± 136) minutes,(5 683±2 950) mL,(4 887±3 682) mL in the study group and (392± 103)minutes,(3 522± 1 885)mL,(3 455±2 630)mL in the control group,respectively,with statistically significant differences between groups (t=3.683,4.358,2.202,P＜0.05).Six patients in the study group had intraoperative portal vein thrombosis (PVT),including 4 in level 1,1 in level 2 and 1 in level 3,and no patients in the control group,showing a statistically significant difference between groups (x2 =1.979,P＜0.05).Five patients with PVT in level 1 or 2 underwent thrombectomy and then end-to-end anastomosis of PV.One patient with PVT in level 1 had PVT recurrence and was cured by postoperative thrombolytic therapy.One patient with PVT in level 3 received PV reconstruction using artificial blood vessels,and had PVT recurrence and then was cured.There was no PV stenosis between groups.The levels of platelet at 1,3 and 7 days postoperatively were (75±60)× 109/L,(71± 45)×109/L,(111±73)×109/L in the study group and (57±32) ×109/L,(52±46) ×109/L,(87±53)×109/L in the control group,respectively,with statistically significant difference between groups (t =1.909,1.957,1.848,P＜ 0.05).The levels of platelet at 14 and 30 days postoperatively were respectively (230± 152)× 109/L,(310± 140)× 109/L in the study group and (193± 125)× 109/L,(286±62)× 109/L in the control group,with no statistically significant difference between groups (t=1.284,1.199,P＞0.05).The cases with postoperative infection,acute rejection,new-onset PVT in level 1-2 and 3-4 and PV stenosis were respectively 23,0,2,0,2 in the study group and 35,1,2,0,1 in the control group,with no statistically significant difference between groups (x2 =1.171,0.590,0.547,1.184,P＞0.05).Patients with postoperative infection and acute rejection were improved by symptomatic treatment.Two patients in the study group with PVT underwent anticoagulant and thrombolytic therapy,including 1 receiving interventional thrombectomy therapy.Two patients in the control group with new-onset PVT were cured by anticoagulant and thrombolytic therapy.Three patients with PV stenosis underwent percutaneous transhepatic portography (PTA) for balloon dilation,including 1 in the study group with good improvement after stent implantation.(2) Follow-up and survival:95 patients were followed up for 3-24 months,with an average time of 18 months.During the follow-up,the rate of chronic rejection in study and control groups was 5.7％(2/35) and 5.0％(3/60),showing no statistically significant difference between groups (x2 =0.023,P＞0.05).The 1-and 2-year accumulative survival rates were respectively 91.4％ (32/35),82.9％ (29/35) in the study group and 93.3％ (56/60),76.7％(46/60) in the control group,with no statistically significant difference between groups (x2 =0.780,P＞0.05).Conclusion The splenectomy before liver transplantation is easy to form PVT,increase time and difficulty of transplantation surgery,however,it doesn't increase complication risk after transplantation and affect postoperative survival.

Objective:To establish the norm of clinical nursing teachers' competency in tertiary first-class hospitals in northwest China.Methods:From August 2019 to February 2020, 1 077 clinical nursing teachers were selected from 12 tertiary first-class hospitals in northwest China by stratified, random and proportional sampling, and were investigated with the Clinical Nursing Teacher Competency Evaluation Scale. Descriptive statistics were carried out on the sample data, and univariate variance analysis and pairwise comparison were carried out on the multi-classification variables of age, nursing age, professional title, teaching years and the number of teachers per year. The verified data were exported to SPSS 26.0 for statistical analysis, variance analysis was used for multi-group comparison, and LSD test was used for pairwise comparison between groups.Results:①The corresponding mean norm was established by grouping the total score and the first-class index; the percentile norm was made with 5% spacing; P10, P30, P70 and P90 were selected as the grading demarcation points, and the demarcation norm was constructed. ②Factor analysis showed that there were statistical differences in personality characteristics among different ages, nursing ages and professional titles ( P<0.05), and also in professional attitudes among different nursing ages and professional titles ( P<0.05). Conclusion:The establishment of norm provides references for individuals or units to evaluate teachers' competence.

Objective:To investigate the application of local rotation flap with subcutaneous pedicle for breast conservation in central breast cancer.Methods:Retrospective analysis of clinical data of 14 patients with stage Ⅰor Ⅱ central breast cancer was performed. The local rotation flap with subcutaneous pedicle was used for breast conservation in Jiangxi Provincial Breast Specialist Hospital (Nanchang Third Hospital) from January 2017 to December 2018. The postoperative complications were recorded. One year after operation, the aesthetic result, satisfactory and comfort index were evaluated. Two years after operation, local tumor recurrence and metastasis were followed.Results:All patients were women, aged 37-75 years old with the median age as 47. First-stage healing was achieved in 12 patients. Wound infection happened in one case and necrotic in one case. They were all healed after secondary suture. Fourteen patients were followed up for 1 year, the suprasternal notch-nipple length was (22.27±2.38) cm at the operative side, and (23.33±2.22) cm at the healthy side, showing no statistical significance ( t=-1.253, P=0.242). The nipple-midsternal line length was(10.12±0.91) cm at the operative side, and (10.68±1.09) cm at the healthy side, showing no statistical significance ( t=-1.937, P=0.094). The nipple-inframammary fold length was (6.94±0.95) cm at the operative side, and (7.05±1.30) cm at the healthy side, showing no statistical significance ( t=-0.478, P=0.645). The patient’s breast satisfaction was 60.2±11.4 points before operation and 61.7±12.7 points after operation, with no difference between them ( t=-0.330, P=0.744). The overall postoperative comfort index was 62.05±4.40 points, which indicates a moderate comfort state. The physiological comfort index was 6.52±2.05 points, the mental and psychological comfort index was 15.13±2.56 points, the social comfort index was 19.09±1.57 points, and the environmental comfort index was 21.29±2.11 points. There was no local recurrence and no systemic metastasis 2 years after operation. Conclusions:The breast conservation in central breast cancer with local rotation flap with subcutaneous pedicle is less invasive with few complication and satisfactory results in cosmetic appearance. The moderate comfort index and good prognosis can be prospected.

Objective:To investigate the application of local rotation flap with subcutaneous pedicle for breast conservation in central breast cancer.Methods:Retrospective analysis of clinical data of 14 patients with stage Ⅰor Ⅱ central breast cancer was performed. The local rotation flap with subcutaneous pedicle was used for breast conservation in Jiangxi Provincial Breast Specialist Hospital (Nanchang Third Hospital) from January 2017 to December 2018. The postoperative complications were recorded. One year after operation, the aesthetic result, satisfactory and comfort index were evaluated. Two years after operation, local tumor recurrence and metastasis were followed.Results:All patients were women, aged 37-75 years old with the median age as 47. First-stage healing was achieved in 12 patients. Wound infection happened in one case and necrotic in one case. They were all healed after secondary suture. Fourteen patients were followed up for 1 year, the suprasternal notch-nipple length was (22.27±2.38) cm at the operative side, and (23.33±2.22) cm at the healthy side, showing no statistical significance ( t=-1.253, P=0.242). The nipple-midsternal line length was(10.12±0.91) cm at the operative side, and (10.68±1.09) cm at the healthy side, showing no statistical significance ( t=-1.937, P=0.094). The nipple-inframammary fold length was (6.94±0.95) cm at the operative side, and (7.05±1.30) cm at the healthy side, showing no statistical significance ( t=-0.478, P=0.645). The patient’s breast satisfaction was 60.2±11.4 points before operation and 61.7±12.7 points after operation, with no difference between them ( t=-0.330, P=0.744). The overall postoperative comfort index was 62.05±4.40 points, which indicates a moderate comfort state. The physiological comfort index was 6.52±2.05 points, the mental and psychological comfort index was 15.13±2.56 points, the social comfort index was 19.09±1.57 points, and the environmental comfort index was 21.29±2.11 points. There was no local recurrence and no systemic metastasis 2 years after operation. Conclusions:The breast conservation in central breast cancer with local rotation flap with subcutaneous pedicle is less invasive with few complication and satisfactory results in cosmetic appearance. The moderate comfort index and good prognosis can be prospected.