Objective To analyze the expression of programmed death ligand 1 (PD-L1),p16 proteins and DNA topoisomerase Ⅱ α (TOPO Ⅱ α) in cervical cancer and their clinical significances.Methods A total of 181 paraffin-embedded operating specimens and the biopsy including 106 cervical squamous cell carcinoma,30 high grade cervical intraepithelial neoplasia (CIN),30 low grade CIN and 33 normal cervical were selected from January 2014 to December 2015.An immunohistochemical EnVision method was used to detect the expression of PD-L1,p16 and TOPO Ⅱ α.Results The positive rate of PD-L1 expression in cervical squamous cell carcinoma was 66.0 ％ (70/106),but it was not expressed in high grade CIN,low grade CIN and normal cervical tissues,the differences were statistically significant (all P =0.000).Whereas,in squamous cell carcinoma,the positive rate of PD-L1 in poor differentiation group [77.3 ％ (51/66)] was higher than that in middle or high differentiation group [56.5 ％ (21/40)],and the difference was statistically significant (x2 =7.02,P =0.01).According to the FIGO stage,the positive rate in stage Ⅰ-Ⅱ group [54.9 ％ (28/51)] was lower than that in stage Ⅲ-Ⅳ group [76.4 ％ (42/55)],and the difference was statistically significant (x2 =5.47,P =0.02).But there was no statistical significance in lesion size or lymph node metastasis (both P ＞ 0.05).The positive rate of p16 in cervical squamous cell carcinoma was 99.1％ (105/ 106),in high grade CIN was 86.7 ％ (26/30),in low grade CIN was 26.7 ％ (8/30),and no expression in normal cervical tissues,the differences were statistically significant (all P ＜ 0.001).The expression of p16 had no relationship with histological differentiation,FIGO stage,lesion size,and lymph node metastasis (all P ＞ 0.05).The positive expression rate of TOPO Ⅱ α in cervical squamous cell carcinoma was 97.2 ％ (103/106),compared with that in high grade CIN [73.3 ％ (22/30)],low grade CIN [66.7 ％ (20/30)],and normal cervical tissues (no expression),the differences were statistically significant (all P =0.000).But there was nosignificant difference in the positive expression rate of TOPOⅡ α between high grade and low grade CIN (x2 =0.32,P =0.570).The expression of TOPO 1Ⅱ α had no relationship with histological differentiation,FIGO stage,lesion size and lymph node metastasis (all P ＞ 0.05).Conclusion The expression of PD-L1,p16 and TOPO Ⅱ α is associated with the invasion of cervical cancer.PD-L1 may be an immune checkpoint for the treatment of patients with invasive cervical cancer.

Congresses as Topic ; Humans ; Thyroid Neoplasms ; surgery

Objective To investigate the disease occurrence-related factors and severity of alcoholic hepatitis (AH) and alcoholic liver cirrhosis (ALC).Methods According to the clinical diagnostic criteria that were passed by the 2010 Chinese Society of Fatty Liver Hepatology and alcoholic liver disease study group,the clinical data of 241 AH and ALC patients were analyzed.Results The amount of liquor taken daily,the time limit of drinking,and total amount of liquor taken in ALC patients were significantly different from those in AH patients (P ＜0.01),respectively.In ALC patients,the proportion (48.39％)of workers,peasants,and unemployed low-income alcoholics was significantly higher than that (25.58％)in AH patients (P ＜0.01).Laboratory tests showed the AST/ALT ratio in the ALC group (2.63 ±4.74)was significantly higher than that in the AH group (1.01 ±0.52) (P ＜0.01); TG [(1.33±1.24)mmol/L] and cholesterol (CHOL) [(3.14 ± 1.25) mmol/L] in ALC group were significantly lower than TG [(2.29 ± 1.60)mmol/L] and CHOL [(4.27 ±0.79)mmol/L] in the AH group (P ＜0.01).Conclusions Alcoholic liver disease occurrence and severity were related to the amount of liquor taken,the time limit of drinking,and the work ; AST/ALT ratio,TG and CHOL values were consistent with the severity of alcoholic liver disease.

Objective To explore the value of serum procalcitonin detection in judging whether severe patients complicate with infection.Methods 188 patients in the intensive care unit (ICU)were collected and divided into the infection and non-infection groups.The serum procalcitonin(PCT),C-reactive protein(CRP),total number of white blood cells(WBC)and neutrophile cell ratio were simultaneously monitored;41 cases in the infection group dynamically monitored PCT and related indicators for continuous 1-6 d and the statistical analysis was conducted.Results The age,PCT and CRP had statistically significant differences between the infection group(112 cases)and non-infection group(76 cases).Except the correlation of PCT and CRP in the infection group showing statistical significance,the comparison of the other indicators had no statistical differences.In the infectors,the PCT value comparison between on 1 d and 2 d in the hospital discharge group(32 cases)and the death group (9 cases)showed P >0.05,the PCT value comparison between on 3-6 d showed P <0.05.Conclusion Serum PCT is an effective indicator to judge whether se-vere infected patient has infection and is significantly superior to the traditional inflammatory indicators.Dynamically monitoring the PCT level in the critical patients has a certain value to judge the control situation of infection.

Objective To evaluate the optimal dosage of misoprostol administered in the rectum for dilation of the cervix. Methods Two hundred and forty women at 40-60 day gestational age without vaginal delivery history were randomly divided into three groups,with 80 cases in each group. Patients received 200,400 or 600μg of misoprostol rectally one hour before electrical vacuum abortions in group A,B and C,respectively. Cervical dilation,blood loss,and drug side effects in the three groups were compared. Venous blood samples were taken before vein anesthesia,and misoprostol acid concentration in the serum was tested by liquid chromatography-mass spectrometry. Results The analgesic rate was 100. 00%in all three dose groups, and cervical dilation rate was 23. 75%,46. 25%and 70. 00%in groups A,B and C,respectively. The severity of drug side effects such as vaginal bleeding and abdominal pain is dose-dependent. Blood concentration of misoprostal acid was(117±65),(206± 98),and(303±149)pg·mL-1 ,in groups A,B and C,respectively. Conclusion The recommended dose of misoprostol is 400 μg administered in rectum. Rectal administration of misoprostol is cheap,safe,and convenient,and therefore could be widely applied.

Objective To study the relationships of fatty liver with the waist to hip ratio (WHR),obesity,blood glucose,blood lipid,so as to guide clinical treatment.Methods A total of 5827 persons who underwent the following examination,including liver function,kidney function,blood lipids,blood glucose,and ultrasound imaging examination were divided into fatty liver suffering group and non-fatty liver suffering group.Results The incidences of WHR,diabetes,hyperlipidemia,and hyperuricemia in the fatty liver suffering group were significantly higher than those in the non-fatty liver suffers group(t =24.6,13.2,21.9,19.6,10.3,P ＜ 0.01).The incidence (44.3％) of fatty liver in males was significantly higher than that (31％) in females (x2 =33.6,P ＜ 0.01).Conclusions There was obvious correction between fatty liver and abdominal obesity.Patients with fatty liver should be given early prevention in order to prevent from the occurrence of cardiovascular events and metabolic syndrome.

Objective To evaluate the effect of neoadjuvant chemotherapy by different arteriovenous ways on ovarian function of patients with locally advanced cervical cancer after surgery. Methods We retrospectively studied 38 cases of young women (surgical age <45 years) who were diagnosed with locally advanced squamous cell carcinoma of the cervix and undergone radical hysterectomy with ovaries. According to the way of adjuvant chemotherapy, these cases were divided into 20 cases of group A (arterial embolization chemotherapy), 18 cases of group B (intravenous chemotherapy). Each patient underwent a course of chemotherapy. Then we retrospectively analyzed and compared serum estradiol (E2 ), follicle stimulating hormone (FSH), lute-inizing hormone (LH) in two groups before and after surgery to assess ovarian function. We compared E2 ,FSH and LH levels 2-3 weeks after chemotherapy (before surgery) and 1 month after surgery,and 6 months after surgery in two groups. Results The E2 levels in group A 1 month before and after surgery significantly decreased, while FSH increased compared with those be-fore chemotherapy(P<0. 05). LH levels in two groups at different time points and 6 months after surgery showed no significant difference (P>0. 05) compared with those before chemotherapy. the E2 , FSH and LH levels in group B at different time points presented no significant difference (P>0. 05). Only E2 level in group A was significantly lower than that in group B before surger-y. Conclusion For patients with locally advanced cervical cancer, the effect of arterial embolization chemotherapy before sur-gical intervention on ovarian function is transient and reversible, while intravenous chemotherapy before surgery exerts few effects on ovarian function. Retaining ovaries in radical hysterectomy is a safe and effective method to protect the endocrine function for young patients with locally advanced cervical cancer.

Objective To improve the descriptions of health information network resources by analyzing the influen-cing factors of information retrieval.Methods The top 10 papers retrieved on 12 Websites in Chinese and English engines according their titles, keywords and descriptions in the HEAD file of HTML source code with 5 biomedical hot words as the search terms were comparatively analyzed and scored.Results The score of Websites in Chinese and English engines was higher than that of medical and health information network, the score of Chinese network information resources was higher than that of English network information resources .Conclusion The current de-scription of network health information resources is poor .Only by strengthening health information network con-struction and improving the description of health information resources , can more accurate health information be provided for the users.

Objective To explore the experience of self-perceived burden in patients with chronic obstructive pulmonary disease (COPD) and provide evidence for clinical nursing interventions.Methods Indepth interviews were conducted among 17 patients with COPD using phenomenological method of qualitative research.Data were analyzed with the Colaizzi's method.Results 3 themes was identified:self-accusation and guilt,loss of dignity and powerlessness,concern and insecurity.Conclusions Nurses should take the experience of SPB in patients with COPD seriously and take the influence of SPB into account during the process of nursing interventions and evaluation.

Objective To analyse the suspected hereditary non-polyposis colorectal cancer (HNPCC) in mismatch repair protein (MMR) expression of hMLH1 and hMSH2. Methods Immunohistochemical staining method was used for the detection of hMLH1 and hMSH2 protein expression in 193 cases suspected HNPCC patients, the deletion of MMR proteins was identified as highly suspected HNPCC cases. Results Of the 193 patients with suspected HNPCC hMLH1/hMSH2 abnormal expression rate was 29.02%; ≤30 years old was 40%, 31 ~ 40 years old was 28.05%, 41 ~ 50 years old was 28.71%,3 suspected HNPCC showed the deletion of hMLH1/hMSH2 protein expression at the same time ,; In the right colon , the left half colon and rectal anomaly detection rates were 40.74%, 32.65%and 18.89%; hMLH1/hMSH2 deletion was 46.15%with family history. Conclusions The deletion of MMR protein is closely related to age,site and family history in suspected HNPCC, and the deletion of hMLH1 is an important factor to induce early-set colorectal cancer. The deletion of hMLH1/hMSH2 at the same time indicates that hMLH1/hMSH2 genes may play important role in the incidence of HNPCC.