1.Analysis of HPV Infection Characteristics and Influencing Factors for Lesion Grade in Patients with Cervical Squamous Intraepithelial Lesion and Cervical Cancer
Jingjing HAN ; Lijie ZHANG ; Ruyu CAI ; Haili LI ; He WANG ; Le DANG ; Hongda CHEN ; Ming'e LI ; Lan ZHU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):156-165
To summarize the distribution characteristics of human papillomavirus(HPV) infection types in patients with cervical squamous intraepithelial lesion(SIL) and cervical cancer(CC), and to explore the impact of HPV vaccination, HPV infection types, and general clinical data on different grades of cervical lesions. Clinical data of women attending the gynecological colposcopy clinic of Shenzhen People's Hospital from January 2020 to December 2023 were retrospectively collected. Patients with HPV genotyping records and histopathologically diagnosed SIL or CC were included and divided into three groups based on pathological results: low-grade squamous intraepithelial lesion(LSIL) group, high-grade squamous intraepithelial lesion(HSIL) group, and CC group. The distribution of high-risk HPV subtypes was analyzed among the three groups, and multivariate Logistic regression was used to identify influencing factors for high-grade cervical lesions. A total of 4162 patients were included, comprising 4057 cervical SIL patients(3317 LSIL and 740 HSIL) and 105 CC patients. The overall mean age was(39.9±11.2) years. The HPV infection rate was 95.1%(3959/4162), and 25.0%(1040/4162) of patients had received HPV vaccination. Among high-risk HPV infections, HPV 52, HPV 16, HPV 58, and HPV 18 were the most common subtypes. HPV 52 had the highest infection rate in the LSIL group(27.6%), while HPV 16 was the most prevalent in the HSIL group(45.3%) and CC group(64.9%). Multivariate Logistic regression analysis showed that HPV vaccination( HPV infection is common in patients with SIL and CC, but the distribution of high-risk HPV subtypes varies among different grades of cervical lesions. It is recommended to strengthen cervical cancer screening and monitoring of key high-risk HPV infections in older and multiparous women in Shenzhen, and to continue promoting HPV vaccination.
2.Age, Comorbidities, and Outcomes following Hip Arthroplasty: A Retrospective Cohort Study from Vietnam
Dao Thi Ngoc NGUYEN ; Vu Ton Ngoc PHAN ; Huy Mach Thai TRAN ; Hung Quoc HA ; Hieu Minh DANG ; Phat Thanh TRAN ; Sang Thanh NGUYEN ; Phuc Tan Nguyen LE
Annals of Geriatric Medicine and Research 2026;30(2):217-227
Background:
While advanced age is a known risk factor for postoperative complications following hip arthroplasty, its role as an independent predictor versus a surrogate for comorbidity remains unclear, particularly in developing countries. This study aimed to investigate the independent impact of age on postoperative outcomes and explore the mediating role of key comorbidities in a resource-limited setting.
Methods:
We retrospectively reviewed 769 adult patients undergoing hip arthroplasty at a Vietnamese tertiary hospital (2021–2024), categorized into three groups: younger adults (18–64 years), older adults (65–79 years), and oldest old (≥80 years). The primary outcome was a composite of major postoperative complications. Multivariable logistic regression and structural equation modeling were used to identify independent predictors and assess mediation effects.
Results:
Among 769 patients, 363 were younger (47.2%), 241 older adults (31.3%), and 165 oldest old (21.5%). Complication rates increased significantly with age (18.7%, 36.9%, and 60.0%, respectively; p<0.001). However, multivariable adjustment showed that age was not an independent predictor. Instead, heart failure (adjusted odds ratio [aOR]=5.49, 95% confidence interval [CI] 2.19–13.74) and preoperative anemia (aOR=1.77, 95% CI 1.21– 2.59) were identified as independent risk factors. Mediation analysis revealed that the effect of age on complications was significantly mediated through preoperative anemia.
Conclusion
Increased postoperative risk in older adults is driven by comorbidity burden rather than chronological age. Preoperative anemia and heart failure are critical, independent predictors, with anemia acting as a key mediator for the effects of age. Individualized correction of modifiable comorbidities may be more beneficial than using age alone to assess surgical risk.
3.Low-air-pressure clean room system: A flexible, high-quality model for assisted reproduction laboratories
Minh Tam LE ; Trung Van NGUYEN ; Thai Thanh Thi NGUYEN ; Hong Nhan Thi DANG ; Quoc Huy Vu NGUYEN
Clinical and Experimental Reproductive Medicine 2025;52(1):56-64
Objective:
This study aimed to develop a configurable clean room paradigm with low air pressure for assisted reproductive technology (ART) clinics and demonstrate the concept’s efficacy using in vitro fertilization (IVF) treatment.
Methods:
A high-standard clean room system with positive pressure (13 Pa) was built using accessible materials and equipment for ART laboratories. Methods for controlling and evaluating the clean room’s characteristics were developed and implemented for quality assessment and calibration to maximize efficiency. The feasibility of the flexible clean room concept was assessed by analyzing the key performance indicators of embryo culture and IVF treatment.
Results:
After 3 weeks of testing, the concentration of particles ≥0.5 μm was 6.04 times lower than the International Organization for Standardization (ISO) class 5 standard (3,520 particles/m3) in the IVF laboratory. Air pressure, noise, temperature, and humidity were controlled stably and appropriately. Five days after installation and handover, the volatile organic compound concentration dropped to 0.00 ppm. With blastocysts and a respectable blastocyst rate, embryonic culture with female patients younger than 40 matched the criteria (63.5% and 38.9%, respectively). After vitrified blastocysts were transferred, the pregnancy and implantation rates were 58.5% and 36.2%, respectively, demonstrating a high degree of treatment success.
Conclusion
Our customizable, high-quality, low-air-pressure clean room model can be implemented to achieve positive outcomes for infertility treatment.
4.Application of the modified computed tomography severity index and retroperitoneal extension classification for evaluation of acute pancreatitis
Cam Nhung DANG ; Anh Tuan NGUYEN ; Thanh Thao NGUYEN ; Trong Binh LE
International Journal of Gastrointestinal Intervention 2025;14(2):51-56
Background:
This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients.
Methods:
Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded.
Results:
The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%).
Conclusion
In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.
5.Application of the modified computed tomography severity index and retroperitoneal extension classification for evaluation of acute pancreatitis
Cam Nhung DANG ; Anh Tuan NGUYEN ; Thanh Thao NGUYEN ; Trong Binh LE
International Journal of Gastrointestinal Intervention 2025;14(2):51-56
Background:
This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients.
Methods:
Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded.
Results:
The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%).
Conclusion
In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.
6.Low-air-pressure clean room system: A flexible, high-quality model for assisted reproduction laboratories
Minh Tam LE ; Trung Van NGUYEN ; Thai Thanh Thi NGUYEN ; Hong Nhan Thi DANG ; Quoc Huy Vu NGUYEN
Clinical and Experimental Reproductive Medicine 2025;52(1):56-64
Objective:
This study aimed to develop a configurable clean room paradigm with low air pressure for assisted reproductive technology (ART) clinics and demonstrate the concept’s efficacy using in vitro fertilization (IVF) treatment.
Methods:
A high-standard clean room system with positive pressure (13 Pa) was built using accessible materials and equipment for ART laboratories. Methods for controlling and evaluating the clean room’s characteristics were developed and implemented for quality assessment and calibration to maximize efficiency. The feasibility of the flexible clean room concept was assessed by analyzing the key performance indicators of embryo culture and IVF treatment.
Results:
After 3 weeks of testing, the concentration of particles ≥0.5 μm was 6.04 times lower than the International Organization for Standardization (ISO) class 5 standard (3,520 particles/m3) in the IVF laboratory. Air pressure, noise, temperature, and humidity were controlled stably and appropriately. Five days after installation and handover, the volatile organic compound concentration dropped to 0.00 ppm. With blastocysts and a respectable blastocyst rate, embryonic culture with female patients younger than 40 matched the criteria (63.5% and 38.9%, respectively). After vitrified blastocysts were transferred, the pregnancy and implantation rates were 58.5% and 36.2%, respectively, demonstrating a high degree of treatment success.
Conclusion
Our customizable, high-quality, low-air-pressure clean room model can be implemented to achieve positive outcomes for infertility treatment.
7.Application of the modified computed tomography severity index and retroperitoneal extension classification for evaluation of acute pancreatitis
Cam Nhung DANG ; Anh Tuan NGUYEN ; Thanh Thao NGUYEN ; Trong Binh LE
International Journal of Gastrointestinal Intervention 2025;14(2):51-56
Background:
This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients.
Methods:
Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded.
Results:
The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%).
Conclusion
In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.
8.Low-air-pressure clean room system: A flexible, high-quality model for assisted reproduction laboratories
Minh Tam LE ; Trung Van NGUYEN ; Thai Thanh Thi NGUYEN ; Hong Nhan Thi DANG ; Quoc Huy Vu NGUYEN
Clinical and Experimental Reproductive Medicine 2025;52(1):56-64
Objective:
This study aimed to develop a configurable clean room paradigm with low air pressure for assisted reproductive technology (ART) clinics and demonstrate the concept’s efficacy using in vitro fertilization (IVF) treatment.
Methods:
A high-standard clean room system with positive pressure (13 Pa) was built using accessible materials and equipment for ART laboratories. Methods for controlling and evaluating the clean room’s characteristics were developed and implemented for quality assessment and calibration to maximize efficiency. The feasibility of the flexible clean room concept was assessed by analyzing the key performance indicators of embryo culture and IVF treatment.
Results:
After 3 weeks of testing, the concentration of particles ≥0.5 μm was 6.04 times lower than the International Organization for Standardization (ISO) class 5 standard (3,520 particles/m3) in the IVF laboratory. Air pressure, noise, temperature, and humidity were controlled stably and appropriately. Five days after installation and handover, the volatile organic compound concentration dropped to 0.00 ppm. With blastocysts and a respectable blastocyst rate, embryonic culture with female patients younger than 40 matched the criteria (63.5% and 38.9%, respectively). After vitrified blastocysts were transferred, the pregnancy and implantation rates were 58.5% and 36.2%, respectively, demonstrating a high degree of treatment success.
Conclusion
Our customizable, high-quality, low-air-pressure clean room model can be implemented to achieve positive outcomes for infertility treatment.
9.Neutrophil-to-lymphocyte-to-albumin ratio as a prognostic marker for mortality in sepsis and septic shock in Vietnam
Nguyen Van Viet THANG ; Le Thi LUYEN ; Nguyen Thi Tuong VI ; Pham Dang HAI
Acute and Critical Care 2025;40(2):244-251
Background:
Sepsis and septic shock are life-threatening global health challenges associated with high mortality rates. Early identification of high-risk patients is critical for improving outcomes. In the present study, the association between the neutrophil-to-lymphocyte-to-albumin ratio (NLAR) and mortality in septic patients was evaluated.
Methods:
A retrospective study was performed at a tertiary hospital in Vietnam. Patients ≥18 years of age diagnosed with sepsis or septic shock based on the Sepsis-3 criteria were included. Exclusion criteria included recent corticosteroid use within 7 days, autoimmune diseases, hematological disorders, and active cancer within 5 years. NLAR was calculated from complete blood counts and albumin levels within the first 24 hours of intensive care unit admission. Receiver operating characteristic (ROC) curves were used to determine the predictive ability of NLAR for in-hospital mortality.
Results:
The present study included 141 patients with a mean age of 72 years. Non-survivors were significantly older with higher rates of mechanical ventilation. NLAR was significantly elevated in non-survivors compared with survivors (0.88 [0.57–1.24] vs. 0.44 [0.28–0.77], P<0.001). In ROC analysis, the area under the curve for NLAR was 0.70 (P<0.001). Using a cutoff value of 0.56, NLAR showed a sensitivity of 77.8% and a specificity of 61.5% for predicting in-hospital mortality.
Conclusions
Elevated NLAR on admission was associated with a higher mortality rate in sepsis patients. NLAR could be used as an early prognostic marker for sepsis mortality.
10.Benign Versus Malignant Solid Liver Lesions: How Can Apparent Diffusion Coefficient Value Be Added to the Differentiation?
Hong Phuong Dung TRAN ; Ngoc Thanh HOANG ; Cam Nhung DANG ; Thanh Thao NGUYEN ; Trong Binh LE
Investigative Magnetic Resonance Imaging 2025;29(4):216-224
Purpose:
To determine the efficacy of apparent diffusion coefficient (ADC) values and ratios (lesion/liver tissue, lesion/splenic tissue, lesion/paraspinal muscle) in differentiating benign from malignant solid liver lesions.
Materials and Methods:
This study retrospectively analyzed data from 115 patients with solid liver lesions who underwent abdominal magnetic resonance imaging (MRI) at a single institution between January 2023 and December 2024. Lesions were classified as benign or malignant based on biochemical tests as well as radiographic and/or histopathologic findings. ADC values and ratios were determined using a 1.5 T MRI scanner.Quantitative variables are presented as mean ± standard deviation or median (interquartile range). Receiver operating characteristic (ROC) analysis was used to determine the cut-off values for ADC value and ratio, for which associated areas under the ROC curve were calculated.
Results:
The present analysis included 115 lesions—36 benign and 79 malignant. The median ADC value of the benign lesions was significantly higher than that of malignant lesions: 1744.5 × 10-6 mm2 /s vs. 1168.0 × 10-6 mm2 /s, respectively. The average lesion-toliver ADC (rADC l), lesion-to-spleen ADC (rADCsp), and lesion-to-paraspinal muscle ADC (rADC m) ratios for the benign lesions were significantly higher than those of malignant lesions: 1.79 vs. 1.09, 2.31 vs. 1.44, and 1.19 vs 0.80, respectively. A threshold of 1416 × 10-6 mm2 /s was used to differentiate benign vs. malignant lesions, with a sensitivity of 83.3% and a specificity of 78.5%. The cut-off values for rADC l, rADCsp, and rADC m were 1.55, 1.95, and 0.97, respectively, with sensitivities of 69.4%, 69.4%, and 83.3% and specificities of 87.3%, 91.1%, and 79.9%, respectively.
Conclusion
ADC metrics obtained from diffusion-weighted MRI effectively distinguished benign from malignant solid liver lesions.

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