Objective: To investigate the role of human papillomavirus (HPV) 16 early genes E2 and E6 and heterogeneous nuclear ribonucleoprotein (hnRNP) E2 and their interaction effects in the progression of the cervical cancer. Methods: Women with normal cervix (NC), low cervical intraepithelial neoplasia (CIN Ⅰ) and high cervical intraepithelial neoplasia (CIN Ⅱ/Ⅲ) from the cervical lesions cohort in Jiexiu County of Shanxi Province from June 2014 to September 2014, and patients with cervical squamous cell carcinoma (SCC) treated at the Second Hospital of Shanxi Medical University in the same period were enrolled in this study. There were 257 participants, about 67 NC cases (26.07%), 69 CIN Ⅰ cases (26.85%), 68 CIN Ⅱ/Ⅲ cases (26.46%), and 53 SCC cases (20.62%), respectively. The information of demographic characteristics, life health habits and cervical lesions were collected by using the structured questionnaire. Cervical exfoliated cells and cervical biopsy tissues were collected to detect the infection of HPV16 and the protein expression levels of hnRNP E2, HPV16 E2 and E6. According to the median-value of the protein expression levels of hnRNP E2, HPV16 E2 and E6 and E2/E6 ratio in the NC group, the study participants were divided into the high and low expression groups/ratio groups. The multivariate logistic regression model was used to analyze the correlation between HPV16 early gene E2 and E6, hnRNP E2 and cervical cancer. The interaction effect was analyzed by using the generalized multifactor dimensionality reduction (GMDR) model. Results: The ages of NC, CIN Ⅰ, CIN Ⅱ/Ⅲ and SCC groups were (47.00±9.07), (47.64±7.35), (46.37±8.67) and (51.26±8.03) years old, respectively. The multivariate logistic regression model analysis showed that the HPV16 E2 low expression, E6 high expression and E2/E6 low ratio could increase the risk of CIN Ⅱ/Ⅲ, about OR (95%CI) values 11.11 (1.63-75.56), 8.00 (1.28-50.04), and 9.75 (1.22-77.72), respectively and SCC, about OR (95%CI) values 14.22 (2.11-95.88), 10.33 (1.67-64.00), and 12.38 (1.56-97.91), respectively. The hnRNP E2 low expression could increase the risk of CIN Ⅱ/Ⅲ and SCC, about OR (95%CI) values 3.35 (1.39-8.10) and 5.53 (1.54-19.88). The result of GMDR showed that there were interaction effects of the hnRNP E2 low expression, HPV16 E2 low expression and HPV16 E6 high expression in both CIN Ⅱ/Ⅲ and SCC groups. Conclusion The HPV16 E2 low expression, HPV16 E6 high expression and hnRNP E2 low expression could increase the risk of high-grade cervical intraepithelial neoplasia and cervical cancer, and they might have an important interaction effect in the progression of the cervical cancer.

Objective To investigate the application of venous superdrainage technique based anterolateral thigh flap based on oblique branch for the soft tissue defect of proximal shank.Methods Between October,2012 and March,2017,11 cases of the soft tissue defect in proximal shank were treated.There were 8 males and 3 females with a mean age of 43 (range,26-59) years.Causes of injury:7 cases of traffic injury,3 cases of bruise,1 case of machine wound;The defect sizes ranged from 10 cm×5 cm to 13 cm×10 cm,with fracture or plate exposure.Accord ing to the size of the defect,the distally based anterolateral thigh flap was designed to repair the defect.The flap sizes ranged from 14 cm×6 cm to 16 cm×8 cm.The oblique branch and their accompanying vein with great saphenous vein was anastomosed to construct the venous superdrainage,and the donor site suture directly.Three cases followed-up by WeChat,and 8 cases by return visit.Results Distally based anterolateral thigh flaps were derived from oblique branches,and no arteriovenous crisis occurred postoperatively.Eleven flaps healed well after operation.There were no distal end blood supply disorder.Followed-up for 6-12 months,the flaps survived well.The texture was closed to the surrounding skin,and no ulcer exposed.There were no serious complications in donor site.And the thighs were linear scars.Conclusion The distally based anterolateral thigh flap based on oblique branch have a long vascular pedicle.The venous superdrainage technique can effectively avoid venous crisis,and improve the survival quality of the flap and the survival rate.