Objective To study the relationship between the level of HPV (hs -HPV)infection in the cervical lavage fluid and the virus clearance.Methods 89 cases of hs -HPV infection were selected as research subjects.According to the different outcomes of 1 year,the patients were divided into persistent infection group (23 cases)and negative group (66 cases).The cervical lavage fluid immunoglobulin (IgA,IgM,IgG)in the two groups were detected,and 37 normal people were selected as control group.The relationship between cervical lavage protein immunoglobulin (IgA,IgM,IgG)level and the removal of hs-HPV was studied.Results Of 89 cases of different types of hs-HPV infection,16 type and 18 type accounted for 55.1%,20.2%;different type of hs-HPV infected cervical lavage fluid,the immunoglobulin IgA,IgM,IgG by the analysis of variance showed no significant difference (P<0.05),HPV16 [IgA(18.3 ±3.8)μg/mL,IgM(89.2 ±9.8)μg/mL,IgG(15.4 ±3.6)μg/mL], HPV18[IgA(17.7 ±4.2)μg/mL,IgM(90.5 ±9.6)μg/mL,IgG(15.2 ±3.0)μg/mL],other type [IgA(17.9 ± 4.0)μg/mL,IgM(92.1 ±8.4)μg/mL,IgG(15.6 ±3.7)μg/mL],mixed infection [IgA(18.4 ±3.9)μg/mL,IgM (93.6 ±9.4)μg/mL,IgG(15.2 ±3.5)μg/mL]were higher than those of the control group [IgA(14.6 ±2.6)μg/mL, IgM(81.3 ±8.5)μg/mL,IgG(11.2 ±2.3)μg/mL],the differences were statistically significant (F=6.547,6.928, 10.217,all P<0.05).Cervical lavage fluid immunoglobulin levels between the different outcomes of hs-HPV infec-tion,the normal control group,infection group and negative group IgA continued IgG,cervical lavage fluid concentra-tion gradually increased,IgM persistent infection group and negative group cervical lavage fluid (P>0.05 )concen-tration had no significant difference,persistent infection group [IgA(17 ±3.1)μg/mL,IgG(86.2 ±5.4)μg/mL,IgM (14.8 ±3.1)μg/mL].The negative group [IgA(18.6 ±3.6)μg/mL,IgG(93.8 ±6.7)μg/mL,IgM(15.8 ± 3.3)μg/mL]were higher than those of the normal control group [IgA(14.6 ±2.6)μg/mL,IgM(81.3 ±8.5)μg/mL, IgG(11.2 ±2.3)μg/mL],the differences were statistically significant (F=6.547,6.928,10.217,all P<0.05). Conclusion The immune defense of the vaginal mucosa is closely related to the high risk of HPV,especially the sIgA plays an important role in the outcome of infection.

Objective To observe the effect of ciprofol on hemodynamics in elderly patients with left ventricular diastolic dysfunctionfrom induction of anesthesia to incision.Methods Eighty-two elderly patients,42 males and 40 females,aged 65-90 years,BMI 18.5-30.0 kg/m2,ASA physical status Ⅱ or Ⅲ,undergoing non-cardiac surgery under elective general anesthesia were enrolled.The patients were ran-domly divided into two groups:ciprofol group(group C)and propofol group(group P),41 patients in each group.Anesthesia induction was performed using ciprofol at a dose of 0.3 mg/kg in group C or propofol at a dose of 1.5 mg/kg in group P.The number of patients with hypotension between anesthesia induction and skin incision were recorded.HR,SBP,DBP,and cardiac index(CI)were recorded immediately before an-esthesia induction(T0),3 minutes after induction(T1),immediately after tracheal intubation(T2),3 mi-nutes after tracheal intubation(T3),5 minutes after tracheal intubation(T4),and 10 minutes after tracheal intubation(T5).Intraoperative use of vasoactive drugs,the incidence of injection pain,bucking,movement and bradycardia from induction of anesthesia to incision were recorded.The occurrence of adverse reactions such as postoperative agitation,nausea and vomiting within 48 hours after surgery were also recor-ded.Results Compared with group P,the incidence of hypotension in group C from induction of anesthesia to incision was significantly decreased(P<0.05).Compared with T0,HR at T1—T5 in the two groups slowed down significantly(P<0.05),and SBP,DBP,and CI were significantly decreased(P<0.05).Compared with group P,CI in group C was significantly higher at T5(P<0.05),and the incidence of in-jection pain was significantly decreased(P<0.05).There was no significant difference in HR,SBP and DBP between two groups at different time points.There was no significant differences in the rates of ephed-rine,phenylephrine and atropine,bucking,intraoperative movement,bradycardia,postoperative agitation and nausea and vomiting within 48 hours after surgery between the two groups.Conclusion Ciprofol has a smaller impact on the hemodynamics of elderly patients with left ventricular diastolic dysfunction and can be safely used for anesthesia induction in elderly patients undergoing non-cardiac surgery.

Objective:To introduce and validate the Pediatric Nausea Assessment Tool (PeNAT) and the Baxter Retching Faces Scale (BARF) in the assessment of chemotherapy induced nausea in Chinese children with malignant neoplasms, and to explore the cut-off value for rescue antiemetic.Methods:A prospective descriptive study was conducted, 244 children in Sun Yat-sen University Cancer Center with malignant neoplasms who received chemotherapy were selected by convenience sampling from July to August 2021. PeNAT, BARF, Visual Analogue Scale (VAS) and the Faces Pain Scale-Revised(FPS-R) were used to assess the severity of nausea and pain before and after chemotherapy, before and 30-60 minutes after the use of rescue antiemetic or analgesic. After chemotherapy, the children also were asked the changes of nausea severity and whether antiemetic was needed.Results:A test-retest reliability was conducted on the patients with the same severity of nausea before and after chemotherapy, and the intraclass correlation coefficient of the PeNAT and BARF were 0.940 (both P<0.05). After chemotherapy, the PeNAT and BARF were 1.5(1.0, 2.0) and 2.0(0, 2.0) points, which were significantly higher than the 1.0(1.0, 1.0) and 0(0, 0) points before chemotherapy ( Z = - 9.19, - 9.09, both P<0.01). The PeNAT and BARF of 11 cases receiving antiemetic before medication were 4.0 (4.0, 6.0) and 3.0(2.0, 4.0) points, which were higher than the 0(0, 2.0) and 1.0(1.0, 2.0) points without antiemetic ( Z = - 4.03, - 3.86, both P<0.05). After chemotherapy, the correlation coefficients between PeNAT or BARF and VAS-nausea were r = 0.933, 0.957 (both P<0.01), and FPS-R were r = 0.192, 0.189 (both P<0.05). After using antiemetic, PeNAT and BARF were 2.0(2.0, 3.0) and 2.5(2.0, 4.0) points, which were significant different than the 3.0(3.0, 3.8) and 4.0(4.0, 8.0) points before using antiemetic ( Z = - 2.97, - 2.83, both P<0.05). According ROC curves and cut-off values, it was determined that PeNAT≥3 and BARF≥4 had clinical significance and require clinical intervention. Conclusions:PeNAT and BARF have excellent reliability and validity in the assessment of chemotherapy induced nausea in children with malignant neoplasms, they can effectively identify the requirement of rescue antiemetic, and evaluate the efficacy of antiemetic.