Objective To investigate the genotype of HPV and L1 gene polymorphism of HPV subtype 6b in patients with condyloma acuminatum (CA) from Wenzhou region. Methods Gene chips were used to profile the genotype of HPV in tissue samples from 73 patients with CA. PCR was performed to amplify the L1 gene in 11 samples positive for HPV type 6 followed by sequencing. Results Of the 73 patients, 61 (83.56%) were positive for HPV DNA. Among the 61 HPV-positive patients, 93.44% were infected with single type of HPV, and 6.56% with mixed type of HPV. In patients infected with single type of HPV, type 11 predominated with a prevalence of 29.51% followed by HPV 6 (18.03%); in those infected with mixed type of HPV, 6and 11 were the most common genotypes. Besides, sequencing analysis revealed single nucleotide polymorphism at 6 sites of HPV 6b type L1 gene, and an A/T polymorphism at position -810 was present in all samples, which was considered to be a local mutation of HPV from Wenzhou region. Conclusions In Wenzhou region, HPV types 11 and 6 prevail in patients with CA, and multiple mutations are present in L1 gene of HPV 6b type.

Objective To investigate the expression of urokinase-type plasminogen activator(uPA)and β-catenin proteins and their relationship with tumor angiogenesis,and explore their correlation with invasion and metastasis of thyroid carcinoma.Methods SP immunohistochemistry was performed to detect the expression of uPA,β-catenin and CD105 in 90 cases of thyroid carcinoma tissues.MVD counting was performed and analyzed in conjunction with the clinicopathological features of human thyroid carcinomas.Results The positive rate of uPA expression and abnormal expression rate of β-catenin and the MVD value was positively correlated with histological typing of thymid carcinoma.There was significant difference in thyroid carcinoma with lymph node metastasis,which was significantly higher than those cases without lymph node metastasis(P＜0.05),as well as between clinical stage Ⅲ～Ⅳ and Ⅰ～Ⅱ.The MVD value was significantly correlated with the positive expression of uPA and abnormal expression of β-catenin in thyroid.There was statistically significant correlation between the expression of uPA and β-catenin.Conclusion The expression of uPA protein in thyroid carcinoma was higher than those in normal.A reduced membranous expression rate and abnormal nuclear/cytoplasmic expression of β-catenin was observed in thyroid carcinoma cells,which was positively correlated with histological typing and clinical staging,invasion and metastasis in thyroid carcinoma.uPA and β-catenin were cooperated in angiogenesis of thyroid carcinoma.MVD was positively correlated with invasion and metastasis in thyroid carcinoma.They were hopeful to be an important prognostic indicator of thyroid carcinoma.

Objective To evaluate the diagnostic and prognostic value of the serum procalcitonin ( PCT ) level in the non-acquired immune deficiency syndrome ( AIDS ) immunocompromised critically ill patients suspected to have infection. Methods A retrospective study was conducted in the non-AIDS immunocompromised patients who were admitted to Department of Critical Care Medicine of Xiangya Hospital, Central South University during January 2011 to December 2014. Demographic characteristics, underlying disease, acute physiology and chronic health evaluationⅡ( APACHEⅡ) score at admission, and clinical records including baseline and peak levels of temperature, white blood count ( WBC ), PCT, and survival rate within 28 days, infection focus, infectious agents ( bacterial, fungi or mixed infection ), and the severity of infection ( sepsis, severe sepsis, or septic shock ) were recorded. Receiver operating characteristic ( ROC ) curve was plotted, and the diagnostic and protective value of above parameters was evaluated. Results A total of 98 patients ( 43 male and 55 female ) were enrolled in the study with a median age of 44 ( 28, 52 ) years old and a median APACHEⅡscore of 17 ( 11, 20 );47 with malignant hematological tumor, 45 with autoimmune diseases, and 6 post solid organ transplantation. Among them 53 patients ( 54.1%) died within 28 days. Twenty-seven patients were diagnosed as systemic inflammatory response syndrome ( SIRS ) without infection. Among 71 patients with infection, 45 were diagnosed as bacterial infection, 10 with fungal infection, and 16 with mixed infection. Sepsis was diagnosed in 7 patients, severe sepsis in 32 patients , and septic shock in 32 patients .①There was no statistical significance in the baseline and peak levels of PCT and WBC, or baseline level of temperature between the groups of SIRS patients without infection and infected patients. The peak level of temperature was significantly higher in the patients with infection as compared with that of the SIRS without infection patients [℃:39.4 ( 38.9, 40.0 ) vs. 38.8 ( 37.8, 39.2 ), Z=-3.268, P=0.001 ]. It was showed by subgroup analysis that in patients with hematological malignant disease or autoimmune diseases, higher level of body temperature was found in infection group compared with non-infection SIRS group [℃:39.5 ( 39.0, 40.0 ) vs. 39.0 ( 38.4, 39.4 ), Z=-2.349, P=0.019;39.0 ( 38.4, 39.5 ) vs. 38.2 ( 37.0, 38.9 ), Z=-2.221, P=0.026 ].②The baseline level of PCT (μg/L ) were 0.54 ( 0.20, 4.19 ), 2.78 ( 0.50, 9.54 ), 1.00 ( 0.45, 6.89 ), and 0.22 ( 0.07, 1.86 ) in non-infection SIRS patients or the patients with bacterial, fungal, and mixed infection, respectively. The peak level of PCT (μg/L ) were 4.19 ( 1.95, 13.42 ), 12.37 ( 3.82, 45.89 ), 1.82 ( 0.49, 17.86 ), and 5.14 ( 2.66, 12.62 ), respectively, in each subgroup. When the comparison was conducted among the patients with different infectious agent, the baseline level of PCT in patients with bacterial infection was significantly higher than that in SIRS patients without infection ( P=0.026 ) and mixed infection patients ( P=0.001 ), and the peak level of PCT was significantly higher than that in the SIRS patients without infection ( P=0.009 ) and the patients with fungal infection ( P=0.016 ). ROC curve showed that the higher value was found in the baseline and peak levels of PCT for diagnosis of septic shock in all patients [ area under ROC curve ( AUC ) of baseline level = 0.681±0.054, P = 0.001; AUC of peak level = 0.690±0.054, P=0.002 ], and the same value was also found in the baseline and peak levels of PCT for diagnosis of bacterial infection in the patients with malignant hematological tumor ( AUC of baseline level=0.687±0.080, P=0.008;AUC of peak level=0.697±0.079, P=0.021 ).③The peak level of PCT (μg/L ) were 4.05 ( 0.53, 31.22 ), 5.78 ( 2.14, 16.68 ), and 11.64 ( 2.94, 58.14 ) in subgroup of patients with sepsis, severe sepsis and septic shock, respectively, and they showed no statistical significance among subgroups ( P>0.05 ). A high serum level of peak PCT strongly indicated the presence of septic shock ( AUC=0.646±0.060, P=0.019 ), especially in the subgroup of patients with systemic autoimmune disease ( AUC=0.689±0.081, P=0.035 ).④The peak level of PCT (μg/L ) in the APACHEⅡ>18 group ( 38 cases ) was significantly higher than that of APACHEⅡ≤18 group [ 60 cases, PCT (μg/L ):11.64 ( 3.36, 39.39 ) vs. 4.42 ( 1.32, 14.70 ), P=0.016 ];there was a certain correlation between the peak level of PCT and the severity of the disease.⑤The peak level of PCT in death group was significantly higher than that of the survival group [μg/L:9.07 ( 3.05, 33.09 ) vs. 4.19 ( 1.26, 14.61 ), P=0.043 ]. ROC curve showed that the peak level of PCT might be valuable in predicting the prognosis in immunocompromised patients ( AUC=0.619±0.057, P=0.043 ). Conclusions The serum level of PCT is found to be a reliable marker for the diagnosis of bacterial infection in immunocompromised critical patients, especially in those with hematologic malignancy. Additionally, PCT provides a useful tool for evaluating the severity of infection and the prognosis of critically ill patients.

Objective The Application of Circular Mapping during Circumferential Pulmonary Vein Ablation (CPVA) for Atrial Fibrillation Guided by Ensite/NavX System. Methods To evaluate the effect of combined circular mapping on the success rate of CPVA. 61 consecutive cases (40 males and 21 females) were included in the study. 50 cases with paroxysmal atrial fibrillation (PAF) and 11 cases with chronic atrial fibrillation (CAF) underwent CPVA guided by the Ensite/NavX system. A circular electrode catheter was used to map the pulmonary vein (PV) potentials. Pulmonary vein isolation was taken as the endpoint for ablation. Results All the 61 cases underwent the procedure successfully. LPVs were isolated in 34 cases and 35 cases underwent single RPVs isolation. Circumferential ablation of both LPVs and RPVs were carried out in 23 cases. Atrial fibrillation was terminated when delivering radiofrequency energy in 16 cases with PAF and 5 cases with CAF. The termination sites were located near the anterior or posterior roof of the superior PVs in 19 cases and at the mid-portion of the posterior wall from RSPV in 1 case. Atrial fibrillation was terminated when after comple to LPV ablation in 1 case. During the follow-up of 6?2 months, 42 PAF cases and 5 of 11 CAF cases were atrial fibrillation free. The total success rate was 77%. Complications: Pericardium effusion was found in 1 case and disappeared after pericardium puncture and drainage. 1 case developed hemothorax and was cured after thorax puncture and drainage. Conclusion The application of circular mapping during circumferential pulmonary vein ablation guided by Ensite/NavX System contributes to improve the success rate of atrial fibrillation ablation.

Chemistry Techniques, Analytical ; instrumentation ; Herbicides ; analysis ; Humans ; Paraquat ; analysis

In this paper,the importance and the necessity of the continuing training of nursing ethics for clinical nurses were analyzed.Then,based on the needs and characteristics of current clinical nursing work in China,a preliminary study on the implementation of the continuing training was conducted in terms of the training objectives,process,content,form,and the evaluation approaches.

With the development of the socialist new rural reconstruction,the contradiction between the demand for medical health care and the insufficiency in hygienic resources in the countryside is increasingly prominent. Training the practical medicine talented person who are willing to go to the countryside and are able to stay there and be used for the countryside community has already become the important mission for the medicine higher professional training school. Taking my school’s actual situation as the example,we make exploration on orientting accurately,deepen medical education reform,establish and raise practical talented persons with skills.

Practical teaching is an important component of higher medical education. The article introduced a number of exploration and experience of Shaoyang Medical College in building a practical teaching quality guarantee system,such as revising personnel training programs, optimizing practice teaching environment,enhancing teaching quality construction projects, strengthening teachers troop construction reinforcing teaching practice management and the teaching quality monitoring,etc.

Child ; Follow-Up Studies ; Humans ; Mandibular Condyle ; injuries ; Mandibular Fractures ; therapy ; Time Factors

Objective To evaluate the potential association of CD4+CD25+ T cells with alopecia areata.Methods Totally,this study enrolled 23 patients with progressive alopecia areata,25 patients with stable alopecia areata,and 25 healthy controls.Peripheral blood was isolated from these subjects followed by isolation of CD4+ CD25+ regulatory T cells,which were then cuhured with the presence of anti-CD3 and-CD28 monoclonal antibodies for four days.Subsequently,enzyme-linked immunosorbent assay was performed to measure the levels of interleukin (IL)-10 and transforming growth factor (TGF)-β1 in the culture supematant of these T cells.Results The levels of IL-10 and TGF-β1 were (31.68 ± 6.78) pg/ml and (32.29 ± 6.8) pg/ml respectively in the culture supernatant of CD4+CD25+ regulatory T cells from patients with progressive alopecia areata,significantly lower than those from the healthy controls ((57.34 ± 14.15) pg/ml and (57.43 ± 15.16) pg/ml,both P ＜ 0.05) and patients with stable alopecia areata ((52.56 ± 13.02) pg/ml and (61.75 ± 14.10) pg/ml,both P ＜ 0.05).However,no significant difference was observed in the supernatant levels of IL-10 or TGF-β1 between the healthy controls and patients with stable alopecia areata.Conclusions The secretion of IL-10 and TGF-β1 by CD4+CD25+ T cells is decreased in patients with progressive alopecia areata,which may contribute to the pathogenesis of alopecia areata.