Objective To study cervical human papillomavirus (HPV) infection and genotype distribution characteristics in patients with vaginal disease.Methods The PCR dot blot was used to carry out HPV detection of cervical exfoliated cells in 816 women with cervical lesions in the hospital, and 23 kinds of HPV genotypes were identified.Results Among the 816 cases receiving HPV type detection, HPV of 532 cases (65.20%) was positive, including 371 cases (69.74%) with low-risk HPV (HR-HPV) infection, 161 cases (30.26%) with low-risk HPV infection (LR-HPV) (P<0.05).The HPV infection rate below 45 years old was relatively higher.The HPV infection rate in patients with cervical cancer (97.10%) was higher than that in patients with cervical intraepithelial neoplasia (CIN) II -III (80.54%), patients with CIN Ⅰ(41.55%) and patients with cervicitis (17.20%) (P<0.05).The top five types of HPV infection were HPV16, 58, 18, 11 and 56 type, respectively.The single infection rate (79.70%) was higher than multiple infection rate (20.30%) (P<0.05); HR-HPV infection was the main infection in single infection, and double infection was the main infection in multiple infection.Conclusion Below 45 years old women are the high-risk groups of HPV infection.16, 58, 18, 11 and 56 are the main types of HPV infection.The infection rates of patients with cervical cancer and precancerous lesions are relatively higher.Paying attention to the screening of HPV infection has positive significance in the prevention and treatment of cervical cancer.

AIM: To investigate the role of reactive oxygen species (ROS) in transforming growth factor-?1 (TGF-?1)-induced regulation of plasminogen activator inhibitor-1 (PAI-1) expression and plasmin activity. METHODS: Growth arrested and synchronized rat mesangial cells were stimulated by TGF-?1. In some experiments,cells were pretreated with BSO or with antioxidant NAC. Intracellular ROS production was visualized using a fluorescent dye. PAI-1 protein secretion by mesangial cells was measured by Western blot and PAI-1 mRNA by both RT-PCR and Northern blot. Plasmin activity was determined using a synthetic fluorometric plasmin substrate. RESULTS: Exogenous TGF-?1 significantly increased intracellular ROS concentration and upregulated PAI-1 mRNA and protein expression in mesangial cells and reduced the plasmin activity. TGF-?1-induced upregulation of PAI-1 mRNA expression was exaggerated by BSO[DL-buthionine-(S,R)-sulfoximine]. NAC (N-acetylcysteine) effectively reversed TGF-?1-induced PAI-1 mRNA overexpression and plasmin activity decreasing. CONCLUSION: TGF-?1 increases intracellular ROS generation. ROS acts as a signaling molecular to mediate TGF-?1-induced PAI-1 overexpression and decrease in plasmin activity.

Objective To explore the role of ROS in TGF ?1 induced changes of plasmin system in rat mesangial cells. Methods Growth arrested and synchronized rat mesangial cells were stimulated by 2 ng/ml TGF ?1 for 12 h. In some experiments cells were pretreated with BSO for 24 h or with antioxidant NAC for 1h. Intracellular ROS production was visualized using a fluorescent dye.The mRNA expression of tPA, uPA and PAI 1 was measured by RT PCR and PAI 1 protein secreted into media by ELISA assay.The activities of plasmin, uPA, tPA were determined using a synthetic fluorometric substrate. Results TGF ?1 significantly increased intracellular ROS concentration. 2 ng/ml TGF ?1 significantly upregulated PAI 1 mRNA and protein expression by 1 9 fold(P

Objective:To explore the sense of coherence in the main caregivers of cancer patients, analyze its influencing factors, and explore the relationship between sense of coherence and care burden.Methods:From March 2018 to March 2019, convenience sampling method was used to select the main caregivers of 229 cancer patients admitted to two ClassⅢ Grade A hospitals in Harbin as the research object. The questionnaire survey was conducted with the General Information Questionnaire, Sense of Coherence Scale (SOC-13) and the Family Caregiver Burden Scale. Statistical analysis was carried out with t test, single factor analysis of variance, Pearson correlation as well as multiple linear regression. A total of 237 questionnaires were issued and 229 valid questionnaires were returned, with an effective recovery rate of 96.62%. Results:The score of sense of coherence in main caregivers of cancer patients was (55.67±9.23) , which was at a low level. The results of univariate analysis showed that there were statistically significant differences in the score of sense of coherence in main caregivers of cancer patients with different genders of caregivers, occupational status of caregivers, medical cost burden status, patient self-care level, and cumulative care time ( P<0.05) . The results of Pearson correlation analysis showed that the score of sense of coherence in main caregivers of cancer patients was positively correlated with the care burden score of the terminal cancer ( r=0.398, P<0.01) . The results of multiple linear regression analysis showed that the burden of medical expenses, the degree of self-care ability of patients, the cumulative care time, and the care burden of end-of-cancer (physical and mental burden, economic burden, life burden) were the main influencing factors of the sense of coherence in the main caregivers of cancer patients ( P<0.05) , which explained 32.2% variation of the sense of coherence. Conclusions:The main caregivers of cancer patients have a low level of sense of coherence and are affected by many factors. Clinical medical and nursing staff can carry out targeted interventions from patients, caregivers, society and other aspects to enhance the sense of coherence of the main caregivers, thereby improving the quality of life of patients and their main caregivers.

Objective:To report a rare case of paroxysmal nocturnal hemoglobinuria (PNH) complicated with chronic tubulointerstitial nephropathy, combined with literature review, and discuss the clinical, imaging and pathological characteristics of the disease and the diagnosis and treatment ideas.Methods:The patient's clinical data, magnetic resonance imaging (MRI) and kidney pathological examination results, treatment measures and effects were collected and reported. Through systematic review of relevant literature, the clinical manifestations and pathogenesis of chronic tubular interstitial nephropathy complicated by PNH were summarized and discussed.Results:In this case, PNH was diagnosed for more than 30 years, the peripheral blood PNH clone was positive, urine specific gravity was 1.012, urine pH 6.0-7.0, urine protein (+), urine sugar (3+), serum creatinine 259 μmol/L, serum lactic acid dehydrogenase 800 U/L. MRI showed bilateral renal cortical signal was low intensity on both T1- and T2- weighted images. Kidney biopsy revealed remarkable chronic tubulointerstitial nephropathy with massive hemosiderin deposition in proximal tubular cells demonstrated by Prussian blue staining and electron microscopy. By using low-dose prednisone to control hemolytic attack and other supportive treatments, the patient's renal function has been stabilized for a long time.Conclusions:PNH complicated with chronic tubulointerstitial nephritis is easy to be misdiagnosed due to insidious onset. MRI and kidney histopathological examination are helpful to clarify the diagnosis. Early diagnosis and treatment are helpful to improve the prognosis of such patients.

Objective:To explore the clinical and histopathologic features of lupus nephritis (LN) patients with positive antineutrophil cytoplasmic antibody (ANCA), so as to provide more theoretical basis to recognize and treat this disease.Methods:Clinical data of biopsy-proven LN patients with ANCA test in the First Affiliated Hospital of Sun Yat-sen University from November 1, 2002 to September 11, 2020 were collected and analyzed retrospectively. The difference of clinical data, laboratory examination, and pathological examination of renal biopsy between ANCA-positive group and ANCA-negative group. The clinicopathological characteristics between different ANCA serotypes were compared.Results:A total of 1 304 patients with LN confirmed by renal biopsy and ANCA test results were enrolled. Eighty ANCA-positive patients from 1 304 LN patients were screened. There are 55(68.8%) ANCA-positive LN patients with positive anti-myeloperoxidase antibodies (MPO). There were 14(17.5%) ANCA-positive LN patients with positive anti-proteinase 3 antibodies (PR3), and 11(13.8%) ANCA-positive patients with double positive antibodies of MPO and PR3. ANCA-positive LN patients had significantly higher serum creatinine [135.5(68.0, 361.8) μmol/L vs 88.0(64.0, 165.0) μmol/L, P=0.004] and blood urea nitrogen [12.35(6.35, 21.18) mmol/L vs 8.60 (5.50, 15.70) mmol/L, P=0.026] as well as lower estimated glomerular filtration rate [45.70(13.83, 84.10) ml·min -1·(1.73 m 2) -1 vs 66.75(38.43, 96.22) ml·min -1·(1.73 m 2) -1, P=0.001] than ANCA-negative patients (stratified sampling of 160 patients). ANCA-positive LN patients had higher chronicity index than ANCA-negative LN patients [3(2, 7) vs 2(0, 5), P=0.006]. There were statistically significant difference in hemoglobin, serum creatinine and estimated glomerular filtration rate among ANCA-positive group, ANCA-negative group, and MPO-ANCA and PR3-ANCA double positive group. MPO-ANCA and PR3-ANCA double positive LN patients had the lowest hemoglobin and estimated glomerular filtration rate, and highest serum creatinine among the three groups (all P<0.05). Conclusions:ANCA-positive LN patients have worse renal function and higher renal histological chronicity index than ANCA-negative LN patients, especially for patients with double positive MPO-ANCA and PR3-ANCA. More stringent monitoring and therapy may be needed in this subgroup of LN patients.

Objective:To explore the risk factors related to delayed pleural effusion in multiple trauma patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 145 multiple trauma patients admitted to the First Affiliated Hospital of Soochow University from January 2022 to October 2023, including 99 males and 46 females, aged 18-81 years [56.0(46.5, 64.5)years]. Based on whether delayed pleural effusion developed after injury, the patients were divided into delayed pleural effusion group ( n=66) and non-delayed pleural effusion group ( n=79). The clinical data of the patients in both groups were collected, including gender, age, underlying disease (diabetes mellitus and hypertension), cause of injury (traffic injury, blow injury, fall from height, and others), comorbid injuries (traumatic brain injury, maxillofacial fracture, clavicular fracture, scapular fracture, sternal fracture, spinal fracture, multiple rib fracture, pneumothorax, lung contusion, and pelvic fracture), severity of injury [injury severity score (ISS) and abbreviated injury scale (AIS) score for the chest], location and number of rib fractures, vital signs at admission (body temperature, heart rate, respiration, systolic blood pressure, diastolic blood pressure), and clinical test indices [white blood cells (WBC), hemoglobin (Hb), platelets (PLT), total protein (TP), albumin (ALB), C-reactive protein (CRP), procalcitonin (PCT), fibrinogen (FIB), fibrin degradation product (FDP), D-dimer (D-D), aspartate transaminase (AST), alanine transferase (ALT), and creatinine (Cr)]. Univariate analysis was conducted to assess the correlation between the forementioned factors and the development of delayed pleural effusion after multiple traumas. Multivariate Logistic regression analysis was used to determine the independent risk factors for the development of delayed pleural effusion after multiple traumas. Results:The results of univariate analysis showed that multiple rib fracture, pneumothorax, pulmonary contusion, chest AIS score, posterior rib fracture, number of rib fractures, TP, ALB, CRP, PCT and FDP were correlated with delayed pleural effusion in multiple trauma patients ( P<0.05 or 0.01); whereas gender, age, underlying disease, cause of injury, sternal fracture, spinal fracture, clavicular fracture, scapular fracture, pelvic fracture, maxillofacial fracture, traumatic brain injury, anterior rib fracture, ISS, vital signs at admission, WBC, Hb, PLT, FIB, D-D, AST, ALT, and Cr were not correlated with delayed pleural effusion in multiple trauma patients ( P>0.05). The results of multivariate Logistic regression analysis revealed that lung contusion ( OR=3.96, 95% CI 1.59, 9.85, P<0.01), ALB ( OR=0.79, 95% CI 0.66, 0.94, P<0.01), and CRP ( OR=1.02, 95% CI 1.01, 1.03, P<0.01) were significantly correlated with delayed pleural effusion in multiple trauma patients. Conclusion:Lung contusion, ALB, and CRP are the independent risk factors for delayed pleural effusion in multiple trauma patients.

Objective:To explore the prevalence and independent associated factors of vascular calcification (VC) in non-dialysis chronic kidney disease (CKD) patients of stage 3-5.Methods:It was a single-center cross-sectional observational study. Non-dialysis stage 3-5 CKD patients ≥18 years old who were admitted to the Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University from May 1, 2022 to December 31, 2022 with VC evaluation were enrolled. The patients' general information, laboratory examination and imaging data were collected. Coronary artery calcification (CAC), thoracic aorta calcification (TAC), abdominal aorta calcification (AAC), carotid artery calcification and aortic valve calcification (AVC) were evaluated by cardiac-gated electron-beam CT (EBCT) scans, lateral lumbar x-ray, cervical macrovascular ultrasound and echocardiography, respectively. The differences in clinical data and the prevalence of VC at different sites of patients with different CKD stages were compared, and the prevalence of VC at different sites of patients in different age groups [youth group (18-44 years old), middle-aged group (45-64 years old) and elderly group (≥65 years old)] and patients with or without diabetes were compared. Multivariate logistic regression analysis was used to analyse the independent associated factors of VC for different areas.Results:A total of 206 patients aged (51±14) years were included, including 129 (62.6%) males. There were 44 patients with CKD stage 3 (21.4%), 51 patients with CKD stage 4 (24.8%), and 111 patients with CKD stage 5 (53.9%). CKD was caused by chronic glomerulonephritis [104 cases (50.5%)], diabetic kidney damage [35 cases (17.0%)], hypertensive kidney damage [29 cases (14.1%)] and others [38 cases (18.4%)]. Among 206 patients, 131 (63.6%) exhibited cardiovascular calcification, and the prevalence of CAC, TAC, AAC, carotid artery calcification, and AVC was 37.9%, 43.7%, 37.9%, 35.9% and 9.7%, respectively. The overall prevalence of VC in young, middle-aged and elderly patients was 24.6%, 73.6% and 97.4%, respectively. With the increase of age, the prevalence of VC in each site gradually increased, and the increasing trend was statistically significant (all P<0.001). The overall prevalence of VC in CKD patients with diabetes was 92.5% (62/67), and the prevalence of VC at each site in the patients with diabetes was significantly higher than that in the patients without diabetes (all P<0.001). Multivariate logistic regression analysis revealed that age (every 10 years increase, OR=2.51, 95% CI 1.77-3.56, P<0.001), hypertension ( OR=5.88, 95% CI 1.57-22.10, P=0.009), and diabetes ( OR=4.66, 95% CI 2.10-10.35, P<0.001) were independently correlated with CAC; Age (every 10 years increase, OR=6.43, 95% CI 3.64-11.36, P<0.001) and hypertension ( OR=6.09, 95% CI 1.33-27.84, P=0.020) were independently correlated with TAC; Female ( OR=0.23, 95% CI 0.07-0.72, P=0.011), age (every 10 years increase, OR=3.90, 95% CI 2.42-6.29, P<0.001), diabetes ( OR=5.37, 95% CI 2.19-13.19, P<0.001) and serum magnesium ( OR=0.01,95% CI 0-0.35, P=0.014) were independently correlated with AAC. Moreover, age and diabetes were independently correlated with carotid artery calcification, AVC and overall VC Conclusions:The prevalence of VC in non-dialysis CKD patients of stage 3-5 is 63.59%, of which CAC reaches 37.9%, TAC is the most common one (43.7%), while AVC is the least one (9.7%). Age and diabetes are the independent associated factors for VC of all sites except TAC, while hypertension is an independent associated factor for both CAC and TAC.

Objective:To explore the role of epithelial-mesenchymal transition(EMT) in fusion of the secondary palatal shelves to form the intact secondary palate induced by 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD).Methods:Twelve C57BL/6 J pregnant mice on gestation day (GD) 10.5 were divided into two groups: one group was conducted through gastric tubes with one dose of 28 μg/kg TCDD (experimental group) and the other group was operated through gastric tubes with equal volume corn oil (control group). Embryos were removed by cesarean section from pregnant mice during the palatal formation stage (GD 15.5) and the morphology of palatal tissue was observed. Primary media edge epithelial(MEE) were divided into experimental group and control group. MEE were treated with medium containing TCDD, 5 nmol/L, 10 nmol/L, 20 nmol/L and normal medium respectively. The expression of cytokeratin 19(CK-19) protein and vimentin protein in MEE were detected by immunofluorescence laser confocal microscopy and Western blotting after 72 hours. Statistical comparisons were made using one-way ANOVA.Results:A total of 36 fetuses were obtained in the experimental group, including 3 dead fetuses and absorbed fetuses. The incidence of cleft palate was 100% (33/33); the incidence of complete cleft palate was 84.8% (28/33), and the incidence of partial cleft palate was 15.2% (5/33); 40 fetuses were obtained in the control group, including 2 dead fetuses and resorbed fetuses, and the incidence of cleft palate was 0 (0/38). After 72 hours, the shape of MEE changed from uniform pebble-like to star-like or irregular shape with pseudopodia. The expressions of CK-19 protein were(0.739 ± 0.120, 0.483 ± 0.023, 1.007 ± 0.109, 1.086 ± 0.145) and fluorescence intensities were (53.384±5.785, 36.818 ± 8.250, 64.575±8.323, 76.898 ± 3.711) in control group and TCDD (5 nmol/L), TCDD (10 nmol/L) and TCDD (20 nmol/L) groups, respectively. The expressions of vimentin protein were (0.527 ± 0.112, 0.781 ± 0.095, 0.284 ± 0.046, 0.216 ± 0.040) and fluorescence intensities were (63.672±6.135, 82.632 ± 4.474, 52.608±7.525, 42.664 ± 7.659). Compared with the control group, the low-dose experimental group (5 nmol/L) had a decrease in CK-19 and an increase in vimentin; the high-dose experimental group (10 nmol/L, 20 nmol/L) had an increase in CK-19 and a decrease in vimentin, and the expression difference was statistically significant ( P<0.05), while there was no statistical significance among high-dose groups ( P>0.05). Conclusions:EMT process of MEE was identified in vitro and was a spontaneous procedure. TCDD-induced cleft palate may be related to the inhibition of the EMT process in MEE and with the increased dose of TCDD, the effects of EMT inhibiton were sustainable.

Objective:To explore the role of epithelial-mesenchymal transition(EMT) in fusion of the secondary palatal shelves to form the intact secondary palate induced by 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD).Methods:Twelve C57BL/6 J pregnant mice on gestation day (GD) 10.5 were divided into two groups: one group was conducted through gastric tubes with one dose of 28 μg/kg TCDD (experimental group) and the other group was operated through gastric tubes with equal volume corn oil (control group). Embryos were removed by cesarean section from pregnant mice during the palatal formation stage (GD 15.5) and the morphology of palatal tissue was observed. Primary media edge epithelial(MEE) were divided into experimental group and control group. MEE were treated with medium containing TCDD, 5 nmol/L, 10 nmol/L, 20 nmol/L and normal medium respectively. The expression of cytokeratin 19(CK-19) protein and vimentin protein in MEE were detected by immunofluorescence laser confocal microscopy and Western blotting after 72 hours. Statistical comparisons were made using one-way ANOVA.Results:A total of 36 fetuses were obtained in the experimental group, including 3 dead fetuses and absorbed fetuses. The incidence of cleft palate was 100% (33/33); the incidence of complete cleft palate was 84.8% (28/33), and the incidence of partial cleft palate was 15.2% (5/33); 40 fetuses were obtained in the control group, including 2 dead fetuses and resorbed fetuses, and the incidence of cleft palate was 0 (0/38). After 72 hours, the shape of MEE changed from uniform pebble-like to star-like or irregular shape with pseudopodia. The expressions of CK-19 protein were(0.739 ± 0.120, 0.483 ± 0.023, 1.007 ± 0.109, 1.086 ± 0.145) and fluorescence intensities were (53.384±5.785, 36.818 ± 8.250, 64.575±8.323, 76.898 ± 3.711) in control group and TCDD (5 nmol/L), TCDD (10 nmol/L) and TCDD (20 nmol/L) groups, respectively. The expressions of vimentin protein were (0.527 ± 0.112, 0.781 ± 0.095, 0.284 ± 0.046, 0.216 ± 0.040) and fluorescence intensities were (63.672±6.135, 82.632 ± 4.474, 52.608±7.525, 42.664 ± 7.659). Compared with the control group, the low-dose experimental group (5 nmol/L) had a decrease in CK-19 and an increase in vimentin; the high-dose experimental group (10 nmol/L, 20 nmol/L) had an increase in CK-19 and a decrease in vimentin, and the expression difference was statistically significant ( P<0.05), while there was no statistical significance among high-dose groups ( P>0.05). Conclusions:EMT process of MEE was identified in vitro and was a spontaneous procedure. TCDD-induced cleft palate may be related to the inhibition of the EMT process in MEE and with the increased dose of TCDD, the effects of EMT inhibiton were sustainable.