Objective To investigate the incidence and risk factors of human papillomavirus type 16 (HPV16) infec?tion among women through health screenings in Tianjin urban area. Methods A total of 2 000 women from Tianjin urban area were recruited for this study, and potential risk factors were investigated by questionnaire as well as by collecting cervi?cal exfoliated cells from the participants. HPV type was examined using polymerase chain reaction and pyrosequencing tech?nology, then the risk factors of HPV16 infection were examined by chi square test and the multiple factor logistic regression analysis. Results Among those 2 000 women who received health screenings, a total of 271 cases were HPV positive (13.55%). HPV16 accounts for the most common human papillomavirus types (39.5%, 107/271) while HPV58 account for 15.13%(41/271)and HPV18 account for 9.59% (26/271). Factors related to HPV16 infection were investigated include smoking history, initial age of sex (>25 years old or not) , number of pregnancies (≥2 or not), number of sexual partners (≥2 or not) and contraception measures (condom or other ways) with χ2=6.268,8.540,4.951,7.123,6.053,5.019, respectively. (P < 0.05). Age, alcohol intake, education level and previous gynecologial examination did not differ significantly among HPV16 positive patients compared to those with negative HPV. Multiple factor Logistic regression model analysis showed that the independent factors were smoking history and initial age for sex(≤25 years old)(P<0.05). Conclusion HPV16 is the most common type of cervical infection among women in Tianjin urban area. Changing inappropriate sexual behavior and smoking cessation are effective measures to prevent HPV16 infection and reduce incidence of cervical cancer.

Objective To investigate the cervical human papillomavirus (HPV) infection, genotypes and related high risk factors in 459 women of annual health examination. Methods A total of 459 cervical cytology specimens were de-tected with nest PCR and pyrosequencing methods. Questionnaires were collected simultaneously and the risk factors of HPV infection were analyzed. Results The detection rate of HPV-positive samples was 17.9%. Seven kinds of high-risk genotypes of HPV were found. The detection of HPV 16 was the most common (9.8%), followed by HPV58 (7.0%) and HPV18 (5.2%). The detection rates of simplex infection, dual infections and multiple infections were 9.6%, 4.8%and 1.5%respectively. The risk factors for HPV infection included alcohol consumption,income <3 000 yuan/ month, sexual part-ners>1, frequency of sexual activity>4 times/month and cervical erosion (P<0.05). Conclusion HPV DNA genotyping can provide important reference for HPV screening at early time and the application of HPV vaccines, which also provide sig-nificant evidence for the prevention, diagnosis and treatment of cervical cancer at early stage for the high risk population.

Objective To compare the diagnosis value of three-dimensional power Doppler imaging(3D-PDI)and color Doppler flow imaging(CDFI)on carotid artery stenosis.Methods Forty-nine patients with carotid artery atherosclerosis plaque or stenosis diagnosed by CDFl were enrolled in the study.The degree and ratio of carotid artery stenosis were measured by 3D-PDI in free-hand mode,and measured by DSA in one week,the results were compared with CDFI.Results 3D-PDI of normal carotid artery with atheromatous plaque showed the stereo image,quantity character and exact position of plaque,volume of vessel lumen and spatial distribution of blood flow directly.There was no statistical difference in diameter stenosis rate between 3D-PDI and CDFI[(52.0±0.9)% vs(51.7±0.8)%,P＞0.05],and the area stenosis rate measured by CDFI was significantly lower than that by 3D-PDI[(58.0±0.2)% vs(52.0±0.5)%,P＜0.01].In the diagnosis of stenosis classification,the rates of light,mild and severe stenosis were significantly different between CDFI and 3D-PDI(P＜0.05)and not significantly between 3D-PDI and DSA methods(X2=0.0538,P＞0.05).The detection rates of atherosclerotic plaques numbers in carotid crotch were significantly different between 313-PDI and CDFI(P＜0.05).Conclusions 3D-PDI can offer more valuable information for the diagnosis and trentment of carotid artery stenosis,it is more accurate than CDFI and similar to DSA.

Objective To evaluate the color Doppler flow imaging (CDFI) findings in predicting possible difficulties of laparoscopic cholecystectomy (LC). Methods A total of 99 patients with acute cholecystitis received CDFI examination, and were divided into easy LC group (n=67) and difficult LC group (n=32) according to the indexes including the volume of gallbladder, the thickness of gallbladder wall, the condition of arterial flow in the gallbladder wall, the condition of gallbladder cavity and fossa, and of the intra-and extra-hepatic bile duct. After LC, all the patients were redivided into easy LC group and difficult LC group according to a difficulty scoring system of LC. The relationship among imaging results, operation difficulties and operation findings was investigated. Results According to the final score of difficulty scoring system of LC, the number of patients in easy LC group and difficult group was 61 and 38, respectively. Compared with easy LC group, patients in difficult LC group had bigger gallbladder volume [(39.5±13.2)am3 vs(32.6±10.4)cm3], thicker gallbladder wall [(10.1±4.0)mm vs(3.8±0.9)mm], more stone incarceration in the neck of gallbladder, abundant color blood flow signal of the gallbladder wall and more severe adhesion of gallbladder to the adjacent tissues, with statistical difference between the 2 groups (t=-2.820,-12.318,-3.952,x2=33.548,19.461,P<0.05). Using gallbladder volume, the thickness of gallbladder wall, infarction of stones in the neck of gallbladder and adhesion of gallbladder to the adjacent tissues as prediction indexes, the accuracy of CDFI in predicting the possible difficulties of LC was 94% (93/99). Conclusion Preoperative CDFI is helpful in predicting difficulties of LC for acute cholecystitis.

Objective To research the clinical significance of acetated Ringer solution and succinylated gelatin in the fluid resuscitation of sepsis patients.Method Fifty-nine sepsis patients were divided into two groups:lactic acid Ringer solution and hetastarch (group A,27 cases)and acetated Ringer solution and suecinylated gelatin (group B,32 cases),compared the fluid resuscitation and other parameter.Results There were no significant difference in the central venous pressure,mean arterial pressure and the dose of noradrenaline (P ＞ 0.05).The activated partial thrombeplastin time in group A was longer than that in group B[(58±10),(74±13)s vs(48±7),(54 ±11) s in 6,24 hours],fibrinogen concentration was lower than that in group B [(3.3 ±0.8),(1.6±0.3)g/L vs (4.2±1.1),(2.1±0.2)g/L in 6,24 hours] (P＜0.05).Serum lactic acid,creatinine,calcium concentration in group A [(6.9±0.8)retool/L,(289 ~ 27)μ mol/L,(2.1 ±0.3)mmol/L]were higher than those in group B [(3.2 ±1.1)mmol/L, (193 ±42)μmol/L, (1.7±0.2)mmol/L](P＜0.05),there was no difference in APACHE Ⅲ scores on the third day between two groups (P＞0.05).Conclusions Acetated Ringer solution and succinylated gelatin in the fluid resuscitation of sepsis patients has the same effect,but fewer impacts on serum coagulation,serum lactic acid and renal function than lactic acid Ringer solution and hetastareh.They may be more suitable for fluid resuscitation of sepsis patients,but hypecalcemia is easy to happen,and there is no significant evidences proving the prognosis.

Objective To investigate the association of the two single nucleotide polymorphisms(SNPs) rs1386494 and G1463A of tryptophan hydroxylase 2 gene with depression in Yunnan Han population. Methods A case-control study Was designed by collecting 102 patients and 102 controls.Polymerase chain reaction-restriction fragment length polymorphisms(PCR-RFLP)technique Was used to detect the rs1386494 and G1463A polymorphisms.All patients were evaluated with Hamilton Rating Scale for Depression(HAMD),and scores were compared according to different genotype.Results 1.There were differences in genotype and allele frequency of rsl386494 in Yunnan Han population(X~2=4.300,P=0.038;X~2=4.067,P=0.044).The A allele frequency of rsl386494 in controls Was higher than in patients(P=0.044).2.No genotype of G1463A polymorphism was observed in all samples.3.No significant association genotype of rsl386494 with scores of HAMD Was observed(F=2.461,P=0.120).Conclusion The polymorphism of rsl386494 may be associated with the vulnerability of Yunnan Han population,and the A allele maybe the protective gene for depression.

Objective To explore the lowest effective dosage of mifepristone combined with misoprostol in terminating ultra-early pregnancy.Methods All the cases of ultra-early pregnancy classified by amenorrhea days,β-hCG and vaginal B-ultrasonic were randomly divided into two groups.One hundred cases in G1 group (minimized dosage) were orally administered 25 mg mifepristone once a day for 2 days and combined with 200 μg misoprostol 48 hours later,while 150 mg mifepristone combined with 600 μg misoprostol 48 hours later were given to 100 cases in G2 group (normal dosage).All cases were observed for 6 hours after taking misoprostol and returned for assessment three days later.Results None missing.Expulsion of conceptus:G1 and G2 group were 22 (22.0％,22/100) and 25 (25.0％,25/100;P ＞ 0.05).Failure rate:cases with incomplete abortion were 1 (1.0％,1/100) and 2 (2.0％,2/100) in G1 and G2 group,hospitalization for suspected ectopic pregnancies both was 1 (1.0％).Bleeding:bleeding cases during the administration of mifepristone in G1 and G2 group were 71 (71.0％,71/100) and 78 (78.0％,78/100; P＞0.05); the mcan bleeding time were (5.3 ± 1.4) days and (6.0± 1.5) days (P ＜0.01).Other side effects:in G1 group,majority showed light nausea (7.0％,7/100) and light abdominal pain (20.0％,20/100).Menses recovery:99 (99.0％,99/100) for G1 group and 98 (98.0％,98/100) for G2 group to recovery on scheduled time.Satisfactions:both were 99 (99.0％,99/100).Except mean bleeding days and side-effects,the differences above showed no significance (P ＞ 0.05).Conclusion It is safe and effective treatment with the lowest dosages of mifepristone and misoprostol to terminate ultra-early pregnancies.

Objective:To explore the effects of eight-week group positive psychotherapy intervention on de-pression associated self-efficacy and subjective well-being in female nursing students.Methods:Totally 74 female nursing students with mild to moderate depression [the score of Beck Depression Inventory (BDI-Ⅱ)was 14 to 28]were selected from three nursing colleges of Changsha.They were randomly divided into two groups,40 in the control group and 34 in the intervention group.Samples in the intervention group were given the eight-week group positive psychotherapy,while the control group was given nothing (the control group could receive the intervention when the intervention was proved to be effective or the control group needed treatments).The General Self-efficacy Scale(GSES)and Index of Well-being(IWB)were used to get the outcome of female nursing students'self-effica-cy,subjective well-being at baseline,the time after the intervention,3 month follow-up,6 month follow-up.Results:The interactive effect between group and time of self-efficacy,subjective well-being were statistically significant (Ps<0.05).Separate analyses showed that at baseline,there was no significant difference between two groups in all variables (Ps >0.05).At the end of the intervention,3 month follow-up and 6 month follow-up,the GSES score and IWB score in the intervention group were higher than those in the control group (Ps <0.05).Conclusion:Eight-week group positive psychotherapy could improve self-efficacy and subjective well-being of female nursing students who have mild to moderate depressive symptom.This intervention also has a long-term effect.

Objective To investigate the phagocytosis function of cigarette smoke extracts (CSE)on the NR8383 cells. Methods The concentration of CSE and the optimal time was defined by cell counting kit-8 assay, Annexin V/PI cell apoptosis assay and CFSE cell proliferation assay. The cell was gained after exposed to the different concentration of CSE for 24 h and mixed with fluorescein-labeled Escherichia coli in 37℃ for 2 h. The fluorescence intensity was used to assay the phagocytosis function of NR8383 cells.Results The phagocytosis function of NR8383 cells may be changed by the concentration of CSE. In the concentration of 100 μg/ml, the phagocytosis function of NR8383 was enhanced 0.5 times than the normal cell when NR8383 cell was exposed to CSE, and the specific activity is the highest. When NR8383 cells were exposed to CSE and LPS, the phagocytosis function of NR8383 cells was enhanced 2 times than the normal cell. In the concentration of 200 μg/ml, the phagocytosis function of NR8383 cells was damaged, the rate of apoptosis is the 54. 1%. Conclusion Low concentration of CSE enhanced the phagocytosis function of NR8383 cells, but high concentration of CSE damaged the phagocytosis function of NR8383 cells. This study reveals a new role of CSE as an activator of macrophage function.

Objective To evaluate the application value of three-dimensional power Doppler imaging(3D-PDI) in diagnosis of carotid artery stenosis in the elderly. Methods A total of 72 elderly patients with history of hypertension, coronary atheroselerosis, diabetes mellitus or hyperlipidemia were included in the study. The condition of carotid artery stenosis was examined by colour doppler flow imaging (CDFI), 3D-PDI in free-hand mode, and measured by digital subtraction angiography (DSA) as a golden standard in 24 hours. The sensitivity, specificity, positive and negative predictive values were calculated, and all the results were compared with CDFI. Results 3D-PDI directly showed the stereo image, including surface character and exact position of plaque,volume of vessel lumen and spatial distribution of blood flow. Seventy two patients had 85 stenosis of carotid arteries. There was no statistical difference in diameter stenosis rate between CDFI and 3D-PDI [(49.2±0.7)% vs. (52.3±0.3)%,P>0.05], and the area stenosis rate measured by 3D-PDI was significantly lower than by CDFI[(53.24±0.7)% vs. (59.3±0.4)%, P<0.01]. In the diagnosis of stenosis classification, the diagnostic sensitivities of light, mild and severe stenosis were significantly different between CDFI(88.9%,100.0%,100.0%) and 3D-PDI(100.0%,70.4%,58.1%) all(P<0.01). The 3D-PDI was better in diagnostic sensitivity of mild and severe stenosis, but specificity was not better than CDFI. Conclusions 3D-PDI is an easy, convenient method with no-wound and good reproducibility in the diagnosis of carotid artery stenosis. It is more accurate than CDFI and similar to DSA.