Objective To explore the role of high-risk human papillomavirus(Hr-HPV) DNA testing in the detection of cervical intraepithelial lesions(CIN) Ⅱ and Ⅲ,or cervical cancers for patients with abnormal cervical cytology.Methods A total of 2197 patients with abnormal cervical liquid-based cytology,who had received Hr-HPV detection and colposcopy,were enrolled into this study.The data were analyzed using ?2-test and Logistic regression.Among the patients,1013(46.5%) had atypical squamous cells undetermined significance(ASC-US),89(4.1%) had atypical squamous cell which cannot exclude high grade squamous intraepithelial lesion(ASC-H),757(34.7%) low squamous intraepithelial lesion(LSIL),253(11.6%) high-grade squamous intraepithelial lesion(HSIL),and 67(3.1%) atypical gland cells(AGC).Results Pathological examination showed CINⅡ in 224 patients(10.3%),CIN Ⅲ in 140(6.4%),cervical cancer in 27(1.2%),and adenocarcinoma in 9(0.4%).The other patients(1779/2179,81.6%) had CINⅠ,condyloma,or chronic cervicitis.The detection rate of CIN Ⅱ and Ⅲ,and cervical cancer was increased in the patients with Hr-HPV.The differences in the rate among ASC-US,ASC-H,LSIL,and HSIL patients were significant.The incidence rate of CINⅡ and Ⅲ,or cervical cancer was 2.2%(13/588),9.7%(21/216),24.9%(97/389),29.8%(182/611),and 23.2%(87/375) for the patients with a Hr-HPV load of 0-0.9,1.0-9.9,10.0-99.9,100.0-999.9,and ≥1000.0.Logistic regression showed that the risk of CINⅡ and Ⅲ,and cervical cancer increased by 1.325 folds with the log of the HPV load.Conclusions Hr-HPV DNA test is helpful for the detection of CIN Ⅱ and Ⅲ or cervical cancer in patients with abnormal cervical cytology.

Objective:To detect the clinical features of vulvar and vaginal intraepithelial neoplasias(VIN and VAIN,respectively).Methods:Total 148 women were performed vulvar or vaginal coloposcopy-directed biopsy pathology tests,from Sep.2004 to Dec.2007.Results:Among 148 women,vulvar or vaginal histologic results were vulvar cancer for 1,VIN or VAIN 2,3 for 23,VIN or VAIN for 16,condyloma for 61,vulvitis and vaginitis for 47.Eighty-five percent(33/39) women with VIN or VAIN 2,3 were more than 30 years old.Compared to women with cervical intraepithelial neoplasia(CIN),women with VIN or VAIN were older.The rate of high-risk HPV DNA in women with vulvar or vaginal lesions was 84%(84/100).VAIN occurred mainly in the upper vagina(90%,69/75).VIN or VAIN often accompanied or followed CIN or cervical cancer(79%,31/39),and VIN or VAIN 2,3 often accompanied or followed CIN 2,3 or cervical cancer(70%,16/23).Conclusion:Our data suggest that women with high-risk HPV infection are at risk of developing VIN or VAIN 2,3.The vulva and vagina should be carefully inspected by colposcopic examination at the time of colposcopy for any abnormal findings.

Objective To evaluate the role of high-risk human papillomavirus (HR-HPV) testing in diagnosis of high-grade cervical intraepithelial neoplasia (CIN2/3+) and cervical cancer.Methods Total 3426 women with known cytologic abnormality tests were subjected to detect high-risk HPV DNA by hybrid capture II and to have established diagnoses by cervical coloposcopy-directed biopsy test.Results Among 3426 women,45 were cervical cancer,670 were CIN 2/3,and 2711 were CIN 1 or other benign lesions based on the cervical histologic results. Compared with the women with CIN 1 or other benign lesions,the women with CIN 2/3+ had higher positive rates of HR-HPV. Higher load of HR-HPV was more common among women with cervical lesions than those without. Fifty-seven women who were transiently HR-HPV positive did not develop CIN2/3+ during follow-up.Conclusions Our data suggest that a high viral load could be used as a short-term marker of CIN 2/3+,and women repeatedly tested positive for HR-HPV are at risk of developing CIN2/3+. Detecting HR-HPV and follow up the positive women would be useful in diagnosis of CIN2/3+.

Objective To investigate the diagnosis and therapy of vaginal intraepithelial neoplasia (VAIN) and correlation to cervical intraepithelial neoplasia (CIN). Methods The clinical and pathological data about age, liquid-based cytology, human papillomavirus (HPV) DNA test, colposcopy,histology types and treatment in 35 patients with VAIN were reviewed to investigate the diagnosis and therapy of VAIN and correlation to CIN. Results Mean age at presentation was 43.9 years. The percentage of VAIN I, VAINⅡ and VAINⅢ were 52% (18/35), 34% (12/35) and 14% (5/35), respectively. 8% (1/13) of patients were younger than 40 years developed VAIN Ⅲ, while 18% (4/22) patients were eider than 40 years. There were 83% (29/35) cases were diagnosed from 2007 to June 2008. 69% (24/35) or 17% (6/35) cases had the history of CIN or cervical cancer, respectively. VAIN Ⅱ - Ⅲ accounted for 3/9, 53% (8/15) and 4/6 of CIN I , CIN Ⅱ - Ⅲ and cervical cancer, respectively. There were 87% (13/15) positive high risk HPV infection in VAIN Ⅰ , while 100% in VAIN Ⅱ and VAINⅢ. There were 97% (33/34) cases with abnormality for liquid-based cytology and 86% (30/35) cases of lesions were located in the upper 1/3 vagina. Among 19 cases received therapy, 14 eases (74%) were treated by surgery, 2 eases (11%) by brachytherapy, 3 cases (16%) used drug on the surface of vagina and the lesions were shown recovery in 9 cases followed up. Conclusion The clinical characteristics of VAIN are similar to CIN and the principles of diagnosis and treatment are also the same as that of CIN.

Background: The side effects of glucocorticoid in treatment of systemic lupus erythematosus (SLE) have been the focus of debate, and our preliminary study indicates that ginsenosides can enhance the efficacy of dexamethasone. Objective: To observe the effects of ginsenosides combined with prednisone in SLE patients. Design, setting, participants and interventions: A total of 60 SLE patients from Department of Rheumatology and Immunology, Changhai Hospital, Second Military Medical University, were randomly divided into treatment group and control group, with 30 patients in each group. Patients in the treatment group were given routine treatment with prednisone plus ginsenosides, while those in the control group were given routine treatment with prednisone plus placebo. They were all treated for 3 months. Main outcome measures: After three-month treatment, syndrome score in traditional Chinese medicine (TCM), total response rate and symptom improvement rate were measured and evaluated. Results: Twenty-eight cases in treatment group and twenty-seven cases in control group were included in analysis. The total response rates in the treatment group and control group were 89.28% and 66.67% respectively, and there was a significant difference between the two groups (P<0.05). After treatment, the TCM syndrome scores in the two groups were lower than those before treatment (P<0.01), and prednisone plus ginsenosides was better in decreasing the TCM syndrome score than prednisone plus placebo (P<0.05). The symptoms were improved in the treatment group as compared with the control group (P<0.05). Conclusion: Prednisone combined with ginsenosides can increase the clinical effective rate and improve the clinical symptoms of SLE patients.

Objective To understand the status of knowledge,attitude,and practice of schistosomiasis prevention and con-trol and infection status in Armed Police Forces stationed along the Yangtze River,so as to provide the reference for formulating the schistosomiasis prevention and control measures in Armed Police Forces. Methods A questionnaire survey was conducted in the Armed Police Forces along the Yangtze River in Jiangsu Province,and the investigation content included social demo-graphic data,schistosomiasis prevention knowledge,attitude and behavior. All the subjects were examined for Schistosoma ja-ponicum infection. Results Totally 376 soldiers were investigated in 2 sites. The total passing rate of schistosomiasis knowl-edge was 72.87%. The passing rate among different age groups had no significant difference( χ2 =0.26,P > 0.05). The passing rate of soldiers from endemic areas was significantly higher than that of the soldiers from non-endemic areas( χ2 =4.71,P <0.05). The passing rate of officers was significantly higher than that of the soldiers(χ2 = 4.21,P <0.05). The passing rate of sol-diers with the education levels of junior school,high school,college,undergraduate and above increased gradually,with a sig-nificant difference( χ2 =8.16,P < 0.05). The soldiers with positive attitude accounted for 93.88%. Among the water contact be-haviors,training accounted for 17.55% and participating in the task(such as flood fighting and water work)accounted for 86.44%. When launching,the rate of taking protective measures was 52.93%. The rate of taking protective measures in the knowledge passing group was much higher than that in the knowledge failed group( χ2 =10.55,P < 0.05). The stool was harm-lessly treated in the two camps. Among 376 soldiers,the positive rate of blood examinations was 0.53%,but the stool examina-tions were all negative. Conclusions The overall level of knowledge and correct behavior of schistosomiasis prevention in the Armed Police Forces along the Yangtze River still should be improved. The better health education and behavior intervention are crucial to schistosomiasis prevention in the army.

OBJECTIVE: This study was performed to evaluate the clinical performance of APTIMA human papillomavirus (AHPV) assay and Hybrid Capture 2 (HC2) assay in screening for cervical disease, especially in women with atypical squamous cell of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL). METHODS: A total of 411 women diagnosed with ASC-US or LSIL were referred and further triaged by HC2 test. Prior to colposcopy, liquid-based cytology specimens were collected for the AHPV assay. Sensitivity and specificity were established based on the histological findings of cervical intraepithelial neoplasia (CIN). RESULTS: In all 411 subjects, the positive detection rate of AHPV assay was 70.8% (95% confidence interval [CI], 66.4 to 75.2), which was significantly lower than the positive detection rate of 94.9% obtained using HC2 test (95% CI, 92.3 to 96.8). Only one CIN 3-positive case was detected among the 120 AHPV-negative women, which was then confirmed by Pap smear test to be LSIL. The sensitivities of AHPV and HC2 for CIN 3 were similar (94.1% and 100%, respectively). However, AHPV showed a significantly higher specificity than HC2 test (30.2% and 5.3%, respectively; p<0.001). CONCLUSION: AHPV assay is effective in identifying CIN 3-positive cases because of its high specificity and lower false-negative rate. The use of AHPV for the triage of ASC-US and LSIL might help to reduce the referral rate of colposcopy during cervical cancer screening.
Adult ; Aged ; Cervical Intraepithelial Neoplasia/*diagnosis/epidemiology/virology ; China/epidemiology ; Colposcopy/methods ; Early Detection of Cancer/methods ; False Negative Reactions ; Female ; Human Papillomavirus DNA Tests/*methods ; Humans ; Middle Aged ; Papillomavirus Infections/complications/*diagnosis/epidemiology ; Prevalence ; Sensitivity and Specificity ; Triage ; Uterine Cervical Neoplasms/*diagnosis/epidemiology/virology ; Young Adult

Objective: To explore the efficacy of an individualized cardiac rehabilitation education model on the knowledge level of cardiac rehabilitation and cardiac rehabilitation exercise for patients after percutaneous coronary intervention (PCI). Methods: This study adopted the method of quasi-experimental research, 96 patients after PCI were randomly divided into the intervention group (49 cases), and the control group (47 cases) according to the discharge order. The intervention group received the individualized education model of cardiac rehabilitation for 12 weeks led by the cardiac rehabilitation outpatient nurse, and the control group received the routine follow-up guidance. Before and after the intervention of the two groups, the changes of cardiac rehabilitation knowledge were evaluated according to The Coronary Artery Disease Education Questionnaire-II(CADE-Q II), the compliance of cardiac rehabilitation exercise were evaluated according to heart rate band mobile APP or mobile WeChat exercise APP, the effects of cardiac rehabilitation exercise were adjusted according to a 6-minute walking test. Results: The increase scores of CADE-Q II in the intervention group after the intervention were higher than that in the control group:(10.04±2.75) points vs (5.57 ± 2.65) points, and the difference was significant (t=2.079, P < 0.05).The exercise compliance of daily aerobic exercise target rate indicated on the App of mobile phones in the intervention group were higher than that in the control group:88%(15/17) vs 53% (7/17), and the difference was significant (t=5.100, P <0. 05). The exercise compliance of daily exercises indicating on the Wechat application in the intervention group were higher than that in the control group: 82% (23/28) vs 48% (13/27), and the difference was significant (t=7.025, P <0.01).6MWD in the intervention group was higher than that in the control group: (48.77±26.67) mvs (16.77±43.65) m, and the difference was significant (t=3.534, P <0.01). Conclusion This cardiac rehabilitation education model can improve the knowledge level and compliance of cardiac rehabilitation exercise, and promote the cardiac rehabilitation of patients after PCI.

OBJECTIVE: To study the clinical characteristics of invasive fungal infection secondary to systemic lupus erythematosus (SLE). METHODS: We observed the clinical features and experimental examination in 91 patients treated in Xiangya Hospital in recent years, of which 48 patients with invasive fungal infection and 41 patients without invasive fungal infection. RESULTS: The invasive fungal infection secondary to SLE mainly occurred in the lungs, nervous system, and urinary system. The fungi were mainly Candida albins and Aspergillus. The rate of invasive fungal infection in SLE patients and the level of CRP and TNF-α in these patients were significantly increased. The occurrence of invasive fungal infection was positively correlated with the prolonged course of disease, long-term use of immunosuppressants and antibiotics, and occurrence of complications, such as hypoproteinemia, leukocytopenia, and so on. The levels of C-reactive protein (CRP) and tumor necrosis factor-α(TNF-α) were increased in SLE patients with invasive fungal infection. CONCLUSION The clinical features of SLE patients with invasive fungal infections are long course of disease, long-time use of immunosuppressants or antibiotics, and occurrence of complications, such as hypoproteinemia or leukopenia. The level of CRP and TNF-α can be used as an important reference index for diagnosing invasive fungal infections.
Adolescent ; Adult ; Aspergillus ; isolation & purification ; C-Reactive Protein ; metabolism ; Candida albicans ; isolation & purification ; Central Nervous System Fungal Infections ; epidemiology ; Child ; China ; Female ; Humans ; Lung Diseases, Fungal ; epidemiology ; Lupus Erythematosus, Systemic ; microbiology ; Male ; Middle Aged ; Mycoses ; complications ; Tumor Necrosis Factor-alpha ; blood ; Young Adult

Objective:To explore the effects of an intervention strategy based on dyadic illness management theory on dyadic coping level, supportive care needs, and patients' disease symptoms with chemotherapy-stage ovarian cancer patients and their spouses, and to provide reference for improving their disease coping ability and quality of life.Methods:This study used the method of randomized controlled trial. Seventy pairs of ovarian cancer patients and their spouses who received regular chemotherapy and their spouses from Obstetrics and Gynecology Hospital, Fudan University from July 2022 to June 2023 were selected using convenience sampling method. They were assigned to the control group (36 pairs) and the observation group (36 pairs) by the random number table method. Participants in the control group received routine nursing care and the observation group received the intervention strategy of dyadic illness management theory. Data were collected and compared the differences in dyadic coping levels, care needs, and disease symptoms between two groups of patients and their spouses before intervention (before chemotherapy) and after intervention (after the end of the chemotherapy cycle). SPSS 20.0 software was used for analysis, and t-tests, χ2 tests, and Wilcoxon rank sum tests were used to compare the two groups. Results:Finally, 36 pairs were included in the control group and 34 pairs in the observation group. The age of the control group patients was (52.03 ± 9.44) years old, while that of the observation group patients was (53.41 ± 10.14) years old. After the intervention, the total score of dyadic coping level in the patients and their spouses of the observation group were (113.50 ± 8.03), (114.62 ± 10.59) points, respectively, which were higher than (106.64 ± 10.06), (108.78 ± 10.89) points of the control group with significant differences ( t=-3.14, -2.27, both P<0.05); the total score of care needs in the patients and their spouses of the observation group were (89.65 ± 8.29), (95.12 ± 7.25) points, respectively, which were lower than (100.25 ± 10.82), (110.11 ± 7.58) points of the control group with significant differences ( t=4.58, 8.45, both P<0.001); the total score of disease symptoms in the patients of the observation group was (20.09 ± 4.70) points, which was lower than (31.53 ± 6.08) points of the control group with significant differences ( t=8.77, P<0.001). Conclusions:The model of dyadic illness management can improve dyadic coping level and supportive care needs of chemotherapy-stage ovarian cancer patients and their spouses, and alleviate patients′ disease symptoms.