Objective To investigate the expression of human papilloma virus L1 (HPV L1)capsid protein in cervical lesions and different human papillomavirus ( HPV) subtypes, and to guide clinical triage management and best individual treatment.Methods Retrospective analysis of 2012 January to 2014 Janu-ary in Jiaxing Hospital of Traditional Chinese Medicine gynecology clinic for HPV L1 protein combined with HPV type, and liquid-based cytology test ( TCT) of 176 patients data.Results The positive expression rate of HPV L1 protein with TCT examination in the negative for intraepithelial lesion or malignancy ( NILM) , atypical squamous cells of undetermined significance( ASCUS) , low-grade squamous intraepithe lial lesion ( LSIL) , atypical squamous cells not except high lesion ( ASC-H) , high-grade squamous intraep-ithelial lesion ( HSIL) , and squamous-cell carcinoma ( SCC) was 28.99%, 44.19%, 64.44%, 22.22%, 12.50%, and 0, respectively.No significant differences were found between the NILM and ASCUS groups ( P >0.05) .The positive expression rate of HPV L1 protein in LSIL group was the highest, and it was sta-tistically significantly different from ASC-H and HSIL groups (χ2 =3.88,5.50, P <0.05) , and 0 expres-sion in SCC group.It suggests that the positive expression rate of HPV L1 protein decreased with the severi-ty of cervical cytology lesions.The top five diseases with positive expression of HPV L1 protein were inflam-mation (44.76%), cervical intraepithelial neoplasia (CIN)Ⅰ(52.94%), CIN Ⅱ(23.81%), CIN Ⅲ(8.33%), and squamous cell carcinoma (0); no significant difference was found between inflammation group and CIN Ⅰ group ( P >0.05 ); and statistically significant difference was found between CIN Ⅰgroup and CINⅡ, CINⅢgroup (χ2 =4.53,5.56, P <0.05), and 0 expression in SCC group.It sug-gests that the positive expression rate of HPV L1 protein increased with the increased level of cervical le-sions.The positive expression rate of HPV L1 protein in top five frequency of HPV infection was 60.78%in multiple infection, 17.65%in type 16, 50%in type 52, 66.67%in type 58, and 12.5%in type 18, re-spectively.The expression rate of HPV L1 protein of Type 16 infection was significantly lower than that of type 52, type 58 infection and multi infection(χ2 =4.15, P <0.05, χ2 =7.88,15.44, P <0.01).The positive expression rate of HPV L1 protein of type 18 infection was lower than the other three, but significant differences occurred only compared to multiple infection(χ2 =4.70, P <0.05).The rest had no significant difference( P >0.05) .Conclusions Detection of HPV L1 protein is of clinical value to evaluate the risk of cervical lesions.HPV L1 protein combined with HPV type and TCT detection is helpful for traffic man-agement and personalized treatment, and benefit patients with cervical lesions.

BACKGROUND: Biomechanical changes of the trunk might be an important factor contributing to the pathogenesis and poor recovery of lumbar disc herniation.OBJECTIVE: To study the biomechanical changes of the trunk of patients with lumbar disc herniation by isokinetic test of the protruded lumbar disc.DESIGN: Non-randomized controlled retrospective study of concurrent patients.SETTING: Department of Rehabilitation Medicine, Changhai Hospital, Second Military Medical University of Chinese PLA.PARTICIPANTS: Thirty patients with lumbar disc herniation, admitted in the clinic of Department of Rehabilitation, Changhai Hospital affiliated to Second Military Medical University between February 2001 and January 2002, were enrolled in this study, with another 30 concurrent patients without lumbar disc herniation serving as the control group. Informed consent was obtained from all patients involved.METHODS: A Biodex Multi-joint Testing System was employed for measuring the peak torque(PT), peak torque to body weight(PT/BW), time to peak torque(TPT), torque at 0. 2 s(T@ 0. 2), total work(TW), average power(AP) and flexion to extension(F/E) ratio of the trunk muscles of the patients. The results were analyzed by t test using SPSS 9.0 software.MAIN OUTCOME MEASURES: Main outcome: isokinetic evaluation of the lumbar and dorsal flexors and extensors; secondary outcome: F/E ratio.RESULTS: The strength of the trunk flexors and extensors decreased significantly in patients with lumbar disc herniation at each testing speed of retraction, and the bursting strength and indices for work efficiency of the muscles also exhibited obvious changes. The flexors showed greater reduction in muscle strength than the extensors. The F/E ratios during isokinetic concentric contraction at 60°/s and 180°/s were 57.99 ±5.68 and 65.74 ± 8.12, respectively, in patients with lumbar disc herniation, in comparison with the ratios of 95.25 ±5. 18 and 83.03 ±7.61 in the control patients, showing significant difference between the two patient groups( P ＜ 0.01 ).CONCLUSION: Biomechanical changes of the trunk muscles of patients with lumbar disc herniation are definite, and proper rehabilitative treatment of these patients should consists of specific training protocols to restore the mechanical balance of the trunk and break the vicious cycle on the basis ofaccurate evaluation of such changes.

Objective:To investigate the clinical value of shear wave elastography (SWE) in predicting pathological responses to neoadjuvant chemotherapy in breast cancer.Methods:According to the postoperative pathological responses, 56 patients who received neoadjuvant chemotherapy followed by surgical excision in the Fujian Cancer Hospital from August 2019 to September 2020 were divided into responders and non-responders. The relative change rates of tumor maximum diameter(ΔD2, ΔD4) and SWE stiffness (ΔEmax2, ΔEmax4, ΔEmean2, ΔEmean4) were assessed before NAC and after different NAC cycles (t2, t4). Clinical information, including age, T, N stages, ER, PR, HER2, Ki67, and molecular subtype were also considered as the variables. The independent influencing factors of pathological responses after neoadjuvant chemotherapy were obtained by logistic regression analysis and diagnostic test was carried out.Results:There were 23 cases as responders (41.0%, 23/56), and 33 cases as non-responders (58.9%, 33/56). Results of multivariate analysis showed ΔEmax4 and HER2 index were independent influencing factors of pathological responses ( OR=1.11, P<0.001; OR=31.81, P=0.002). Area under curve of the ΔEmax4 (AUC: 0.869, 95% CI: 0.746-0.941) was higher than that of HER2 (AUC: 0.690, 95% CI: 0.545-0.834). The combination of ΔEmax4 and HER2 gave the best prediction of pathological responses (AUC 0.930, 95% CI: 0.829-0.981). the sensitivity, specificity, diagnostic accuracy, postive predictive value, and negative predictive value were 78.26%, 96.97%, 75.23%, 94.73%, and 86.49%, respectively. Conclusions:ΔEmax4 and HER2 are independent predictors of pathological responses after neoadjuvant chemotherapy for breast cancer. Combined ΔEmax4 and HER2 can improve the predictive diagnostic efficacy of pathological responses to chemotherapy for breast cancer.