Objective To detect the genotypes of human papillomaviral infection(HPV)in 970 women who were suspicious as HPV infection, and to investigate its clinical significance. Methods Cervical cast-off cells were acquired with the special cervix brush. DNA hybridization technique was applied to detecting HPV genotypes in 970 clinical specimens. Results Totally 390 case(40.2%) were HPV positive among 970 clinical specimens. A total of 12 subtypes were detected. In 390 cases of HPV infection,260 cases (26.8%) were infected with single HPV subtype, and while 130 cases(13.4%) were with infection of two or above HPV subtypes. HPV6 and 11 were the most frequent low-risk sub-types,and in the high-risk subtypes,HPV16,33,52,58 and 18 were dominant. Conclusion The cervix HPV infection rate is considerable in women in Wuxi area. HPV6 and 11 are the most frequent sub-types. The determination of HPV genotypes plays all important role in early discovery, prevention and treatment of gential tract and cervical cancer.

OBJECTIVE: To study the effect of transplanting autologous bone marrow mesenchymal stem cells (BMSCs) at different time point after myocardial infarction on cardiac function, and to approach its mechanism. METHODS: Thirty healthy Taihu Meishan swine were prepared for myocardial infarction models, and divided into 6 experimental groups, with 5 animals in each group. BMSCs were transplanted into 3 groups through coronary artery at 3 hours, 2 weeks and 4 weeks after myocardial infarction, named G1, G2 and G4, respectively. Meantime, DMEM culture medium was injected in the control group at correspond periods. Each swine was examined by MRI and Doppler before infarction, before transplantation, and at 8 weeks after infarction, respectively, to observe the change of cardiac function. The VEGF values of blood serum in different periods after transplantation were detected. All swine hearts were harvested after 8 weeks (the experimental terminus), and the planting and differentiation of transplanted cells in cardiac muscle were detected by the method of immunity histochemistry. The density of blood vessels in cardiac muscle was acquired simultaneously. RESULTS: There was no statistic difference of cardiac function between G1 and its control groups. The groups of G2 and G4 could improve cardiac function compared to the control groups, and G4 was superior to G2 (P < 0.05). There was no statistics difference of the decreased absolute value of myocardial infarcted area between G1 and the control groups. The myocardial infarcted area of G4 was greater than G2 (P < 0.05). The value of blood serum VEGF rose obviously in the G2 and G4, while G1 and all control groups did not present any marked changes, the rising amplitude of G4 was larger than G2 (P < 0.05). There were not any planting and differentiation of transplanted stem cells in G1 and all control groups at 8 weeks after infarction, but G2 and G4 could display, especially in G4 group (P < 0.05). There was no statistic difference of the density of blood vessels in cardiac muscle between G1 and all control groups at 8 weeks after infarction, but the differences were significant in all experimental groups, which was superior in G4 group to G1 and G2 groups (P < 0.05).CONCLUSION: There is disparity of transplanting BMSCs at different time point after myocardial infarction on cardiac function. Transplantation in acute period of myocardial infarction has no significant effect, but transplantation in non-acute period can ameliorate cardiac function. The therapeutic effect of transplanted at 4 weeks is superior to other time point. The MRI can display the location and compass of infarct cardiac muscle, and reflect the variation of cardiac function.

Objective To investigate the efficiency of autologous transplantation of bone-marrow mononuclear cells for treatment of patients with diabetic lower limb ischemia. Methods Twenty patients of type 2 diabetes (22 legs) with diabetic lower limb ischemia were treated by autologous transplantation of bone-marrow mononuclear cells. Results All ischemic legs were preserved except three feet, which were amputated due to the previously existed foot gangrene in one and unsolved pain in two. The pain-alleviated rate was 85.0%. The amputation rate was 13.6%. The skin turned warm in all legs(100.0%). TcPO2 of the ischemic legs was elevated in 17 patients with 19 legs. Angiography showed a noticeable increase of visible collateral vessels in 7 patients with 8 limbs who had angiographic follow-up. Conclusion Autologous transplantation of bone-marrow mononuclear cells could be a simple, safe, and effective method to treat patients with diabetic lower limb ischemia.

Objective To investigate the effect and safety of autologons bone margow-mononuclear cell (BM-MNC)transplantation after the bone marrow stimulation in patients with thromboangiitis obliterans (TAO).Methods The bone marrows of 12 patients were stimulated by an injection of the recombinant human granuloeyte-macmphage colony-stimulatory factor(GCSF)for 3-5 days.150-200 ml bone marrow was drown from the iliac spine and the autologous BM-MNC were obtained in each patients.Fifteen lower limbs of 12 patients received implantation of the autologous BM-MNC by an intramuscular iniecdon.A series of subjective indexes(including improvement of pain and cold sensation)and objeetive indexes [including increase of ankle braehial index(ABI),transcutaneons oxygen pressure(TcPO2)and improvement of foot skin ulcer] were used to evaluate the effects.Results The outcomes were evaluated after 2 months of transplantation.The pain-relief rate and the cold feeling improvement rate were 86.7%(13/15)and 93.3%(14/15)respectively.The ABI were 0.38 ±0.05 vs.0.61 ±0.14(P<0.05)before transplantation and 2 months after transplantation respectively.increased in 66.7%(10/15)limbs.The TcPO2 of the ischemic legs increased from(27.47±2.85)mm Hg to(43.53 ±8.38)mm Hg(t=-7.03,P<0.05)after the transplantation,and the improvement rate of TcPO2 was 93.3%(14/15).Skin ulcers in improved in 8/9 limbs.Twelve patients were followed up for all average period of 10 months.The patients'symptoms improved in 80.0%(12/15)limbs,as to the objective index the ABI was0.57±0.13,TcPO2 was(42.07 ±7.81)mm Hg,which improved significandy compared to before treatment(t=-5.33,-7.80,Ps<0.05).skin ulcer healing rate was 66.7%(6/9).The ischemic symptoms in 2 patients were not relieved.There WBS no mortality and high level amputation in all subjects.The complications,such as proliferative retinopathy,malitpmnt tumor,myocardial infarction,stroke or hemangioma were not found in any patients.Conclusion In patients with TAO,intramuscular transplantation of autologous BM-MNC after the bone marrow stimulation has advantages of less bone marrow aspiration,more mononuclear cell content and relatively high safety.It may be a new and effective method to alleviate symptoms and accelerate the healing of skin ulcer.

Congenital biliary atresia is considered a neonatal rare disease with multiple causes and phenotypes, whose pathogenesis remains unclear. At present, the etiological study of congenital biliary atresia mainly focuses on viral infection, immune disorder, and dysplasia. This paper summarizes the main etiological hypotheses about congenital biliary atresia nowadays and the connections between them. The research progress provides valuable clues and evidence for the etiology and control of this disease.

ObjectiveTo investigate the effect of sorafenib and/or thalidomide on angiogenesis in chick chorioallantoic membrane (CAM). MethodsWhite eggs incubated for 7 days were used to establish a CAM model. The model eggs were randomly divided blank control group, sorafenib group, thalidomide group, and sorafenib/thalidomide group. After treatment, each egg was incubated for another 2 days. The CAM samples were collected and fixed to take their pictures under a microscope, and the vascular coverage of each sample was calculated. Comparison between these groups was made by analysis of variance, and comparison between each two groups was made by SNK-q test. ResultsThe thalidomide group or sorafenib group had significantly lower vascular coverage than the blank control group (30.2%±2.9% or 26.5%±2.1% vs 38.3%±2.7%, P＜0.05). The sorafenib/thalidomide group had significantly lower vascular coverage than the thalidomide group or sorafenib group (12.6%±1.5% vs 30.2%±2.9% or 26.5%±2.1%, P＜0.05). ConclusionBoth sorafenib and thalidomide have a good anti-angiogenic effect on CAM, but a combination of the two drugs shows better efficacy.

BACKGROUND: A great quantity of cell loss in early stage following stem cell transplantation can significantly affect transplantation effect. Presently, it is confirmed that overexpression of AKT1 gene significantly inhibit cell apoptosis. OBJECTIVE: To explore whether AKT1 gene overexpression can block stem cell apoptosis under hypoxic condition following pig autologous bone marrow mesenchymal stem cell (BMSC) transplantation, and the effect of repairing damaged myocardium. DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Soochow University from August 2005 to February 2007.MATERIALS: A total of 24 healthy male Meishan pigs were supplied by the Animal Experimental Center of Soochow University. METHODS: The CDS (regulation domin of AKT1) AKT1-cDNA fragment was amplified. Lentivector Packaging Kit was used to transfect BMSCs after synthesized with pCDH1-AKT1 shuttling plasmid. Following BrdU labeling, models of myocardial infarction were constructed by occluding the distal left anterior descending coronary artery in pigs with gelatin sponge. 4 weeks later, pigs were randomly divided into four groups: the model control group, the DMEM group, the BMSCs group, and the AKT-transfected group. In model control group, there was no other injection after occluding the left anterior descending coronary artery. In the DMEM group, 5 mL DMEM was injected into the coronary artery. 5 mL BMSCs (1×10~7 cells) were infused into the coronary artery in the BMSCs group. 5 mL BMSCs transfected with the AKT1 gene were injected in the AKT-transfected group MAIN OUTCOME MEASURES: Western blot analysis and real time RT-PCR were used to test the plasmid. The cardiac function was evaluated by magnetic resonance image. Histological characteristics of the myocardium were observed using immunohistochemistry. Serum vascular endothelial growth factor and transforming growth factor β1 levels were determined by ELISA. RESULTS: AKT1-cDNA was cloned into pCDH1-MCS1-EF1-copGFP and the sequence was confirmed in comparison with the published one. AKT mRNA expression could be detected distinctly 24 and 48 hours after transfecting cells. The expression of AKT1 intensity in MSCs remained strong 2 weeks later with detected by real time RT-PCR and Western blot analysis. AKT1-mRNA transcriptional levels were 120 times of primary cells. Before the cell implantation, the left ventricular end-diastolic dimension increased and the stroke volume decreased in the myocardial infarction hearts. The cardiac function was significantly improved after cell implantation, and the implanted MSCs prevented the infarct region from thinning and expanding, improved contraction and increased perfusion in all groups relative to the control hearts. The left ventricular chamber size was smaller in the hearts with being transplanted cells than that in the control hearts. Moreover, the improvement was even markedly greater in AKT-transfected group (P < 0.05). Hematoxylin-eosin staining results showed that fibering was significant in the model control group and DMEM group. Island-like myocardium was observed in the infarct zone of the BMSCs group and AKT-transfected group, and plenty of small vessels-shape structure was detected in the AKT-transfected group. Immunohistochemistry demonstrated that Von Willebrand Factor (vWF) and Cx-43 expression was determined in the myocardium in the BMSCs group and AKT-transfected group, and the proportion of BrdU and Cx-43-positive cells to BrdU-positive cells was significantly greater in the AKT-transfected group compared with the BMSCs group 4 weeks following transplantation (P < 0.05). Following cell transplantation, vascular endothelial growth factor levels were gradually increased, peaked at 1 week, gradually decreased, and reached a normal level at 4 weeks. Transforming growth factor p1 levels were gradually reduced, and significantly less than the model control group, DMEM group 4 weeks later (P < 0.05), and significantly lower than that pretransplantation (P < 0.05).CONCLUSION: Using lentiviral vector to construct with AKT1 gene could stably make BMSCs overexpress AKT1. The BMSCs engraftment in host myocardium might improve the left ventricle function by attenuating the contractile dysfunction and pathologic thinning in this model of left ventricular wall infarction. AKT1 overexpression can significantly improve cardiac function following infarction.

OBJECTIVETo explore an effective method for treatment of tennis elbow.

METHODSOne hundred and twenty-eight cases were randomly divided into a treatment group and a control group, 64 cases in each group. The treatment group were treated by electroacupuncture at Hegu (LI 4) and Taichong (LR 3), combined with cake-seperated moxibustion at Ashi points and Shousanli (LI 10) in the affected elbow, and the control group by routine block treatment of 1 mL lidocane and 25 mg prednisone.

RESULTSThe cured rate and the effective rate were 40.6% and 93.7% in the treatment group, and 25.0% and 78.1% in the control group, respectively, with a significant difference between the two groups (P < 0.05).

CONCLUSIONElectroacupuncture combined with cake-separated moxibustion is an effective method for tennis elbow.

Acupuncture Points ; Elbow Joint ; Electroacupuncture ; Humans ; Moxibustion ; Tennis Elbow

OBJECTIVETo evaluate the clinical effect of combination of acupuncture, cupping and medicine for treatment of fibromyalgia syndrome.

METHODSBy using multi-central randomized controlled method, 186 cases were randomly divided into an acupuncture combined with cupping and western medicine group (group A), an acupuncture combined with cupping group (group B) and a western medicine group (group C) and treated continuously for 4 weeks. The treatment of acupuncture combined with cupping was produced by acupuncture at five mental points and moving cupping on the Hechelu of the back, once evrey other day, thrice each week, and the western medicine therapy by oral administration of Amitriptyline, once each day. The scores of McGill Pain Questionnaire (MPQ), the amount of tenderness point and the time of producing effect were compared and the therapeutic effects were assessed with the Hamilton Depression Scale (HAMD).

RESULTSThe cured and markedly effective rate was 65.0% (39/60) in the group A, which was superior to 15.9% (10/63) in the group B and 16.1% (9/56) in the group C (both P < 0.001). After treatment, the scores of MPQ and HAMD and the amount of tenderness point all decreased in the three groups, group A being significantly better than group B and group C, and the time of producing effect in the group A was more earlier than those in the group B and the group C.

CONCLUSIONThe therapeutic effect of combination of acupuncture, cupping and medicine on fibromyalgia syndrome is superior to that of the simple acupuncture combined with cupping or the simple medicine.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Amitriptyline ; therapeutic use ; Antidepressive Agents, Tricyclic ; therapeutic use ; Combined Modality Therapy ; Female ; Fibromyalgia ; drug therapy ; therapy ; Humans ; Male ; Middle Aged ; Young Adult

Objective:To explore the effect of healthcare failure mode and effect analysis (HFMEA) in reducing the incidence of nursing interruption with negative outcome in operating room, so as to maximize the smooth progress of the surgical process.Methods:This was a quasi experimental study. The gastrointestinal surgery room of Shandong Provincial Hospital Affiliated to Shandong First Medical University was selected for the study. According to the surgical sequence, 38 surgeries performed in the gastrointestinal surgery suite from August 15-30, 2021 were set as the control group, and the conventional healthcare cooperation model process was implemented; 42 surgeries performed from September 15-30, 2021 were set as the intervention group, and the operating room under the HFMEA model was implemented negative outcome care disruption event management process.A video tracking method combined with a surgical care disruption event register was used to investigate the occurrence of negative outcome care disruption events in the operating room, comparing the number, duration, source of disruption events and the incidence of near miss events in the operating room between the control group and the intervention group.Results:In the control group, there were 38 observed surgeries, 190 negative outcome care interruptions, negative outcome interruptions of (5.26 ± 1.02) min duration, and no near misses; in the intervention group, there were 42 observed surgeries, 84 negative outcome care interruptions, negative outcome interruptions of (2.06 ± 0.08) min duration, and no near misses. There were statistically significant differences in the number, duration of negative outcome care interruptions between the intervention group and the control group ( χ2 = - 18.71, t = - 20.28; all P<0.01). There was statistically significant difference in the source of negative outcome care interruptions between the intervention group and the control group ( χ2 = - 12.71, P<0.01). Conclusions:HFMEA model can effectively reduce the number of negative nursing interruptions in the operating room, shorten the duration of interruptions, and minimize potential safety hazards caused by nursing interruptions, which is conducive to ensuring the safety of patients.