Objective To construct and validate a nomogram prediction model for the high-risk human papilloma-virus(HPV)infection and its natural clearance in professional women.Methods Women with regular professions,who underwent professional medical examination and were confirmed with high-risk HPV infection without cervical cancer and cervical epithelial neoplasia in a hospital from March 2020 to March 2021 were studied.Patients were di-vided into the model group and the validation group in a 7:3 ratio.The model group were subdivided into the natural clearance group and the persistent infection group based on follow-up results.The general information,reproduc-tive-related treatment,sexual partner-related information,and examination results of the two groups of patients were compared.Potential factors for natural clearance of high-risk HPV infection in professional women were screened out by LASSO regression.Independent influencing factors were screened out with multivariate logistic re-gression.Based on multivariate logistic regression results,a nomogram prediction model was constructed and valida-ted using R programming language.Results A total of 329 cases were included,230 in the model group and 99 in the validation group.There was no statistically significant difference in general information between the two groups of patients(all P＞0.05).Among the 230 high-risk HPV infection patients in the model group,165 turned negative at the end of follow-up,with a natural clearance rate of 71.74％.Based on LASSO regression analysis,multivariate logistic regression analysis showed that age,contraceptive method,number of sexual partners,excessive foreskin of sexual partners,initial viral load,HPV infection type,and reproductive tract inflammation were independent influ-encing factors for the natural clearance of high-risk HPV infection in professional women(all P＜0.05).The re-ceiver operating characteristic(ROC)curve analysis showed that the areas under the curve(AUC)of natural clea-rance of high-risk HPV infection in professional women in the model group and validation group were 0.834(95％CI:0.776-0.893)and 0.817(95％CI:0.755-0.879),respectively.H-L goodness-of-fit test result showed that the difference between the nomogram model and the ideal model was not statistically significant(P＞0.05).The cali-bration curve results showed that the predicted curves of the model group and validation group were basically fit with the standard curve,indicating a high predictive accuracy of the model.The decision curve analysis results of the model group showed that when the probability threshold of natural clearance of high-risk HPV infection in profes-sional women predicted by the nomogram model was 0.15-0.95,the net benefit rate of patients was＞0.Conclusion The natural clearance rate of high-risk HPV infection in professional women is high,mainly influenced by factors such as age,contraceptive method,and number of sexual partners.The nomogram model constructed in this study has high accuracy and discrimination in predicting the natural clearance rate of high-risk HPV infection in profes-sional women.

This study aimed to provide scientific evidence for predicting quality markers(Q-markers) of Elephantopus scaber by establishing UPLC fingerprint of E. scaber from different geographical origins and determining the content of 13 major components, as well as conducting in vitro anti-cancer activity investigation of the main components. The chromatographic column used was Waters CORTECS UPLC C_(18)(2.1 mm×150 mm, 1.6 μm), and the mobile phase consisted of acetonitrile and 0.1% formic acid solution(gradient elution). The column temperature was set at 30 ℃, and the flow rate was 0.2 mL·min~(-1). The injection volume was 1 μL, and the detection wavelength was 240 nm. The UPLC fingerprint of E. scaber was fitted using the Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine(2012 edition) to determine common peaks, evaluate similarity, identify and determine the content of major components. The CCK-8 assay was used to explore the inhibitory effect of the main components on the proliferation of lung cancer cells. The results showed that in the established UPLC fingerprint of E. scaber, 35 common peaks were identified. Thirteen major components, including neochlorogenic acid(peak 1), chlorogenic acid(peak 2), cryptochlorogenic acid(peak 3), caffeic acid(peak 4), schaftoside(peak 6), galuteolin(peak 9), isochlorogenic acid B(peak 10), isochlorogenic acid A(peak 12), isochlorogenic acid C(peak 18), deoxyelephantopin(peak 28), isodeoxyelephantopin(peak 29), isoscabertopin(peak 31), and scabertopin(peak 32) were identified and quantified, and a quantitative analysis method was established. The results of the in vitro anti-cancer activity study showed that deoxyelephantopin, isodeoxyelephantopin, isoscabertopin, and scabertopin in E. scaber exhibited inhibition rates of lung cancer cell proliferation exceeding 80% at a concentration of 10 μmol·L~(-1), higher than the positive drug paclitaxel. These results indicate that the fingerprint of E. scaber is highly characteristic, and the quantitative analysis method is accurate and stable, providing references for the research on quality standards of E. scaber. Four sesquiterpene lactones in E. scaber show significant anti-cancer activity and can serve as Q-markers for E. scaber.
Humans ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal/chemistry* ; Asteraceae/chemistry* ; Lung Neoplasms/drug therapy*

Platelets are reprogrammed by cancer via a process called education, which favors cancer development. The transcriptional profile of tumor-educated platelets (TEPs) is skewed and therefore practicable for cancer detection. This intercontinental, hospital-based, diagnostic study included 761 treatment-naïve inpatients with histologically confirmed adnexal masses and 167 healthy controls from nine medical centers (China, n = 3; Netherlands, n = 5; Poland, n = 1) between September 2016 and May 2019. The main outcomes were the performance of TEPs and their combination with CA125 in two Chinese (VC1 and VC2) and the European (VC3) validation cohorts collectively and independently. Exploratory outcome was the value of TEPs in public pan-cancer platelet transcriptome datasets. The AUCs for TEPs in the combined validation cohort, VC1, VC2, and VC3 were 0.918 (95% CI 0.889-0.948), 0.923 (0.855-0.990), 0.918 (0.872-0.963), and 0.887 (0.813-0.960), respectively. Combination of TEPs and CA125 demonstrated an AUC of 0.922 (0.889-0.955) in the combined validation cohort; 0.955 (0.912-0.997) in VC1; 0.939 (0.901-0.977) in VC2; 0.917 (0.824-1.000) in VC3. For subgroup analysis, TEPs exhibited an AUC of 0.858, 0.859, and 0.920 to detect early-stage, borderline, non-epithelial diseases and 0.899 to discriminate ovarian cancer from endometriosis. TEPs had robustness, compatibility, and universality for preoperative diagnosis of ovarian cancer since it withstood validations in populations of different ethnicities, heterogeneous histological subtypes, and early-stage ovarian cancer. However, these observations warrant prospective validations in a larger population before clinical utilities.
Humans ; Female ; Blood Platelets/pathology* ; Biomarkers, Tumor/genetics* ; Ovarian Neoplasms/pathology* ; China

OBJECTIVE: To establish a prognostic nomogram based on response to bortezomib and BTK expression for treatment-experienced multiple myeloma patients. METHODS: The Oncomine database was utilized to determine BTK expression, sex, age, albumin, Mayo index, response to bortezomib treatment, follow-up time and survival status in multiple myeloma(MM) patients. Cut-off point for BTK expression was calculated using R software. Univariate and multivariate analyses by Cox proportional hazards regression were then performed. Significant prognostic factors were combined to build a nomogram. The discrimination ability and predictive accuracy of the nomogram were evaluated using the index of concordance (C-index) and calibration curves. RESULTS: Multivariate analysis showed that response to bortezomib, BTK expression and sex were independent risk factors for prognosis. The C-index value of the nomogram made according to the independent risk factors was 0.729 (95%CI, 0.642-0.8164). The calibration curves showed good consistency between predicted and actual survivals for 1-year and 2-year overall survival. CONCLUSION The proposed nomogram is accurate in predicting the prognosis of patients with MM.
Bortezomib/therapeutic use* ; Humans ; Multiple Myeloma/drug therapy* ; Nomograms ; Prognosis ; Proportional Hazards Models

Post-traumatic osteomyelitis (PTO) is a worldwide problem in the field of orthopaedic trauma. So far, there is no ideal treatment or consensus-based gold standard for its management. This paper reviews the representative literature focusing on PTO, mainly from the following four aspects: (1) the pathophysiological mechanism of PTO and the interaction mechanism between bacteria and the body, including fracture stress, different components of internal fixation devices, immune response, occurrence and development mechanisms of inflammation in PTO, as well as the occurrence and development mechanisms of PTO in skeletal system; (2) clinical classification, mainly the etiological classification, histological classification, anatomical classification and the newly proposed new classifications (a brief analysis of their scope and limitations); (3) imaging diagnosis, including non-invasive examination and invasive examination (this paper discusses their advantages and disadvantages respectively, and briefly compares the sensitivity and effectiveness of the current examinations); and (4) strategies, including antibiotic administration, surgical choices and other treatment programs. Based on the above-mentioned four aspects, we try to put forward some noteworthy sections, in order to make the existing opinions more specific.
Anti-Bacterial Agents/therapeutic use* ; Fractures, Bone/diagnostic imaging* ; Humans ; Osteomyelitis/therapy*

OBJECTIVE: To evaluate and compare the normativity of overview report of systematic review (Overviews) of acupuncture and moxibustion at home and abroad so as to further improve the report quality of Overviews of acupuncture and moxibustion in China and provide reliable evidences. METHODS: The articles relevant with Overviews of acupuncture and moxibustion at home and abroad were retrieved by computer from the databases of CNKI, VIP, Wanfang, China BioMedical Literature database (SinoMed), PubMed, Embase and Conchrane Library, dated from the time of establishment to February 12, 2019. The preferred reporting items for Overviews (PRIO-harms) was adopted to evaluate their normativity and make the comparison of the articles between China and foreign countries. RESULTS: A total of 13 articles of Overviews of acupuncture and moxibustion were included, 9 articles of them were of Chinese version and the rest were of English version. The results of PRIO-harms indicated that the proportions of the item numbers related to adequate, partial and inadequate adherence of Chinese version were 3.7%, 63.8% and 32.5%, and those of English version were 12.0%, 57.4% and 30.6% respectively. The reports on the item 10 "additional search for primary studies", the item 12 "data items" and the item 26 "Dual/(co-)authorship" were inadequate adherence by 100% in the articles of both Chinese and English version. CONCLUSION The overall information of English article report is better than Chinese one, but the reports of either Chinese or English articles are not so satisfactory. It is suggested that the Overviews report should be in reference to the specification in PRIO-harms and the Chinese researchers should study the advantages of English article report and improve the normalization and report quality so as to obtain the high-quality evidences in evidence-based medicine.
Acupuncture Therapy ; China ; Humans ; Moxibustion

We review the representatives literatures on chronic osteomyelitis, sum up the new insights in recent years into diagnostic options and treatment regimens, analyze the advantages and disadvantages of various diagnostic approaches and treatment strategies, and propose areas of interest to make current diagnostic and treatment strategies more specific.

OBJECTIVETo investigate the change in the expression of tight junction protein ZO-1 in intestinal epithelial cells (Caco-2 cells) and the protective effect of eicosapentaenoic acid (EPA) after adherent-invasive Escherichia coli (E.coli) LF82 infection.

METHODSThe Caco-2 cell line was used to establish an in vitro model of tight junction of intestinal epithelial cells. Caco-2 cells were divided into EPA treatment groups (0, 25, 50, 100, and 200 μmol/L EPA) and EPA (0, 25, 50, 100, and 200 μmol/L EPA)+E.coli LF82 treatment (0, 6, and 12 hours) groups. A microscope was used to observe the morphological characteristics of the cells. MTT assay was used to determine the cell growth curve. The activity of alkaline phosphatase (ALP) at both sides of the cell membrane was compared to evaluate the Caco-2 cell model. MTT assay and flow cytometry were used to investigate the effects of different concentrations of EPA on the survival rate and apoptosis rate of Caco-2 cells. RT-qPCR was used to measure the mRNA expression of ZO-1 in Caco-2 cells after EPA and/or E.coli LF82 treatment. ELISA was used to measure the change in the level of tumor necrosis factor-α (TNF-α) in culture supernatant.

RESULTSAfter EPA treatment (25 and 50 μmol/L), the proliferation of Caco-2 cells was induced in a dose-dependent manner. The survival rates of the cells were significantly higher than those in the control group (P<0.05). The EPA treatment (100 and 200 μmol/L) groups had a significant inhibitory effect on the proliferation of Caco-2 cells in a dose-dependent manner. The survival rates of the cells were significantly lower than those in the control group (P<0.05). The EPA treatment (100 and 200 μmol/L) groups had a significant increase in cell apoptosis rate compared with the control group (P<0.05). The 6- and 12-hour E.coli LF82 treatment groups had decreasing mRNA expression of ZO-1 in Caco-2 cells over the time of treatment and had significantly lower mRNA expression of ZO-1 than the untreated group (P<0.05). The Caco-2 cells treated with E.coli LF82 and 25 or 50 μmol/L EPA for 6 or 12 hours showed an increase in the mRNA expression of ZO-1 with the increasing concentration of EPA, as well as significantly higher mRNA expression of ZO-1 than the Caco-2 cells treated with E.coli LF82 alone (P<0.05). The Caco-2 cells treated with E.coli LF82 alone for 6 or 12 hours had increasing secretion of TNF-α over the time of treatment and had significantly higher secretion than the untreated Caco-2 cells (P<0.05). The Caco-2 cells treated with E.coli LF82 and 25 or 50 μmol/L EPA for 6 or 12 hours showed a reduction in the secretion of TNF-α with the increasing concentration of EPA and had significantly lower secretion than the Caco-2 cells treated with E.coli LF82 alone (P<0.05).

CONCLUSIONSEPA can effectively prevent the destruction of tight junction of intestinal epithelial cells induced by E.coli LF82 infection and inhibit the secretion of inflammatory factors. Therefore, it has a certain protective effect on intestinal mucosal barrier.

Apoptosis ; drug effects ; Caco-2 Cells ; Eicosapentaenoic Acid ; pharmacology ; Escherichia coli ; pathogenicity ; Humans ; Intestinal Mucosa ; metabolism ; microbiology ; RNA, Messenger ; analysis ; Tight Junctions ; drug effects ; Tumor Necrosis Factor-alpha ; secretion ; Zonula Occludens-1 Protein ; genetics

Objective:To investigate the effect of early enteral nutrition on ventilator-associated pneumonia in patients with severe cerebrovascular disease,and to evaluate nutritional status,intestinal nutrition tolerance,pH value of gastric juice and incidence of gastrointestinal bleeding.Methods:This study was a prospective study.The subjects were 72 patients with severe cerebrovascular disease in the intensive care unit of Neurology Department of our hospital from March 2014 to May 2017.All patients were treated with nasal feeding and mechanical ventilation.Among them,36 patients received enteral nutrition support treatment within 24 hours (early group),and 36 patients received enteral nutrition support treatment after 24 hours (control group).The two groups were compared with the incidence of ventilator-associated pneumonia,weaning success rate,complications of enteral nutrition rate,and gastrointestinal bleeding within 7 days,serum albumin and serum prealbumin level after 7 days,survival rate after 28 days.We also analyzed the changes in pH of the gastric juice at admission,1 day,3 days,7 days,and 14 days after treatments.Results:In the early group,the incidence of ventilator-associated pneumonia,gastrointestinal bleeding,complications of enteral nutrition,were lower than the control group.The serum level of albumin and prealbumin,the rate of successful weaning and 28 day survival rate were higher than the control group.After the early enteral nutrition,the pH value of gastric juice increased significantly.Conclusion:Early application of enteral nutrition support therapy can improve the nutritional status of patients,reduce the incidence of ventilatorassociated pneumonia,improve the success rate of weaning,reduce the fatality rate and improve the prognosis of patients.Early enteral nutrition support treatment can also increase pH value of gastric juice and reduce the incidence of gastrointestinal complication and gastrointestinal bleeding.