Objective To analyze the status of persistent human papillomavirus (HPV) infection and the distribution of viral subtypes in the Zhengzhou region. Methods Clinical data of 55239 patients who underwent HPV-DNA genotyping tests from 2018 to 2024 were collected. On the basis of HPV follow-up results, patients were divided into three groups: 849 cases of infection with the same HPV type, 255 cases of persistent infection with different HPV types, and 857 cases of transient HPV infection. Results Among the 9232 initially-screened patients who were positive with HPV, the high-risk HPV (HR-HPV) positive rate was 84.6% (7813/9232), and predominant subtypes were HPV-16 (20.8%), HPV-52 (17.2%), and HPV-53 (9.6%). The low-risk HPV (LR-HPV) positive rate was 15.4% (1419/9232), mainly HPV-81 (28.1%) and HPV-42 (27.0%). Among the 1961 follow-up cases, the rates of persistent and non-persistent infections with the same HPV type were 35.7% (701/1961) and 7.5% (148/1961), respectively. The rates of persistent and non-persistent infections with different HPV types were 10.9% (214/1961) and 2.1% (41/1961), respectively. Meanwhile, 43.7% (857/1961) tested negative upon follow-up. Among the 701 cases of persistent infection with the same HPV type, HR-HPV accounted for 85.7% (601/701), and LR-HPV accounted for 14.3% (100/701). Among the 214 cases of persistent infection with different HPV types, 89.7% (192/214) were high-risk transitions, and 10.3% (22/214) were low-risk transitions. Regardless of HPV types, HR-HPV was more likely to cause persistent infection than LR-HPV. In addition, over 60% of HR-HPV persistent infections resolved within 18 months, 30% developed into persistent infections, and only 15% of patients had persistent infections that last more than 24 months. Conclusion Persistent HPV infections are predominantly high-risk types. Most patients clear the infection within 18 months, approximately 30% develop persistent infections, and about 15% of patients have persistent infections that last more than 24 months. However, the HR-HPV persistent infection rates across different age groups slightly differ.

Objective:This study collected a real-world data on survival and efficacy of gemcitabine-containing therapy in advanced breast cancer. Aimed to find the main reasons of affecting the duration of gemcitabine-base therapy in advanced breast cancer patients.Methods:Advanced breast cancer patients who received gemcitabine-base therapy from January 2017 to January 2019 were enrolled(10 hospitals). The clinicopathological data, the number of chemotherapy cycles and the reasons for treatment termination were collected and analyzed. To identify the reasons related with continuous treatment for advanced breast cancer and the factors which affect the survival and efficacy.Results:A total of 224 patients with advanced breast cancer were enrolled in this study, with a median age of 52 years (26-77 years), 55.4%(124/224) was postmenopausal. Luminal type were 83 cases, TNBC were 97 cases, and human epidermal growth factor receptor 2 (HER's-2) overexpression were 44. At the analysis, 224 patients who received the gemcitabine-based regimens were evaluated, included 5 complete reponse (CR), 77 partial response (PR), 112 stable disease (SD) and 27 progressive disease (PD). The objective response rate (ORR) was 36.6%(82/224). Seventy patients had serious adverse diseases, including leukopenia (9), neutrophilia (49), thrombocytopenia (15), and elevated transaminase (2). The median follow-up time was 41 months (26~61 months), and the median PFS was 5.6 months. The reasons of termination treatment were listed: disease progression were 90 patients; personal reasons were 51 patients; adverse drug reactions were 18 patients; completed treatment were 65 patients. It was found that progression-free survival (PFS) was significantly longer in patients receiving >6 cycles than that in patients with ≤6 cycles (8.2 months vs 5.4 months, HR=2.474, 95% CI: 1.730-3.538, P＜0.001). Conclusions:Gemcitabine-based regimen is generally well tolerated in the Chinese population and has relatively ideal clinical efficacy in the real world. The median PFS is significantly prolonged when the number of treatment cycles are appropriately increased.

Objective:This study collected a real-world data on survival and efficacy of gemcitabine-containing therapy in advanced breast cancer. Aimed to find the main reasons of affecting the duration of gemcitabine-base therapy in advanced breast cancer patients.Methods:Advanced breast cancer patients who received gemcitabine-base therapy from January 2017 to January 2019 were enrolled(10 hospitals). The clinicopathological data, the number of chemotherapy cycles and the reasons for treatment termination were collected and analyzed. To identify the reasons related with continuous treatment for advanced breast cancer and the factors which affect the survival and efficacy.Results:A total of 224 patients with advanced breast cancer were enrolled in this study, with a median age of 52 years (26-77 years), 55.4%(124/224) was postmenopausal. Luminal type were 83 cases, TNBC were 97 cases, and human epidermal growth factor receptor 2 (HER's-2) overexpression were 44. At the analysis, 224 patients who received the gemcitabine-based regimens were evaluated, included 5 complete reponse (CR), 77 partial response (PR), 112 stable disease (SD) and 27 progressive disease (PD). The objective response rate (ORR) was 36.6%(82/224). Seventy patients had serious adverse diseases, including leukopenia (9), neutrophilia (49), thrombocytopenia (15), and elevated transaminase (2). The median follow-up time was 41 months (26~61 months), and the median PFS was 5.6 months. The reasons of termination treatment were listed: disease progression were 90 patients; personal reasons were 51 patients; adverse drug reactions were 18 patients; completed treatment were 65 patients. It was found that progression-free survival (PFS) was significantly longer in patients receiving >6 cycles than that in patients with ≤6 cycles (8.2 months vs 5.4 months, HR=2.474, 95% CI: 1.730-3.538, P＜0.001). Conclusions:Gemcitabine-based regimen is generally well tolerated in the Chinese population and has relatively ideal clinical efficacy in the real world. The median PFS is significantly prolonged when the number of treatment cycles are appropriately increased.

With the population aging,the number of elderly with Alzheimer's disease or other types of dementia is increasing,which seriously threatens the health and quality of life in elderly.The early screening and detection of dementia among high-risk population and appropriate interventional measures would delay the disease course,and maintain patients' self-care abilities and dignity.Computerized neuropsychological assessment devices are economic and efficient,and suitable for screening in large population.This article reviews the theory,characteristics and application of internet-based neuropsychological assessment for age-related cognitive impairment,as well as the prospect in the future studies.

Objective To explore the clinical efficacy and side effects of intraperitoneal perfusion of verapamil and chemotherapeutic drugs in treating patients with gastric cancer after operation.Methods Totally 184 gastric cancer patients accepted radical surgery with postoperative classification (pT1/2/3/4N2/3M0) were randomly divided into control group (n =58) and treatment group (n =126).For the post-gastrectomy chemotherapeuric treatment,1 g of 5-fluorouracil and 70 to 90 mg of cisplatin were administrated for the patients in the control group,while 1 g of 5-fluorouracil,70 to 90 mg of cisplatin and 25 mg of verapamil were given to the patients in the treatment group.Patients in both groups received intravenous administration of 20 to 30 mg of doxorubicin 3 ～ 5 hours before the intraperitoneal chemotherapy,and 0.1 g of leucovorin 30 minutes prior to the intraperitoneal chemotherapy.On the second day,intraperitoneal chemotherapy of 0.5 to 0.75 g 5-fiuorouracil was given to all patients for 3 to 5 days.The disease-free survival rate,overall survival rate,disease-free survival (DFS),overall survival (OS),peritoneal recurrence rate,liver metastasis rate,gastric remnant recurrence rate,adverse reactions were examined and recorded at the time points of 12 and 24 months after the chemotherapy treatment.Results In the treatment group,disease-free survival and overall survival rates at 12 and 24 months were significantly higher than those in the control group,and the median DFS and OS were significantly longer than the control group (P ＜ 0.05).In patients with regional lymph node staging (N2,N3),low differentiated adenocarcinoma,tumor diameter greater than 4-cm,the disease free survival rate and overall survival rate at 12 and 24-months were significantly higher than the control group,and the median DFS and OS were significantly longer than the control group (P ＜0.05).In the treatment group,intraperitoneal recurrence rate and liver metastasis rate at 12 and 24-months were significantly lower than the control group (P ＜ 0.05).There was no significant difference in recurrence rate of gastric stump between the control group and treatment group.Application of verapamil did not increase the incidence rate of adverse reactions.There were 8 patients with mild abdominal pain and 3 patients with incomplete intestinal obstruction,and all of them were cured after one week of treatment.Conclusion The intraperitoneal perfusion of verapamil and chemotherapeutic drugs can significantly increase the disease-free survival rate and overall survival rate,prolong the median DFS and OS,reduce the recurrence rate of intra-abdominal and liver metastasis rate in the gastric cancer patients at 12 and 24 months after chemotherapy.

Objective To explore the clinical efficacy and side effects of intraperitoneal perfusion of verapamil and chemotherapeutic drugs in treating patients with gastric cancer after operation.Methods Totally 184 gastric cancer patients accepted radical surgery with postoperative classification (pT1/2/3/4N2/3M0) were randomly divided into control group (n =58) and treatment group (n =126).For the post-gastrectomy chemotherapeuric treatment,1 g of 5-fluorouracil and 70 to 90 mg of cisplatin were administrated for the patients in the control group,while 1 g of 5-fluorouracil,70 to 90 mg of cisplatin and 25 mg of verapamil were given to the patients in the treatment group.Patients in both groups received intravenous administration of 20 to 30 mg of doxorubicin 3 ～ 5 hours before the intraperitoneal chemotherapy,and 0.1 g of leucovorin 30 minutes prior to the intraperitoneal chemotherapy.On the second day,intraperitoneal chemotherapy of 0.5 to 0.75 g 5-fiuorouracil was given to all patients for 3 to 5 days.The disease-free survival rate,overall survival rate,disease-free survival (DFS),overall survival (OS),peritoneal recurrence rate,liver metastasis rate,gastric remnant recurrence rate,adverse reactions were examined and recorded at the time points of 12 and 24 months after the chemotherapy treatment.Results In the treatment group,disease-free survival and overall survival rates at 12 and 24 months were significantly higher than those in the control group,and the median DFS and OS were significantly longer than the control group (P ＜ 0.05).In patients with regional lymph node staging (N2,N3),low differentiated adenocarcinoma,tumor diameter greater than 4-cm,the disease free survival rate and overall survival rate at 12 and 24-months were significantly higher than the control group,and the median DFS and OS were significantly longer than the control group (P ＜0.05).In the treatment group,intraperitoneal recurrence rate and liver metastasis rate at 12 and 24-months were significantly lower than the control group (P ＜ 0.05).There was no significant difference in recurrence rate of gastric stump between the control group and treatment group.Application of verapamil did not increase the incidence rate of adverse reactions.There were 8 patients with mild abdominal pain and 3 patients with incomplete intestinal obstruction,and all of them were cured after one week of treatment.Conclusion The intraperitoneal perfusion of verapamil and chemotherapeutic drugs can significantly increase the disease-free survival rate and overall survival rate,prolong the median DFS and OS,reduce the recurrence rate of intra-abdominal and liver metastasis rate in the gastric cancer patients at 12 and 24 months after chemotherapy.

cleaning and disinfection.Results All 28 surveyed medical institutions had separate endoscope disinfection rooms, 89.29% of which had integrated endoscopic cleaning station,17.86% had automatic endoscope washer/disinfector;100% used multi-enzymatic detergent,chose the right disinfectant,monitored disinfectant concentration every day, and implemented standard disinfection time.But only 39.29% changed multi-enzymatic detergent for each endo-scope,cleaning and disinfection personnel in 78.57% of medical institutions wore personal protective equipment correctly.77 digestive endoscopes were detected,the qualified rate was 88.31%.Conclusion Cleaning and disin-fection management of digestive endoscope in secondary and above medical institutions in Suzhou City is generally standardized,there are still some problems in the manipulation procedures,relevant national regulations should be strictly complied with,efficacy of cleaning and disinfection of digestive endoscope should be further improved.

Objective To investigate the clinical efficacy of hyperbaric oxygen (HBO) on postherpetic neuralgia (PHN) in the treatment of type 2 diabetes mellitus (T2DM) coupled with herpes zoster.Methods Fifty-two patients with T2DM coupled with PHN were divided into the control group and the combined treatment group,in accordance with different treatment methods.The 2 groups were all treated with diclofenac sodium and cobalt amine,but the combined treatment group was additionally given HBO treatment,one session a day for a total of 30 sessions.Evaluations were made on the scores of visual analogue scale (VAS),sleep quality score (SQI) and Hamilton depression scale (HAMD) the day after treatment,3 and 6 months after treatment to assess the therapeutic effects in the patients of the 2 groups.Results Statistical significance could be seen in the scores of VAS,SQI and HAMD for the patients of both groups following treatment (P ＜ 0.05).There was statistical significance in the scores of VAS for the patients of the combined treatment group,as compared with those of the control group (P ＜0.01).There was also statistical significance in the scores of SQI and HAMD,when comparisons were made between the 2 groups (P ＜ 0.05).Conclusions HBO combined with diclofenac sodium and cobalt amine could alleviate the seriousness of pain,improve sleep and decrease depression symptoms,in the patients with T2DM coupled with PHN.Combined treatment was obviously superior to simple drug treatment.

Objective To investigate the clinical efficacy of hyperbaric oxygen (HBO) on postherpetic neuralgia (PHN) in the treatment of type 2 diabetes mellitus (T2DM) coupled with herpes zoster.Methods Fifty-two patients with T2DM coupled with PHN were divided into the control group and the combined treatment group,in accordance with different treatment methods.The 2 groups were all treated with diclofenac sodium and cobalt amine,but the combined treatment group was additionally given HBO treatment,one session a day for a total of 30 sessions.Evaluations were made on the scores of visual analogue scale (VAS),sleep quality score (SQI) and Hamilton depression scale (HAMD) the day after treatment,3 and 6 months after treatment to assess the therapeutic effects in the patients of the 2 groups.Results Statistical significance could be seen in the scores of VAS,SQI and HAMD for the patients of both groups following treatment (P ＜ 0.05).There was statistical significance in the scores of VAS for the patients of the combined treatment group,as compared with those of the control group (P ＜0.01).There was also statistical significance in the scores of SQI and HAMD,when comparisons were made between the 2 groups (P ＜ 0.05).Conclusions HBO combined with diclofenac sodium and cobalt amine could alleviate the seriousness of pain,improve sleep and decrease depression symptoms,in the patients with T2DM coupled with PHN.Combined treatment was obviously superior to simple drug treatment.

Objective To explore the application value of diffusion tensor imaging and diffusion tensor tractography in the benign lesion of spinal cord.Methods 30 cases with the benign lesions of spinal cord and 10 healthy volunteers underwent MRI and DTI scanning by 1.5T MR.Results Compared with normal control group,ADC values [(1.29±0.24)×10 -3 mm2/s]of extramedullary group-Ⅰwere increased slightly,and FA values (0.46±0.06)were decreased slightly(P <0.05).In extramedullary group-Ⅱ,ADC values [(2.03±0.19)×10-3 mm2/s]were significantly increased and FA values (0.37±0.03)decreased in the lesion level (P <0.05).The ADC values [(1.71±0.24)×10 -3 mm2/s]of intramedullary group was significantly elevated,and the FA values (0.30±0.06)was obviously reduced (P <0.05 ).The fiber tracts showed the abnormality of the white matter,including compression,sparseness, grow downwards,interruption and other changes.Conclusion The changes of the FA and ADC values,diffusion tensor imaging of the bundle can quantitatively evaluate the severity of spinal cord damage and stereo display fiber bundle damage.