Objective To investigate the factors influencing the natural outcome of low-grade squamous intraepithelial lesions(LSIL)of the cervix.Methods A total of 154 patients who underwent colposcopic cervical biopsy in the Third Affiliated Hospital of Zhengzhou University from January 2022 to January 2023 were selected and divided into negative conversion group(55 cases),continuous group(70 cases)and upgraded group(29 cases)according to the follow-up results.Logistic regression was used to analyze the influence of related factors on the outcome of LSIL.Results There were statistically significant differences in the number of vaginal births,the results of thin-prep cytology test,human papilloma virus(HPV)typing,whether vaginal LSIL was combined,whether there were symptoms,and vaginal microecology among three groups(P＜0.05).Multivariate Logistic analysis showed that combined vaginal LSIL,vaginal microecological abnormalities,atypical squamous cell-cannot exclude high-grade squamous intraepithelial lesion(ASC-H)/high-grade squamous intraepithelial lesion(HSIL),HPV 16/18 positive or mixed positive were independent risk factors for persistent infection(P＜0.05),combined vaginal LSIL,symptomatic,vaginal microecological abnormalities,ASC-H/HSIL,HPV 16/18 positive or mixed positive were all independent risk factors for escalation of lesions(P＜0.05).Conclusion Patients with vaginal LSIL,vaginal microecological abnormalities,ASC-H/HSIL,HPV 16/18 positive or mixed positive should be followed up and early intervention to reduce the risk of disease escalation.

OBJECTIVE To investigate the distribution and drug resistance of multidrug-resistant bacteria in the neonatal intensive care unit of a three-A children's hospital in Henan Province,and to provide reference for ational drug use in clinical practice.METHODS Clinical specimens from hospitalized newborns in neonatal intensive care unit from a three-A children's hospital from Jan.1,2019 to Dec.31,2023 were subjected to etiological exam-ination and drug sensitivity test,and to analyze the distribution and drug resistance of multidrug-resistant bacteri-a in hospitalized newborns.RESULTS During the 5-year period,1139 strains of multidrug-resistant bacteria were i-solated,including 229 gram-positive bacteria(20.11％)and 910 gram-negative bacteria(79.89％).There were 92 strains of methicillin-resistant Staphylococcus aureus(MRSA)(accounting for 8.08％),57 strains(accounting for 5.00％)of methicillin-resistant coagulase-negative Staphylococcus epidermidis and 28 strains(accounting for 2.46％)of methicillin-resistant coagulase-negative human Staphylococcus.370 strains(accounting for 32.48)of carbapenem-resistant Klebsiella pneumoniae(CRKP),268 strains(accounting for 23.53％)of extenspectrum β-lactamase-producing Escherichia coli and 85 strains(accounting for 7.46％)of K.pneumoniae,there were 767 sputum specimens(67.34％),160 blood specimens from peripheral intravenous puncture and central venous cath-eterization(PICC)(14.05％),63 bronchoalveolar lavage fluid specimens(5.53％),29 secretion specimens(eye and wound secretions)(2.54％),and 120 other specimens(10.54％).K.pneumoniae and E.coli producing su-per-broad spectrum β-lactamase,CRKP and MRSA were the main drug-resistant bacteria.CONCLUSION The sit-uation of drug resistance in neonatal intensive care unit is serious,therefore monitoring bacterial resistance should be strengthened according to the clinical laboratory results,and antibiotics should be applied rationally.

Objective:To observe any therapeutic effect of repeated high-frequency transcranial magnetic stimulation (rTMS) on patients with medication overuse headache (MOH).Methods:Fifty-seven persons with MOH were divided at random into a control group of 29 cases and an rTMS group of 28 cases. Both groups of patients stopped taking analgesics and were treated with topiramate and trazodone. The rTMS group received an additional 20 minutes of rTMS treatment daily, 5 days a week for 8 consecutive weeks. The control group received sham stimulation. Before and after the treatment, both groups′ headache symptoms, disability, depression, anxiety, cognition and sleep quality were evaluated using a visual analog scale (VAS) for pain, a migraine disability assessment scale (MIDAS), the Montreal cognitive assessment (MoCA), the Hamilton depression scale (HAMD), the Hamilton anxiety scale (HAMA) and the Pittsburgh sleep quality index (PSQI). Auditory event-related potential P300 was also measured for both groups.Results:After the treatment, the average VAS, MIDAS, HAMD, HAMA and PSQI scores of both groups had decreased significantly. The HAMD, HAMA and PSQI average scores of the rTMS group were then significantly better than the control group′s averages. The average MoCA score of the rTMS group had also improved significantly. The average latency of the auditory event-related potential P300 in the rTMS group was then (368.25±9.25)ms and its amplitude was (6.62±1.40)μV, showing significant improvement compared to before the treatment and compared with the control group.Conclusions:On the basis of oral administration of topiramate and trazodone, additional high-frequency rTMS treatment can significantly alleviate anxiety and depression in MOH patients, and improve their sleep quality and the latency and amplitude of event-related potential P300.

Glaucoma is the world's leading progressive and irreversible cause of blindness.Lowering intraocular pressure is the main method for treating glaucoma.Refractory glaucoma is a special type of glaucoma where intraocular pressure can't be effectively controlled by medication, laser or conventional surgery.Ahmed glaucoma drainage valve (AGV) implantation is one of the main treatment methods for refractory glaucoma.Its unique valve structure effectively inhibited early postoperative low intraocular pressure and related complications.However, the long-term success rate is not ideal.The most common cause of surgical failure is excessive fibrous tissue formation around glaucoma drainage devices, resulting in the increase of outflow resistance in the filtering area, and elevating intraocular pressure.Therefore, inhibiting the formation of fibrous tissues around glaucoma drainage devices is the key to improving the success rate.At present, the most common clinical anti-scarring method is the application of anti-metabolic drugs during and after operation, but the long-term effect is not ideal.In recent years, with the continuous improvement of the structural design, manufacturing materials and manufacturing technology of aqueous humor drainage device, the success rate of AGV implantation in the treatment of refractory glaucoma is also gradually improving.In this review, we discuss the inhibition of scarring after glaucoma drainage valve implantation by adding coating, constructing porous structure and depicting surface micropatterns.These improvements in surface structure may provide a new approach for the treatment of filtration area scarring after AGV implantation.

Glaucoma is the world's leading progressive and irreversible cause of blindness.Lowering intraocular pressure is the main method for treating glaucoma.Refractory glaucoma is a special type of glaucoma where intraocular pressure can't be effectively controlled by medication, laser or conventional surgery.Ahmed glaucoma drainage valve (AGV) implantation is one of the main treatment methods for refractory glaucoma.Its unique valve structure effectively inhibited early postoperative low intraocular pressure and related complications.However, the long-term success rate is not ideal.The most common cause of surgical failure is excessive fibrous tissue formation around glaucoma drainage devices, resulting in the increase of outflow resistance in the filtering area, and elevating intraocular pressure.Therefore, inhibiting the formation of fibrous tissues around glaucoma drainage devices is the key to improving the success rate.At present, the most common clinical anti-scarring method is the application of anti-metabolic drugs during and after operation, but the long-term effect is not ideal.In recent years, with the continuous improvement of the structural design, manufacturing materials and manufacturing technology of aqueous humor drainage device, the success rate of AGV implantation in the treatment of refractory glaucoma is also gradually improving.In this review, we discuss the inhibition of scarring after glaucoma drainage valve implantation by adding coating, constructing porous structure and depicting surface micropatterns.These improvements in surface structure may provide a new approach for the treatment of filtration area scarring after AGV implantation.

Objective To investigate the factors influencing the natural outcome of low-grade squamous intraepithelial lesions(LSIL)of the cervix.Methods A total of 154 patients who underwent colposcopic cervical biopsy in the Third Affiliated Hospital of Zhengzhou University from January 2022 to January 2023 were selected and divided into negative conversion group(55 cases),continuous group(70 cases)and upgraded group(29 cases)according to the follow-up results.Logistic regression was used to analyze the influence of related factors on the outcome of LSIL.Results There were statistically significant differences in the number of vaginal births,the results of thin-prep cytology test,human papilloma virus(HPV)typing,whether vaginal LSIL was combined,whether there were symptoms,and vaginal microecology among three groups(P＜0.05).Multivariate Logistic analysis showed that combined vaginal LSIL,vaginal microecological abnormalities,atypical squamous cell-cannot exclude high-grade squamous intraepithelial lesion(ASC-H)/high-grade squamous intraepithelial lesion(HSIL),HPV 16/18 positive or mixed positive were independent risk factors for persistent infection(P＜0.05),combined vaginal LSIL,symptomatic,vaginal microecological abnormalities,ASC-H/HSIL,HPV 16/18 positive or mixed positive were all independent risk factors for escalation of lesions(P＜0.05).Conclusion Patients with vaginal LSIL,vaginal microecological abnormalities,ASC-H/HSIL,HPV 16/18 positive or mixed positive should be followed up and early intervention to reduce the risk of disease escalation.

OBJECTIVE To investigate the distribution and drug resistance of multidrug-resistant bacteria in the neonatal intensive care unit of a three-A children's hospital in Henan Province,and to provide reference for ational drug use in clinical practice.METHODS Clinical specimens from hospitalized newborns in neonatal intensive care unit from a three-A children's hospital from Jan.1,2019 to Dec.31,2023 were subjected to etiological exam-ination and drug sensitivity test,and to analyze the distribution and drug resistance of multidrug-resistant bacteri-a in hospitalized newborns.RESULTS During the 5-year period,1139 strains of multidrug-resistant bacteria were i-solated,including 229 gram-positive bacteria(20.11％)and 910 gram-negative bacteria(79.89％).There were 92 strains of methicillin-resistant Staphylococcus aureus(MRSA)(accounting for 8.08％),57 strains(accounting for 5.00％)of methicillin-resistant coagulase-negative Staphylococcus epidermidis and 28 strains(accounting for 2.46％)of methicillin-resistant coagulase-negative human Staphylococcus.370 strains(accounting for 32.48)of carbapenem-resistant Klebsiella pneumoniae(CRKP),268 strains(accounting for 23.53％)of extenspectrum β-lactamase-producing Escherichia coli and 85 strains(accounting for 7.46％)of K.pneumoniae,there were 767 sputum specimens(67.34％),160 blood specimens from peripheral intravenous puncture and central venous cath-eterization(PICC)(14.05％),63 bronchoalveolar lavage fluid specimens(5.53％),29 secretion specimens(eye and wound secretions)(2.54％),and 120 other specimens(10.54％).K.pneumoniae and E.coli producing su-per-broad spectrum β-lactamase,CRKP and MRSA were the main drug-resistant bacteria.CONCLUSION The sit-uation of drug resistance in neonatal intensive care unit is serious,therefore monitoring bacterial resistance should be strengthened according to the clinical laboratory results,and antibiotics should be applied rationally.

Objective:To observe any therapeutic effect of repeated high-frequency transcranial magnetic stimulation (rTMS) on patients with medication overuse headache (MOH).Methods:Fifty-seven persons with MOH were divided at random into a control group of 29 cases and an rTMS group of 28 cases. Both groups of patients stopped taking analgesics and were treated with topiramate and trazodone. The rTMS group received an additional 20 minutes of rTMS treatment daily, 5 days a week for 8 consecutive weeks. The control group received sham stimulation. Before and after the treatment, both groups′ headache symptoms, disability, depression, anxiety, cognition and sleep quality were evaluated using a visual analog scale (VAS) for pain, a migraine disability assessment scale (MIDAS), the Montreal cognitive assessment (MoCA), the Hamilton depression scale (HAMD), the Hamilton anxiety scale (HAMA) and the Pittsburgh sleep quality index (PSQI). Auditory event-related potential P300 was also measured for both groups.Results:After the treatment, the average VAS, MIDAS, HAMD, HAMA and PSQI scores of both groups had decreased significantly. The HAMD, HAMA and PSQI average scores of the rTMS group were then significantly better than the control group′s averages. The average MoCA score of the rTMS group had also improved significantly. The average latency of the auditory event-related potential P300 in the rTMS group was then (368.25±9.25)ms and its amplitude was (6.62±1.40)μV, showing significant improvement compared to before the treatment and compared with the control group.Conclusions:On the basis of oral administration of topiramate and trazodone, additional high-frequency rTMS treatment can significantly alleviate anxiety and depression in MOH patients, and improve their sleep quality and the latency and amplitude of event-related potential P300.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

Objective To investigate the effect of sulforaphane(SFN)on the expression of apoptosis-related proteins(caspase-3 and caspase-9),in brain tissue of rats with acute carbon monoxide poisoning(ACOP),and to explore the molecular mechanism underlying its intervention in ACOP-induced brain injury.Methods The healthy male Sprague-Dawley(SD)rats were randomly assigned to three groups:normal control(NC)group,ACOP group,and SFN group,with 36 rats in each group.An ACOP animal model was established by exposing the rats to carbon monoxide(CO)in a hyperbaric oxygen chamber,while the rats in the NC group were allowed to breathe fresh air.The SFN group received an intraperitoneal injection of SFN 20 mg/kg within 2 hours after poisoning,once daily,until euthanasia.The NC and ACOP groups were injected with an equivalent volume of saline.Rats from each group were sacrificed on days 1,3,and 7 of the intervention to collect brain tissue,hematoxylin-eosin(HE)staining was performed to assess pathological damage in the brain tissue;Nissl staining was used to examine neuronal pathological changes;Immunohistochemistry was employed to detect the positive expression of caspase-3 and caspase-9 in the cortical region of the brain.Western blotting and quantitative reverse transcription-polymerase chain reaction(qRT-PCR)were conducted to measure the protein and mRNA expression of caspase-3 and caspase-9 in the brain tissue.Results After CO poisoning,brain tissue damage in the ACOP group progressively worsened,with a gradual decrease in the number of Nissl bodies and a gradual increase in the number of positive cells for caspase-3 and caspase-9 in the cortical region of the brain.The protein and mRNA expression of caspase-3 and caspase-9 in the brain tissue also gradually increased.Compared with the NC group at the same time point,the differences were statistically significant[Nissl bodies:69.33±0.94 vs.91.33±1.25;caspase-3 positive expression(A value):0.149±0.003 vs.0.113±0.004;caspase-9 positive expression(A value):0.178±0.002 vs.0.111±0.010;caspase-3 protein(caspase-3/GAPDH):1.634±0.045 vs.0.844±0.021;caspase-9 protein(caspase-9/GAPDH):1.754±0.024 vs.0.811±0.053;caspase-3 mRNA(2-ΔΔCt):1.718±0.052 vs.1;caspase-9 mRNA(2-ΔΔCt):1.722±0.066 vs.1,all P<0.05).Compared with the ACOP group at the same time point,the brain tissue damage in the SFN group improved,with a significant increase in the number of Nissl bodies(84.67±1.53 vs.69.33±0.94,P<0.05).The number of positive cells for caspase-3 and caspase-9 in the cortical region of the brain decreased significantly(A value:0.126±0.002 vs.0.149±0.003,0.127±0.002 vs.0.178±0.002,both P<0.05).The protein and mRNA expression of caspase-3 and caspase-9 in the brain tissue were significantly reduced[caspase-3 protein(caspase-3/GAPDH):0.999±0.037 vs.1.634±0.045;caspase-9 protein(caspase-9/GAPDH):0.993±0.040 vs.1.754±0.024;caspase-3 mRNA(2-ΔΔCt):1.120±0.059 vs.1.718±0.052;caspase-9 mRNA(2-ΔΔCt):0.520±0.045 vs.1.722±0.066,all P<0.05].Conclusion SFN partially attenuated ACOP-induced brain injury in rats,potentially by downregulating both protein and mRNA expression of caspase-3 and caspase-9,thereby reducing cellular apoptosis.