Objective To investigate human papillomavirus(HPV)infection in Jiading District of Shang-hai,and to explore the relationship between different HPV subtypes and cervical lesions.Methods A retro-spective analysis was conducted for HPV subtype results and pathological results during the same period of time from 19 030 patients who visited Maternity and Children Health Care Hospital of Jiading District from March 13th,2023 to March 31,2024,and underwent the HPV subtype detection.The relationship between HPV infection and age and cervical lesions were analyzed.Results Out of 19 030 samples,3 506 were HPV positive,and the infection rate was 18.42%.There were 2 185 cases of single infection and 1 321 cases of mul-tiple infection.The HPV infection rate in each age group were as below:the infection rates were 30.34%in≤20-year-old group,18.46%in 20-30 year-old group,16.46%in>30-40 year-old group,14.83%in>40-50 year-old group,21.29%in>50-60 year-old group and 32.74%in>60 year-old group,and there was a statistically significant difference in HPV infection rates among different age groups(P<0.001).The top 5 subtypes were type 52(21.50%),53(10.84%),58(10.02%),33(8.33%)and 59(6.85%).The proportions of the who progressed to higher-level cervical lesions in individuals with HPV subtypes of the top 5 infection rates,as well as those with HPV16 and 18 positive,were significantly higher than that in HPV negative indi-viduals,among which the individuals with HPV16,18,58,and 33 were more likely to progress to severe cervi-cal lesions[atypical squamous cells:cannot exclude high-grade squamous intraepithelial lesion(ASC-H)+low-grade squamous intraepithelial lesion(LSIL)+high-grade squamous intraepithelial lesion(HSIL)+squamous cell carcinoma(SCC)](P<0.05).Compared to HPV 52 positive individuals with the highest infection rate,HPV 16,18,58,and 33 positive individuals were more likely to progress to higher-level cervical lesions(P<0.05).Conclusion HPV infection rates in≤20 year-old group and>60 year-old group are relatively high in Jiading District of Shanghai.The risk of progression to cervical lesions varies among different HPV subtypes.In addition to HPV 16 and 18,HPV 58 and HPV 33 are also closely related to higher levels of cervical lesions and should be given sufficient attention.

Female ; Humans ; Hypoglycemic Agents/therapeutic use* ; Insulin Resistance ; Metformin/therapeutic use* ; Phosphatidate Phosphatase ; Pioglitazone/therapeutic use* ; Polycystic Ovary Syndrome/genetics*

Objective:To evaluate the effects of opioid-sparing analgesia on the incidence of sepsis in severely burned patients in the retrospective cohort study.Methods:The clinical data from patients with severe burns admitted to three teaching hospitals in Guangdong from 2011 to 2020 were retrospectively extracted and analyzed. The patients were divided into 2 groups based on the analgesic regimen within 30 days after injury: continuous opioids analgesia group (continuous opioid infusion at a relative constant rate for more than 72 h) and opioid-sparing analgesia group (patient-controlled intravenous analgesia/intermittent administration/opioid-free analgesia). Patient′s age, severity of burn, inhalation injury and basal pain score at rest were matched by the propensity score at a 1∶1 ratio. The primary outcome measure was the occurrence of sepsis within 90 days of admission. Secondary outcome measures included 30-day and 90-day all-cause mortality, clinical diagnosis of multiple organ dysfunction syndrome, and prevalence of burn wound infection. The amount of opioid used was also recorded.Results:A total of 328 severely burned patients were finally enrolled, with 145 patients in continuous opioid analgesia group and 183 patients in opioid-sparing analgesia group, and 110 pairs of patients (220 cases) were finally matched by the propensity score.Compared with continuous opioid analgesia group, the total consumption of opioid, daily consumption per analgesia, and consumption per burn area were significantly decreased, and the incidence of sepsis and wound infection was decreased( P<0.05), and no significant change was found in the incidence of multiple organ dysfunction syndrome, 30-day and 90-day all-cause mortality in opioid-sparing analgesia group( P>0.05). Conclusions:Compared with the continuous opioid analgesia regimen, opioid-sparing analgesia can reduce the risk of sepsis in severely burned patients.

Objective:To analyze the phenotype and genotype of a Chinese pedigree with congenital dysfibrinogenemia and investigate the molecular mechanism of the disease.Methods:Pedigree analysis. Peripheral blood samples were collected from 7 members of the pedigree and routine coagulation tests were conducted. The activity of fibrinogen was measured using Clauss method, and fibrinogen antigen was measured by immunoturbidimetry. All the exons and exon-intron boundaries of FGA, FGB and FGG genes were amplified using PCR, which was followed by direct sequencing. Electrophoretic and immunological analysis of fibrinogen, fibrinogen clottability measurement, fibrin polymerization measurement and scanning electron microscopy were used to investigate the pathogenesis of this disease. Results:The proband showed normal activated partial thromboplastin time (APTT) , prolonged prothrombin time(PT), thrombin time (TT),and reptilase time (RT).The antigen level of fibrinogen in the proband (1.6 g/L) decreased slightly, while the activity level of fibrinogen (0.7 g/L) decreased significantly. His father and grandmother showed normal APTT and PT, prolonged TT and RT. The antigen levels of fibrinogen in both of them were normal (2.0 g/L and 2.2 g/L, respectively), while the activity levels of fibrinogen were low (1.0 g/L and 1.1 g/L, respectively). The results of other members from the pedigree were all within the normal range. Genetic analysis revealed a heterozygous A>G mutation at nucleotide 4774 in exon 6 of FGG gene in the proband, which was predicated to be a novel Gln195Arg mutation. The mutation was also found in his father and grandmother.Western blot results showed that no abnormal bands of plasma fibrinogen were found in the proband, his father and grandmother. The fibrinogen clottability in the proband was 49.3%, while that in the heathy control was 98.9%. Both thrombin-induced fibrin polymerization and reptilase-induced fibrin polymerization were significantly impaired in the proband, compared to that in the heathy control. Scanning electron microscopy revealed that compared with the heathy control, the average fiber diameters of the fibrin clot in the proband increased significantly ( P<0.001), while the density of fibers decreased and the arrangement of fibers was sparse. Conclusions:The heterozygous Arg19Gly mutation, which probably damages functions of fibrinogen, should be responsible for the congenital dysfibrinogenemia in this pedigree. This mutation has not been reported.

Objective: To analyze the phenotype and genotype of a Chinese pedigree with inherited dysfibrinogenaemia and investigate the molecular mechanism of the disease. Methods: Venous blood samples were collected from all family members, and routine coagulation tests were conducted. Functional fibrinogen in venous blood samples was measured by Clauss method, and the antigen level of fibrinogen in plasma was measured by immunoturbidimetry assay. All the exons and exon-intron boundaries of the three fibrinogen genes were analyzed by direct sequencing. Fibrinogen electrophoresis, fibrinogen clottability measurement, fibrin polymerisation measurement and electron microscopy scanning were also used to investigate the molecular characteristics and pathogenesis. Results: The proband had normal activated partial thromboplastin time, prothrombin time and plasma fibrinogen antigen, but prolonged thrombin time, prolonged reptilase time and reduced fibrinogen activity level, which were also found in his father. The sequencing results of the proband revealed heterozygous A1211G in the exon 2 of FGA gene originating from his father, which caused Arg19Gly missense mutation. The western-blot results showed that no abnormal bands of plasma fibrinogen were found in the proband and his father. Both thrombin-induced fibrin polymerisation and reptilase induced fibrin polymerisation were significantly impaired compared to normal control. Fibrinogen clottability measurement showed that only about 20.8% molecules of plasma fibrinogen in the proband were involved in the clot formation. Scanning electron microscopy revealed that the proband′s average fibre diameters were found to be significantly thicker than that of the control(P＜0.001), and the density was smaller than that of normal control. Conclusion The Arg19Gly mutation should be responsible for the proband′s dysfibrinogenaemia and the relevant clinical symptoms.

Objective To explore the correlation between injection peak pressure and tubal patency during real-time three-dimensional hysterosalpingo-contrast sonography(RT 3D-HyCoSy).Methods One hundred and seven patients who were scheduled to undergo transvaginal RT 3D-HyCoSy with SonoVue contrast agent were included in the study.They were injected with contrast agent by an YLD-YZ-800 auto contrast agent injection device. The patients were divided into tubal patency included bilateral patency group,one side patency group and bilateral positive group according to imaging results. During the examination,the injection peak pressure was recorded to analyze whether there were significant differences among the three groups.Results The contrast agent injection peak pressures of bilateral patency group,one side patency group and bilateral positive group were (34.58 ± 8.25)kPa,(44.85 ± 10.05)kPa and (54.26 ± 11.65)kPa,respectively. The differences of injection pressure among the three groups were statistically significant ( F = 38.732; P = 0.000,0.000,0.033). The peak pressure was negatively correlated with tubal patency ( r = -0.653,P =0.000).Conclusions Contrast agent injection peak pressure is associated with tubal patency in RT 3D-HyCoSy,and can be quantitatively measured to help for assessing fallopian tube patency.

Objective To summarize 500 cases of surgical experience in restoration of adult congenital heart disease ( ACHD) treatment and early postoperative.Methods During January 2012 to December 2014 in Fuwai Hospital, 500 cases of ACHD treated by operation were chosen to collect the clinical data .We divided the groups according to whether the case was a complex malformation and whether the case had an ICU retention time is more than the 5 days.Results The average age was 35, the average weight was 59 kg.The operation average cardiopulmonary bypass(CPB) time was 102min.The average ICU treatment time was 2 days, the average duration of mechanical ventilation was 23 hours, 3 early deaths occurred.The complex malformation group had younger age and less weight than the simple malformation group , the complex malformation group had longer time of cardiopulmonary bypass time, aortic cross clamping time, mechanical ventilation time and ICU treatment time, had higher rate of complication and blood transfusion peri-operative period than the simple malformation group.(P<0.05) The group of ICU retention time less than 5 days had higher rate of the male proportion, had younger age and less weigh, had longer time of cardiopulmonary bypass time , mechanical ventilation time and ICU treatment time , had higher rate of complication and blood transfusion peri-operative period than the control group(P <0.01).Conclusion Although ACHD patients have long medical history and complicated pathological and physiological changes , when they get proper surgical operation and periopera-tive treatment, they should obtain satisfied effect.Professional medical team or organization service for the ACHD patient is very important and urgent to build.

Objective To compare the cleaning effect of before and after improvement of P′750 type endoscopic infusion pump sensing infusion. Methods 240 cases of urinary calculi patients were divided into experimental group (120 cases) and control group (120 cases) according to the random number table method. Experimental group made improvements on P′750 type endoscopic infusion pump sensing infusion, Took latex transmission pipe, sampling module, metal fittings and parenteral nutrition infusion bags, disposable connecting pipe connection, and surgery using improved sensing infusion. The control group used unimproved sensing infusion. Results Visual inspection of cleaning pass rate before and after improvement sensing infusion were 85.83% (103/120), 99.17% (119/120), 5 times with light magnifier inspection were 78.33%(94/120), 97.50% (117/120), tampons method inspection were 75.83% (91/120), 95.83% (115/120), ATP bioluminescence monitoring were 70.83% (85/120), 91.67% (110/120), dry pass rate were 90.83%(109/120), 100.00% (120/120), cleaning and drying pass rate were significantly improved (χ2=18.296, 29.159, 32.986, 40.976, 11.528, all P<0.01). Cleaning time before and after improvement sensing infusion were (1 020.40±8.22) s, (539.30±8.70) s. Dry time were (1 199.35±26.70) s, (61.50±5.79) s. Cleaning and drying time were significantly shortened (t=440.340, 456.206, all P<0.01). Conclusion Improvement sensing infusion increased the quality of cleaning and drying, shortened the cleaning and drying time, ensured the quality of surgery using equipment, improved work efficiency, and provided a guarantee for the safe and smooth implementation of the surgery.

Adult ; Body Weight ; Humans ; Liver ; enzymology

Objective: To summarize the major post-operative complication of modiifed extended Morrow procedure in patients with hypertrophic obstructive cardiomyopathy (HOCM) and to explore the major factors affecting its prognosis. Methods: We retrospectively analyzed 139 consecutive HOCM patients who received the procedure by same surgeon in our hospital from 2012-06 to 2014-07. There were 87 male and 52 female patients with the age of (10-67) years, body weightof (26-105) kg and pre-operative left ventricular outlfow tract peak gradient (LVOTPG) of (84.48 ± 44.75) mmHg. Concomitant operations were performed with known cardiac disease as necessary. Pre- and post-operative echocardiography, ECG and chest X-ray were examined to assess the adequacy of resection and mitral valve structure and function. Results: There was no peri-operative death. 73/139 (53%) patients received simple modiifed expanded Morrow procedure, the other 66 (47%) patients received concomitant surgery including 21 patients with coronary artery bypass grafting, 15 mitral valve plasty, 7 mitral valve replacement, 10 tricuspid valve plasty, 2 aortic valve replacement, 3 modiifed Maze procedure, 2 unblock of right ventricular outlfow tract, 2 sub aortic membrane resection, 1 ventricular aneurysm resection. The mechanical ventilation time was (24.05±36.74) hours, post-operative ICU and in-hospital stays were (2.85±3.18) days and (10.11±4.57) days; the complications included arrhythmia in 108 cases, pleural effusion in 25 cases, secondary intubation in 1 case, tracheotomy in 1 case, hemoifltration in 1 case, intra-aortic balloon pump in 1 case, back into ICU in 3 cases; no pneumothorax, secondary thoracotomy/operation. The post-operative left atrial diameter, LVOTPG, inter-ventricular septal thickness and LVEF were all decreased; mitral valve closed well or with mild regurgitation, systolic anterior motion (SAM) basically disappeared. The major factors for delayed ICU stay included age≥55 years, female, CPB time≥120 min, AOC time≥90 min, the patients combining with arrhythmia and right ventricular dysfunction. Late follow-up presented that the patients were almost without the symptoms, NYHA classiifcation at (I-II), no late death, complication or re-operation. Conclusion: Modified expand Morrow procedure has good surgical and short/late post-operative effects, concomitant operation does not increase the complication and mortality; correction of arrhythmia and improving right ventricular function at peri-operative period are important for treating the relevant patients.