ObjectiveTo explore the clinical efficacy and safety of a combined therapy by using recombinant human interferon α2b, Baofukang suppository and vaginal lactobacillus for high-risk human papillomavirus (HR-HPV) infection in postmenopausal women, and to provide a reference for the treatment of HR-HPV infection. MethodsThis study was a single-center, prospective, randomized, open-label, and parallel-controlled trial. A total of 210 postmenopausal women with cervical HR-HPV infection who visited the Maternal and Child Health Care and Family Planning Service Center of Deqing County from January 2022 to December 2023 were consecutively selected. They were randomly divided into study group (112 cases) and control group (98 cases) using a random number table. The control group was treated with recombinant human interferon α2b vaginal effervescent capsules and Baofukang suppositories. The study group received vaginal lactobacillus capsules in addition to the treatment given to the control group. The primary outcome measure was the HPV clearance rate at 6 and 12 months after treatment. The secondary outcomes included the rate of cervical cytology improvement, symptom relief rate, vaginal microecological indicators (vaginal pH value, proportion of lactobacillus), and the incidence of adverse reactions. ResultsA total of 196 patients (112 in the study group and 84 in the control group) completed the 12-month follow-up. At 6 months after treatment, there was no significant difference in the negative rate of HR-HPV between the two groups (χ²=3.36, P=0.072). At 12 months after treatment , the negative rate of HPV in the study group (78.57%, 88/112) was higher than that in the control group (52.38%, 44/84) (χ²=3.98, P=0.046). At 6 months after treatment, there was no significant difference in the improvement rate of cervical cytology between the two groups (χ²=0.12, P=0.063). At 12 months after treatment, the improvement rate of cervical cytology in the study group (73.21%, 82/112) was higher than that in the control group (47.62%, 40/84) (χ²=4.26,P=0.039).In terms of vaginal microecology, at 6 months after treatment, the median vaginal pH value of the study group [4.17 (4.03,4.26)] was lower than that of the control group [4.60 (4.31,4.85)] (U=386.52, P=0.004), and the average proportion of lactic acid bacteria [(82.36±5.12)%] was higher than that of the control group [(68.57±6.34)%] (t=7.56, P=0.002). At 12 months after treatment, the median vaginal pH value of the study group [4.04 (3.81,4.12)] was lower than that of the control group [4.06 (3.83,4.19)] (U=352.04, P=0.006), and the average proportion of lactic acid bacteria [(91.25±4.36)%] was higher than that of the control group [(78.63±5.72)%] (t=6.73, P=0.001). At 6 months after treatment, the remission rate of symptoms in the study group (64.29%, 72/112) was higher than that in the control group (40.48%, 34/84) (χ²=10.957, P=0.001). At 12 months after treatment, the remission rate of symptoms in the study group (87.50%, 98/112) was higher than that in the control group (64.29%, 54/84) (χ²=56.81, P<0.001). Regarding side effects, during the treatment period and within one month after the completion of treatment, only three types of mild local side effects, including increased vaginal discharge, vaginal burning sensation, and vulvar pruritus, were observed in both groups. All adverse reactions were alleviated after symptomatic management (such as perineal cleaning and adjusting medication posture). The total incidence of adverse reactions in the study group was 6.25%, compared to 7.14% in the control group, with no statistically significant differences between the two groups (χ²=0.09, P=0.768). ConclusionThe combined treatment of recombinant human interferon α2b vaginal effervescent capsules, Baofukang suppositories, and vaginal lactobacillus capsules in postmenopausal women with cervical HR-HPV infection could effectively increase the HPV clearance rate, improve cervical cytology, restore vaginal microbiota balance, and relieve clinical symptoms.

Objective:To investigate clinical and imaging parameters to predict blood loss and cranial nerve injury (CNI) following carotid body paraganglioma (CBP) resection.Methods:A retrospective examination of clinical and imaging data was conducted on 63 patients who underwent CBP resection at Xiangya Hospital of Central South University from January 2016 to December 2022, including 23 males and 40 females, aged 26-87 years old. Three imaging parameters including tumor volume, the angle of contact with the internal carotid artery (ICA), and the distance to the base of skull (DTBOS) were gauged using the IMEDPACS software on CTA and MR imaging. The predictive efficacies of age, gender, Shamblin classification, and three imaging parameters for blood loss and CNI following surgery were analysed. Logistic composite parameter models were constructed and their predictive validity was assessed.Results:Multivariate logistic regression analysis underscored that only tumor volume ( OR=1.381,95% CI:1.167-1.507, P=0.001) showed significant statistical correlations with blood loss following surgery. Area under curve (AUC) values of 0.910 for receiver operating characteristic (ROC) curves showed a sensitivity of 1.000 and a specificity of 0.694. Tumor volume ( OR=1.126,95% CI:1.030-1.231, P=0.002) and DTBOS ( OR=0.225,95% CI:0.081-0.630, P=0.005) were significantly associated with postoperative CNI. The analysis of logistic composite model showed AUC values for tumor volume, DTBOS and combination of the two parameters were 0.858, 0.788, and 0.872, respectively. The model for combination of tumor volume and DTBOS also proved superior in predicting postoperative CNI ( Z=3.106, P<0.001), with a sensitivity of 0.833 and a specificity of 0.769. Conclusions:Tumor volume and DTBOS emerged as effective predictors for blood loss and/or CNI in patients with CBP resection. Moreover, the logistic composite parameter model outclassed single-parameter models in terms of their predictive clinical value.

Objective:To explore the diagnostic accuracy of muscle ultrasound and plasma monocyte chemoattractant protein-1 (MCP-1) for ICU-acquired weakness (ICU-AW) in patients with sepsis.Methods:A prospective observational study was conducted. Patients with sepsis admitted to the intensive care unit (ICU) of Henan Provincial People's Hospital from April 2021 to October 2021 were enrolled. The demographic data were collected. The enrolled patients were evaluated with Medical Research Council (MRC) score every day until discharged from ICU. During this period, patients with total MRC score < 48 (for two consecutive times and a time interval of 24 hours) were divided into ICU-AW group, those with total MRC score ≥ 48 were served as non-ICU-AW group. On the 1st, 4th and 7th day following admission into ICU, ultrasound was used to measure the muscle linear thickness of the rectus femoris (RF-MLT), the cross sectional area of the rectus femoris (RF-CSA) and the muscle linear thickness of the vastus intermedius muscle (VI-MLT). And meanwhile, the plasmas samples of patients were collected to measure MCP-1 concentration by enzyme-linked immunosorbent assay (ELISA). The difference of each index was compared between the ICU-AW group and the non-ICU-AW group. The risk factors of ICU-AW in patients with sepsis were analyzed by binary Logistic regression. Besides, receiver operator characteristic curve (ROC curve) was plotted, the diagnostic value of ultrasound parameters and plasma MCP-1 level for ICU-AW in patients with sepsis was analyzed.Results:A total of 99 septic patients were enrolled, with 68 patients in the ICU-AW group and 31 patients in the non-ICU-AW group. Compared with the patients in the ICU-AW group, the patients in the non-ICU-AW group tended to be older, and had higher sequential organ failure assessment (SOFA) score, higher acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, higher rates of septic shock, higher blood lactic acid and lower Glasgow coma score (GCS). Binary Logistic regression analysis showed that APACHEⅡ score and septic shock were the risk factors of ICU-AW for septic patients [odds ratio ( OR) and 95% confidence interval (95% CI) were 1.310 (1.138-1.509) and 0.232 (0.072-0.746), respectively, both P < 0.05]. The RF-MLT, RF-CSA and VI-MLT on the 1st, 4th and 7th ICU day was falling over time. Compared with the patients in the ICU-AW group, the patients in the non-ICU-AW group had smaller RF-MLT on the 7th day [cm: 0.32 (0.22, 0.47) vs. 0.45 (0.34, 0.63), P < 0.05] and higher 7-day RF-CSA atrophy rate [25.85% (10.37%, 34.28%) vs. 11.65% (2.28%, 22.41%), P < 0.05]. According to ROC curve analysis, 7-day RF-MLT had diagnostic value for ICU-AW of septic patients. Area under ROC curve (AUC) was 0.688 (95% CI was 0.526-0.849); when the cut-off value was 0.41 cm, the sensitivity and the specificity were 66.7% and 68.4%. The levels of plasma MCP-1 in the ICU-AW group were significantly higher than those in the non-ICU-AW group on the 1st, 4th and 7th day. ROC curve analysis showed that the plasma MCP-1 levels on the 1st, 4th and 7th day played a significant role to diagnose ICU-AW for septic patients, the AUC and 95% CI were 0.732 (0.629-0.836), 0.865 (0.777-0.953), 0.891 (0.795-0.986), respectively. When the cut-off values were 206.3, 410.9, 239.5 ng/L, the sensitivity was 87.1%, 64.0%, 82.4%, and the specificity was 54.4%, 96.1%, 86.2%, respectively. Conclusion:The muscle mass parameters on the 7th day of bedside ultrasound and plasma MCP-1 levels had certain diagnostic values for ICU-AW in patients with sepsis.

Objecive:To observe the clinical effects of one-off root canal therapy using iRoot SP in the treatment of chronic apical periodontitis with sinus in anterior teeth.Methods:240 anterior teeth of chronic apical periodontitis witn sinus were randomly divided into 2 groups(n=120).One-off root canal filling were performed using iRoot SP(group A) and AH-plus(group B) respectively after Nd:YAG laser disinfection.Clinical effects were evaluated 48 h,10 days and 1 year after treatment.Results:In group A and B,the 48 h postoperative pain reaction rate was 7.14% and 15.0%(P<0.05),10 days postoperative effective rate was 95.8% and 88.3%(P<0.05),1 year after treatment the effective rate was 98.3% and 94.8%(P>0.05) respectively.Conclusion:iRoot SP and AH-plus show reliable effect in the treatment of chronic apical periodontitis with sinus in anterior teeth with one-off root canal therapy.iRoot SP may result in sligher postoperative reaction and shorter healing time.

Objective: To investigate the effects of Ginkgo biloba extract (EGb 761) on the morphology and function of retinal ganglion cells (RGC) in guinea pigs with optic nerve transection. Methods: Seventy-five albino guinea pigs were randomly divided into five groups: normal control group, sham-operated group, untreated group, normal saline group and EGb 761 group. No operation was performed in the normal control group. Optic nerve was merely exposed in the sham-operated group, but transected at 1.0 mm from posterior pole of the eye ball in the untreated, normal saline and EGb 761 groups. Guinea pigs in the EGb 761 group or the normal saline group received daily intraperitoneal injection of EGb 761 (100 mg/kg) or corresponding volume of normal saline from 7 days before experiment to 28 days after experiment. Three guinea pigs in each group were sacrificed for apoptosis assay (TUNEL method) of RGC. Pattern electoretinograms (PERGs) were recorded 14 and 28 days after transection, respectively. At the end of the examination, six guinea pigs were killed for histological examination and RGC count. Results: No TUNEL-positive cells were observed in the normal control, sham-operated and EGb 761 groups, but there were TUNEL-positive cells in the untreated group and the normal saline group. The numbers of RGCs in the untreated and normal saline groups were less than those in the normal control and sham-operated groups at 14 days or 28 days (P<0.05). Although the number of RGCs in the EGb 761 group was less than those in the normal control and sham-operated groups (P<0.05), it was more than those in the untreated and normal saline groups (P<0.05). N(95) amplitude in EGb 761 group was higher than those in the untreated and normal saline groups (P<0.05) and close to those in the normal control and sham-operated groups (P>0.05) at 14 days or 28 days. The number of RGCs was positive correlated to N(95) amplitude (r=0.859, P=0.001 5). Conclusion: EGb 761 can inhibit the apoptosis of RGCs in guinea pigs after optic nerve transection, thus protect the morphology and function of RGCs.