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.

Objective:To analyze the association between the pre-pregnancy oral microbiota of women and fetal overgrowth, and the possible mechanisms involved.Methods:A nested case-control study design based on a pre-pregnancy cohort was used to select 51 mothers who delivered macrosomia and/or large-for-gestational-age (LGA) infants from the population recruited at the Maternal and Child Health Care Hospital of Jiading District in Shanghai from October 2016 to December 2021 as the case group. A control group was formed by selecting 204 mothers who delivered infants with normal birth weight and appropriate for gestational age during the same period, in a 1:4 ratio. The LGA subgroup consisted of 48 mothers who delivered LGA infants from the total population, and a corresponding control group of 192 was randomly selected from the remaining mothers who delivered non-LGA infants in a 1∶4 ratio for the LGA subgroup analysis. The 16S rRNA gene sequencing technique was utilized to detect pre-pregnancy saliva samples to compare the characteristics of the oral microbiota, differential microorganisms, and differential functional pathways between groups. Nonparametric Wilcoxon rank-sum tests, two independent samples t-tests, or Chi-square (or Fisher's exact) tests were used for statistical analysis. Factor analysis was conducted on the pre-pregnancy diet data of women, and the primary dietary pattern of each study subject was identified based on the highest score of the dietary pattern factors. For microbiota count data, α and β diversity indices were calculated using R and QIIME2 software, and the corresponding microbiota functional count data were acquired through PICRUSt2. Results:(1) General data: There was no significant difference in the time interval from pre-pregnancy sampling to pregnancy and from sampling to delivery between the two groups. In the case group, there were three cases of macrosomia and 48 cases (94.1%) of LGA. The corresponding control group for the LGA subgroup consisted of 192 cases. There were no significant differences in dietary patterns between the case group and the control group. (2) α diversity analysis: The species richness index of the case group was lower than that of the control group [(367.27±84.57) vs. (408.71±93.08), multivariate analysis, P=0.009], while no significant differences were found between the two groups in the Shannon and Simpson indices; the species richness index of the LGA subgroup was also lower than that of the corresponding control group [(371.04±83.92) vs. (408.04±94.21), multivariate analysis, P=0.033], with no significant differences in the Shannon and Simpson indices. (3) β diversity analysis: There was a statistically significant difference in the unweighted UniFrac distance of the oral microbiota between the case group and the control group ( R2=0.006, F=1.479, P=0.048). No significant differences were found in the β diversity indices of the oral microbiota between the LGA subgroup and the corresponding control group. (4) Differential microbiota analysis: There were 14 differential microbiotas from phylum to genus between the case group and the control group. At the genus level, members of the G1 genus of the Streptococcaceae were enriched in the case group, while the Lautropia, Dialister, Leptotrichia, and Rothia were enriched in the control group. In the LGA subgroup and its corresponding control group, there were 14 differential microbiota from phylum to genus; at the genus level, Leptotrichia, Rothia, G6 genus of the Saccharibacteria, and Selenomonas were enriched in the control group (all LDA value>2, and all P<0.05). (5) Differential functional analysis: In the case group, metabolic pathways such as nicotinate degradation [log 2 fold change ( FC)=3.510, q=0.005], de novo synthesis of pyrimidine nucleotides (log 2FC=0.078, q=0.005), and L-tyrosine degradation pathway (log 2FC=0.710, q=0.034) were enriched in the oral microbiota of women. In the LGA subgroup, compared to the corresponding control group, metabolic pathways related to nicotinate degradation were enriched in the oral microbiota (log 2FC=3.660, q=0.012). Conclusions:There are differences in the structure of the pre-pregnancy oral microbiota of mothers with overgrown fetuses compared to those with normally grown fetuses, and mothers of normally grown fetuses show higher diversity in their pre-pregnancy oral microbiota. The enrichment of certain pathogenic bacteria and the reduction of symbiotic bacteria in the pre-pregnancy oral microbiota are associated with fetal overgrowth, and this association may be mediated by functional pathways such as nicotinate degradation.

Objective:To investigate the association between exposures of seven classic phthalate metabolites and fertility among preconception women before pregnancy.Methods:Based on the preconception cohort, a nested case-control study was carried out. Preconception couples who were recruited from Shanghai Jiading District Maternal and Child Health Hospital from 2016 to 2020 with intention to conception were selected. A total of 100 women whose time to pregnancy (TTP) >12 months were selected as the case group, and 151 women with the TTP≤12 months were randomly selected as control group. The single and joint effects on fertility of phthalate metabolites were analyzed by the comparison between the two groups via the multivariate binary logistic regression model, and the weighted quantile sum regression model.Results:There were significant differences in mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-carboxmethyl)-hexyl phthalate (MCMHP), the sum of the detected concentrations of MEHP, MCMHP, mono-(2-ethyl-5-oxohexyl) phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate and mono-(2-ethyl-5-carboxypentyl) phthalate (∑DEHP), and the sum of the detected concentrations of the seven phthalate metabolites (∑PAE) exposure levels between the case group and control group ( P=0.005, P<0.001, P=0.001, P=0.007). As shown by the multivariate binary logistic regression model, women with MEHP, MCMHP, ∑DEHP, ∑PAE at the highest quartile level were found to have significantly increased risk of infertility compared with women at the lowest quartile level (a OR=2.40, 95% CI: 1.12-5.15, P=0.025; a OR=7.74, 95% CI: 3.14-19.08, P<0.001; a OR=4.35, 95% CI: 1.93-9.79, P<0.001; a OR=2.04, 95% CI: 0.96-4.34, P=0.044). The weighted quantile sum regression model demonstrated that the exposure to seven phthalate metabolite mixtures in preconception was associated with an increased risk of infertility ( P<0.05). Among the seven phthalate metabolites, MCMHP had the largest contribution weight (61.7%). Conclusion:Women of childbearing age should avoid the exposure to phthalates in the environment when preparing for conception, such as to reduce the consumption of highly processed foods and foods packaged with plastic/polyvinyl chloride materials to promote fertility.

Objective:To investigate the association between exposures of seven classic phthalate metabolites and fertility among preconception women before pregnancy.Methods:Based on the preconception cohort, a nested case-control study was carried out. Preconception couples who were recruited from Shanghai Jiading District Maternal and Child Health Hospital from 2016 to 2020 with intention to conception were selected. A total of 100 women whose time to pregnancy (TTP) >12 months were selected as the case group, and 151 women with the TTP≤12 months were randomly selected as control group. The single and joint effects on fertility of phthalate metabolites were analyzed by the comparison between the two groups via the multivariate binary logistic regression model, and the weighted quantile sum regression model.Results:There were significant differences in mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-carboxmethyl)-hexyl phthalate (MCMHP), the sum of the detected concentrations of MEHP, MCMHP, mono-(2-ethyl-5-oxohexyl) phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate and mono-(2-ethyl-5-carboxypentyl) phthalate (∑DEHP), and the sum of the detected concentrations of the seven phthalate metabolites (∑PAE) exposure levels between the case group and control group ( P=0.005, P<0.001, P=0.001, P=0.007). As shown by the multivariate binary logistic regression model, women with MEHP, MCMHP, ∑DEHP, ∑PAE at the highest quartile level were found to have significantly increased risk of infertility compared with women at the lowest quartile level (a OR=2.40, 95% CI: 1.12-5.15, P=0.025; a OR=7.74, 95% CI: 3.14-19.08, P<0.001; a OR=4.35, 95% CI: 1.93-9.79, P<0.001; a OR=2.04, 95% CI: 0.96-4.34, P=0.044). The weighted quantile sum regression model demonstrated that the exposure to seven phthalate metabolite mixtures in preconception was associated with an increased risk of infertility ( P<0.05). Among the seven phthalate metabolites, MCMHP had the largest contribution weight (61.7%). Conclusion:Women of childbearing age should avoid the exposure to phthalates in the environment when preparing for conception, such as to reduce the consumption of highly processed foods and foods packaged with plastic/polyvinyl chloride materials to promote fertility.

Objective:To establish the biology reference interval (RI) of peripheral blood procalcitonin (PCT) for children between 3 days and 6 years old in China.Methods:Totally 3 353 reference individuals with apparent health or no specific diseases were recruited in 18 hospitals throughout the country during October 2020 to May 2021. Reference individuals were divided into four groups: 3-28 days, 29 days - 1 year, 1-3 years and 4-6 years. Vein blood or capillary blood were collected by percutaneous puncture from every reference individual. The PCT level in serum and the capillary whole blood were assayed by Roche Cobas e601 and Norman NRM411-S7 immunoanalyzer. Outliers were deleted and 95th percentiles of every group were provided as RIs. Man-Whitney U test or Kruskal-Wallis test were used performed to assess the difference among different gender, age or method groups. Results:The difference of PCT distribution between male and female is not statistically significant, but the difference between serum and capillary whole blood is statistically significant. The differences between age groups are significant too. For Roche e601, serum PCT RI of 3-28 days group is <0.23 μg/L, 29 days - 6 years are <0.11 μg/L. For NRM411, Serum PCT RI of 3-28 days group is <0.21 μg/L, 29 days - 1 year: <0.09 μg/L, 1 - 6 years: <0.10 μg/L. For whole blood PCT, RI of 3-28 days group is <0.26 μg/L, 29 days - 6 years is <0.15 μg/L.Conclusions:Serum and capillary whole blood PCT have different RIs, however, capillary whole blood PCT testing is valuable in pediatric application. Children in 3-28 days show higher PCT levels than other age group. To establish the RIs and understand the differences among different groups are essential for the interpretation and clinical application of peripheral blood PCT testing results.

Objective To investigate the distribution of pathogens and drug resistance by analyzing cervical secretion culture and drug sensitivity in 3 132 parturient women ,therefore to provide references for reasonable application of antibiotics .Methods Bacte‐rial culture and drug sensitivity testing using automatic bacteria identification system in cervical secretion samples were retrospec‐tively analyzed in 3 132 parturient women from January 2013 to December 2015 .Results Totally 634 positive samples were separa‐ted from cervical secretion in 3 132 parturient women with positive rate of 20 .2% .Of positive samples ,Gram‐positive bacteria were 16 .8% ,Gram‐negative Bacilli 45 .7% ,Fungus 37 .5% .Gram‐positive and Gram‐negative bacteria were all most sensitive to vanco‐mycin .Conclusion The pathogens have wide distribution in cervical secretion and differences in drug resistant bacteria .