Effectiveness of cardioneuroablation in different subtypes of vasovagal syncope

BACKGROUND Cardioneuroablation(CNA)has shown encouraging results in patients with vasovagal syncope(VVS).However,data on different subtypes was scarce.METHODS This observational study retrospectively enrolled 141 patients[mean age:40±18 years,51 males(36.2%)]with the diagnosis of VVS.The characteristics among different types of VVS and the outcomes after CNA were analyzed.RESULTS After a mean follow-up of 4.3±1.5 years,41 patients(29.1%)experienced syncope/pre-syncope events after CNA.Syncope/pre-syncope recurrence significantly differed in each subtype(P=0.04).The cardioinhibitory type of VVS had the lowest recurrence rate after the procedure(n=6,16.7%),followed by mixed(n=26,30.6%)and vasodepressive(n=9,45.0%).Additionally,a significant difference was observed in the analyses of the Kaplan-Meier survival curve(P=0.02).Syncope/pre-syncope burden was significantly reduced after CNA in the vasodepressive type(P<0.01).Vasodepressive types with recurrent syncope/pre-syncope after CNA have a lower baseline deceleration capacity(DC)level than those without(7.4±1.0 ms vs.9.0±1.6 ms,P=0.01).Patients with DC<8.4 ms had an 8.1(HR=8.1,95%CI:2.2-30.0,P=0.02)times risk of syncope/pre-syncope recurrence after CNA compared to patients with DC≥8.4 ms,and this association still existed after adjusting for age and sex(HR=8.1,95%CI:2.2-30.1,P=0.02).CONCLUSIONS Different subtypes exhibit different event-free rates.The vasodepressive type exhibited the lowest event-free rate,but those patients with DC≥8.4 ms might benefit from CNA.

Stability and variability of molecular subtypes:comparative analysis of primary and metastatic triple-negative breast cancer

Objective:Triple-negative breast cancer(TNBC)is a heterogeneous and aggressive cancer.Although our previous study classified primary TNBC into four subtypes,comprehensive longitudinal investigations are lacking.Methods:We assembled a large-scale,real-world cohort comprised of 880 TNBC patients[465 early-stage TNBC(eTNBC)and 415 metastatic TNBC(mTNBC)patients]who were treated at Fudan University Shanghai Cancer Center.The longitudinal dynamics of TNBC subtypes during disease progression were elucidated in this patient cohort.Comprehensive analysis was performed to compare primary and metastatic lesions within specific TNBC subtypes.Results:The recurrence and metastasis rates within 3 years after initial diagnosis in the eTNBC cohort were 10.1%(47/465).The median overall survival(OS)in the mTNBC cohort was 27.2 months[95%confidence interval(CI),24.4–30.2 months],which indicated a poor prognosis.The prognostic significance of the original molecular subtypes in both eTNBC and mTNBC patients was confirmed.Consistent molecular subtypes were maintained in 77.5%of the patients throughout disease progression with the mesenchymal-like(MES)subtype demonstrating a tendency for subtype transition and brain metastasis.Additionally,a precision treatment strategy based on the metastatic MES subtype of target lesions resulted in improved progression-free survival in the FUTURE trial.Conclusions:Our longitudinal study comprehensively revealed the clinical characteristics and survival of patients with the original TNBC subtypes and validated the consistency of most molecular subtypes throughout disease progression.However,we emphasize the major importance of repeat pathologic confirmation of the MES subtype.

Single-cell transcriptomic profiling reveals ZEB1-mediated regulation in microglial subtypes and the impact of exercise on neuroinflammatory responses

Background:This study aims to identify distinct cellular subtypes within brain tissue using single-cell transcriptomic analysis,focusing on specific biomarkers that differentiate cell types and the effects of traditional and exercise therapy.Methods:Four samples were analyzed:older control(OC),older exercise(OE),younger control(YC),and younger exercise(YE).Single-cell RNA sequencing was used to distinguish cellular subtypes through their biomarker profiles.Data visualization included violin and t-SNE plots to illustrate biomarker expression across cell clusters such as oligodendrocytes,microglia,and astrocytes.Additionally,BV2 cells were exposed to amyloid-beta fragments to simulate Alzheimer’s disease,assessing the impact of exercise-induced cellular responses.Results:Distinct cellular subtypes were identified:oligodendrocytes(MBP,St18),microglia(Dock8),and astrocytes(Aqp4,Gpc5).Sample OE was predominantly oligodendrocytes,while YE had more astrocytes,inhibitory neurons,and Canal-Retzius cells.YC showed a significant presence of Olfm3+ganglion neurons.ZEB1 gene knockout revealed changes in SMAD family gene expression,which regulate ferroptosis.Oxidative stress levels were also evaluated.Conclusion:This profiling enhances our understanding of brain cellular functions and interactions,potentially informing targeted therapies in neurological research.Exercise may influence brain cell immune responses and cell death pathways by regulating specific gene expressions,offering new insights for treating neuroinflammation and degeneration.

Identification of prognostic molecular subtypes and model based on CD8+ T cells for lung adenocarcinoma

Background:Cytotoxic T lymphocytes(CD8+T)cells function critically in mediating anti-tumor immune response in cancer patients.Characterizing the specific functions of CD8+T cells in lung adenocarcinoma(LUAD)could help better understand local anti-tumor immune responses and estimate the effect of immunotherapy.Methods:Gens related to CD8+T cells were identified by cluster analysis based on the single-cell sequencing data of three LUAD tissues and their paired normal tissues.Weighted gene co-expression network analysis(WGCNA),consensus clustering,differential expression analysis,least absolute shrinkage and selection operator(LASSO)and Cox regression analysis were conducted to classify molecular subtypes for LUAD and to develop a risk model using prognostic genes related to CD8+T cells.Expression of the genes in the prognostic model,their effects on tumor cell invasion,and interactions with CD8+T cells were verified by cell experiments.Results:This study defined two LUAD clusters(CD8+0 and CD8+1)based on CD8+T cells,with cluster CD8+0 being significantly associated with the prognosis of LUAD.Three heterogeneous subtypes(clusters 1,2,and 3)differing in prognosis,genome mutation events,and immune status were categorized using 42 prognostic genes.A prognostic model created based on 11 significant genes(including CD200R1,CLEC17A,ZC3H12D,GNG7,SNX30,CDCP1,NEIL3,IGF2BP1,RHOV,ABCC2,and KRT81)was able to independently estimate the death risk for patients in different LUAD cohorts.Moreover,the model also showed general applicability in external validation cohorts.Low-risk patients could benefit more from taking immunotherapy and were significantly related to the resistance to anticancer drugs.The results from cell experiments demonstrated that the expression of CD200R1,CLEC17A,ZC3H12D,GNG7,and SNX30 was significantly downregulated,while that of CDCP1,NEIL3,IGF2BP1,RHOV,ABCC2 and KRT81 was upregulated in LUAD cells.Inhibition of CD200R1 greatly increased the invasiveness of the LUAD cells,but inhibiting CDCP1 expression weakened the invasion ability of LUAD cells.Conclusion:This study defined two prognostic CD8+T cell clusters and classified three heterogeneous molecular subtypes for LUAD.A prognostic model predictive of the potential effects of immunotherapy on LUAD patients was developed.

Histologic subtypes of non-muscle invasive bladder cancer

The majority of bladder cancers(BCs)are non-muscle invasive BCs(NMIBCs)and show the morphology of a conventional urothelial carcinoma(UC).Aberrant morphology is rare but can be observed.The classification and characterization of histologic subtypes(HS)in UC in BC have mainly been described in muscle in-vasive bladder cancer(MIBC).However,the currently used classification is ap-plied for invasive urothelial neoplasm and therefore,also valid for a subset of NMIBC.The standard transurethral diagnostic work-up misses the presence of HS in NMIBC in a considerable percentage of patients and the real prevalence is not known.HS in NMIBC are associated with an aggressive phenotype.Conse-quently,clinical guidelines categorize HS of NMIBC as“(very)high-risk”tumors and recommend offering radical cystectomy to these patients.Alternative strategies for bladder preservation can only be offered to highly selected patients and ideally within clinical trials.Novel treatment strategies and biomarkers have been established MIBC and NMIBC but have not been comprehensively invest-igated in the context of HS in NMIBC.Further evaluation prior to implementation into clinical practice is needed.

Identification of tumor antigens and immune subtypes of hepatocellular carcinoma for mRNA vaccine development

BACKGROUND mRNA vaccines have been investigated in multiple tumors,but limited studies have been conducted on their use for hepatocellular carcinoma(HCC).AIM To identify candidate mRNA vaccine antigens for HCC and suitable subpopu-lations for mRNA vaccination.METHODS Gene expression profiles and clinical information of HCC datasets were obtained from International Cancer Genome Consortium and The Cancer Genome Atlas.Genes with somatic mutations and copy number variations were identified by cBioPortal analysis.The differentially expressed genes with significant prognostic value were identified by Gene Expression Profiling Interactive Analysis 2 website analysis.The Tumor Immune Estimation Resource database was used to assess the correlation between candidate antigens and the abundance of antigen-presenting cells(APCs).Tumor-associated antigens were overexpressed in tumors and associated with prognosis,genomic alterations,and APC infiltration.A consensus cluster analysis was performed with the Consensus Cluster Plus package to identify the immune subtypes.The weighted gene coexpression network analysis(WGCNA)was used to determine the candidate biomarker molecules for appropriate populations for mRNA vaccines.immune subtypes showed distinct cellular and clinical characteristics.The IS1 and IS3 immune subtypes were immunologically“cold”.The IS2 and IS4 immune subtypes were immunologically“hot”,and the immune checkpoint genes and immunogenic cell death genes were upregulated in these subtypes.IS1-related modules were identified with the WGCNA algorithm.Ultimately,five hub genes(RBP4,KNG1,METTL7A,F12,and ABAT)were identified,and they might be potential biomarkers for mRNA vaccines.CONCLUSION AURKA,CCNB1,CDC25C,CDK1,TRIP13,PES1,MCM3,PPM1G,NEK2,KIF2C,PTTG1,KPNA2,and PRC1 have been identified as candidate HCC antigens for mRNA vaccine development.The IS1 and IS3 immune subtypes are suitable populations for mRNA vaccination.RBP4,KNG1,METTL7A,F12,and ABAT are potential biomarkers for mRNA vaccines.

HIV-1 Subtype Diversity and Factors Affecting Drug Resistance among Patients with Virologic Failure in Antiretroviral Therapy in Hainan Province,China,2014–2020

Objective This study aimed to determine the HIV-1 subtype distribution and HIV drug resistance(HIVDR)in patients with ART failure from 2014 to 2020 in Hainan,China.Methods A 7-year cross-sectional study was conducted among HIV/AIDS patients with ART failure in Hainan.We used online subtyping tools and the maximum likelihood phylogenetic tree to confirm the HIV subtypes with pol sequences.Drug resistance mutations(DRMs)were analyzed using the Stanford University HIV Drug Resistance Database.Results A total of 307 HIV-infected patients with ART failure were included,and 241 available pol sequences were obtained.Among 241 patients,CRF01_AE accounted for 68.88%,followed by CRF07_BC(17.00%)and eight other subtypes(14.12%).The overall prevalence of HIVDR was 61.41%,and the HIVDR against non-nucleoside reverse transcriptase inhibitors(NNRTIs),nucleotide reverse transcriptase inhibitors(NRTIs),and protease inhibitors(PIs)were 59.75%,45.64%,and 2.49%,respectively.Unemployed patients,hypoimmunity or opportunistic infections in individuals,and samples from 2017 to 2020 increased the odd ratios of HIVDR.Also,HIVDR was less likely to affect female patients.The common DRMs to NNRTIs were K103N(21.99%)and Y181C(20.33%),and M184V(28.21%)and K65R(19.09%)were the main DRMs against NRTIs.Conclusion The present study highlights the HIV-1 subtype diversity in Hainan and the importance of HIVDR surveillance over a long period.

宫颈病变患者病灶组织miR-21、miR-146a、miR-224表达与HR-HPV感染、宫颈病变程度的关系

目的分析宫颈病变患者病灶组织miR-21、miR-146a、miR-224表达与高危型人乳头状瘤病毒(HR-HPV)感染、宫颈病变程度的关系。方法选取宫颈病变患者252例,根据宫颈病变程度分为宫颈癌组、低级别鳞状上皮内病变(LSIL)组、高级别鳞状上皮内病变(HSIL)组;根据是否感染HR-HPV分为感染组和非感染组。另选宫颈正常的子宫肌瘤患者84例为对照组。PCR检测各组miR-21、miR-146a和miR-224表达水平,并分析宫颈癌患者临床病理特征与miR-21、miR-146a和miR-224表达的关系。结果感染组、非感染组miR-224水平高于对照组,感染组miR-224水平高于非感染组,宫颈癌组高于对照组、LSIL组、HSIL组(P<0.05)。低分化、FIGO分期Ⅱb~Ⅲa期、淋巴结转移、HR-HPV感染的宫颈癌患者病灶组织中miR-224高于中高分化、FIGO分期Ⅰb~Ⅱa期、无淋巴结转移及非HR-HPV感染者(P<0.05)。分化程度、HR-HPV感染、FIGO分期、淋巴结转移是影响宫颈病变患者病灶组织miR-224水平的影响因素。结论宫颈癌组织miR-224表达明显上调,且HR-HPV感染者miR-224表达水平更高;HR-HPV感染、分化程度、FIGO分期、淋巴结转移与宫颈癌组织miR-224表达密切相关。

消疣汤对宫颈HR-HPV持续感染患者疗效及对宫颈癌Hela细胞上皮间充质转化的影响

目的探究消疣汤对宫颈HR-HPV持续感染患者的疗效及对宫颈癌Hela细胞上皮间充质转化(EMT)影响。方法收集高危型人乳头瘤病毒(HR-HPV)持续感染且病理分级为CINⅠ级的患者114例随机均分为干扰素组和消疣汤组,干扰素组应用重组人干扰素α-2b凝胶、消疣汤组在干扰素组的基础上给予消疣汤治疗,与治疗3个月时评价两组患者中医症候积分和临床疗效;将宫颈癌Hela细胞随机分为空白对照组(Control组),消疣汤低剂量组(XYD-L组,1 g/L)、中剂量组(XYD-M组,2 g/L)及高剂量组(XYD-H组,4 g/L),于24、48及72 h时,采用CCK-8法Hela细胞增殖能力、Transwell法检测侵袭能力、蛋白质印迹法检测细胞中E-Cadherin、N-Cadherin、Vimentin表达。结果与Control组相比,XYD-L组、XYD-M组和XYD-H组Hela细胞增殖能力、侵袭数目及细胞中N-Cadherin、Vimentin蛋白表达明显降低,细胞中E-Cadherin蛋白表达均明显增加(P<0.05);XYD-H组宫颈癌细胞增殖能力、侵袭数目及细胞中N-Cadherin、Vimentin蛋白表达明显低于XYD-L组、XYD-M组,细胞中E-Cadherin蛋白表达明显高于XYD-L组、XYD-M组(P<0.05);干扰素组HR-HPV持续感染患者治疗3个月时的临床疗效总有效率为78.95%、消疣汤组临床疗效总有效率(94.74%),P<0.05;和治疗前相比,治疗后两组患者中医症候积分明显降低(P<0.05);与治疗后干扰素组相比,消疣汤组患者中医症候积分明显降低(P<0.05)。结论消疣汤可明显改善宫颈HR-HPV持续感染患者临床症状,其机制可能与消疣汤影响宫颈癌细胞EMT及细胞的增殖和侵袭有关。

Rare synchronous colorectal carcinoma with three pathological subtypes: A case report and review of the literature

BACKGROUND Synchronous colorectal carcinomas(SCRC)are two or more primary colorectal carcinomas identified simultaneously or within 6 mo of the initial presentation in a single patient.Their incidence is low and the number of pathological types of SCRC is usually no more than two.It is very unusual that the pathological findings of a patient with SCRC show more than two different pathological subtypes.Here,we report a rare case of SCRC with three pathological subtypes.CASE SUMMARY A 75-year-old woman who had no previous medical history or family history was admitted to the hospital because of intermittent hematochezia for more than a month.Colonoscopy displayed an irregularly shaped neoplasm of the rectum,a tumor-like lesion causing intestinal stenosis in the descending colon,and a polypoidal neoplasm in the ileocecum.Subsequently,she underwent total colectomy,abdominoperineal resection for rectal cancer,and ileostomy.After operation,the pathological report showed three pathological subtypes including well-differentiated adenocarcinoma of the ascending colon,moderately differen-tiated adenocarcinoma of the descending colon,and mucinous adenocarcinoma of the rectum.She is now recovering well and continues to be closely monitored during follow-up.CONCLUSION Preoperative colonoscopy examination,imaging examination,and extensive intraoperative exploration play important roles in reducing the number of missed lesions.

不同治疗方案对宫颈HR-HPV感染的临床疗效分析

目的:本研究旨在分析重组人干扰素α-2b阴道泡腾片联合保妇康栓对HR-HPV感染患者的HPV、TCT的转归及阴道微生态的影响。方法:选取2021年1月~2022年12月于郑州大学第二附属医院妇科门诊就医的HR-HPV感染患者共200例,其宫颈病变程度均低于HSIL,依据治疗方案的不同分为双药组(干扰素联合保妇康栓双药治疗)、单药组(干扰素单药治疗)及观察组(未使用药物进行干预),比较三组间HPV、TCT及阴道微生态的变化,以及不同年龄段HR-HPV的转阴率。结果:双药组HR-HPV的转阴率和总体有效率高于单药组及观察组(P < 0.017);且双药组和单药组中<45岁患者的HR-HPV转阴率均高于≥45岁患者(P < 0.05);双药组和单药组治疗后TCT正常率高于观察组(P < 0.017);双药组和单药组患者阴道分泌物的PH值及Nugent评分均较治疗前好转(P < 0.05),且双药组的好转情况更显著(P < 0.05)。结论:干扰素联合保妇康栓治疗可提高HR-HPV的转阴率及宫颈细胞学正常率,改善阴道微生态情况;且<45岁患者药物治疗效果更佳,预后更好。

Blood typing and transfusion therapy in a patient with A2 subtype acute myeloid leukemia M2:A case report

BACKGROUND Acute myeloid leukemia(AML)is one of the most common types of leukemia in adults.However,AML is relatively rare in the population overall,accounting for only about 1 percent of all cancers.Treatment for AML can be very effective for some patients,yet it leaves others with serious and even life-threatening side effects.Chemotherapy is still the primary treatment for most AML,but over time,leukemia cells become resistant to chemotherapy drugs.In addition,stem cell transplantation,targeted therapy,and immunotherapy are currently available.At the same time,with the progression of the disease,the patient may have corresponding complications,such as coagulation dysfunction,anemia,granulocytopenia,and repeated infection,so transfusion supportive therapy will be involved in the overall treatment regime.To date,few articles have reported on blood transfusion treatment options for patients with ABO subtypes AML-M2.Blood transfusion therapy is an important supportive treatment for AML-M2,and accurate determination of patients'blood type is one of the most important steps in the treatment process.In this study,we explored blood typing and supportive treatment strategies for a patient with A2 subtype AML-M2 to provide the basis for treatment for all patients.CASE SUMMARY In order to determine the blood type of the patient,serological and molecular biological methods were used for reference tests,and the genetic background was studied to determine the patient's final blood type and select the appropriate blood products for infusion treatment.According to the results obtained by serological and molecular biological methods,the blood type of the patient was A2 subtype;the genotype was A02/001;the irregular antibody screening was negative,and anti-A1 was found in the plasma.According to the overall treatment plan,active anti-infection,elevated cells,component blood transfusion support,and other rescue and supportive treatments were given,and the patient successfully passed the stage of myelosuppression after chemotherapy.Re-examination of bone marrow smears showed that AL was in complete remission of bone marrow signs,and minimal residual leukemia lesions suggested no cells with obvious abnormal immunophenotype(residual leukemia cells<10-4).CONCLUSION The infusion of patients with A2 subtype AML-M2 with A irradiated platelets and O washing red blood cells can meet the needs of clinical treatment.

清利解毒方联合重组人干扰素α-2b治疗高危型HR-HPV感染湿热下注证的临床研究

目的 评价清利解毒方联合重组人干扰素α-2b治疗高危型人乳头瘤病毒(High-risk human papillomavirus,HR-HPV)感染湿热下注证的临床疗效。方法 选取2018年9月至2020年9月北京中医医院延庆医院门诊治疗的高危型宫颈HR-HPV感染湿热下注证患者120例,随机分为观察组和对照组各60例。两组患者均予重组人干扰素α-2b阴道纳药治疗,观察组同时予中药清利解毒方阴道灌洗。对比两组HPV转阴率、中医证候积分改善情况及临床疗效。结果 观察组HPV总转阴率为78.33%,高于对照组的60.00%,差异有统计学意义(P<0.05)。治疗后,观察组中医证候积分总分、单证带下量多、带下颜色、带下性质、带下气味、外阴瘙痒证候积分改善均优于对照组,差异有统计学意义(P<0.05);治疗后,两组小便短赤、口苦咽干、胸闷心烦积分比较,差异无统计学意义(P>0.05)。观察组临床总有效率为76.67%,高于对照组的60.00%,差异有统计学意义(P<0.05)。结论 清利解毒方联合重组人干扰素α-2b治疗HR-HPV感染湿热下注证,可改善患者中医证候,提高HPV转阴率,疗效确切。

Classification of patients with metastatic colorectal cancer into consensus molecular subtypes into real-world: A pilot study

BACKGROUND Colorectal cancer is a complex disease with high mortality rates.Over time,the treatment of metastatic colorectal cancer(mCRC)has gradually improved due to the development of modern chemotherapy and targeted therapy regimens.However,due to the inherent heterogeneity of this condition,identifying reliable predictive biomarkers for targeted therapies remains challenging.A recent promising classification system—the consensus molecular subtype(CMS)system—offers the potential to categorize mCRC patients based on their unique biological and molecular characteristics.Four distinct CMS categories have been defined:immune(CMS1),canonical(CMS2),metabolic(CMS3),and mesenchymal(CMS4).Nevertheless,there is currently no standardized protocol for accurately classifying patients into CMS categories.To address this challenge,reverse transcription polymerase chain reaction(RT-qPCR)and next-generation genomic sequencing(NGS)techniques may hold promise for precisely classifying mCRC patients into their CMSs.AIM To investigate if mCRC patients can be classified into CMS categories using a standardized molecular biology workflow.METHODS This observational study was conducted at the University of Chile Clinical Hospital and included patients with unresectable mCRC who were undergoing systemic treatment with chemotherapy and/or targeted therapy.Molecular biology techniques were employed to analyse primary tumour samples from these patients.RT-qPCR was utilized to assess the expression of genes associated with fibrosis(TGF-βandβ-catenin)and cell growth pathways(c-MYC).NGS using a 25-gene panel(TumorSec)was performed to identify specific genomic mutations.The patients were then classified into one of the four CMS categories according to the clinical consensus of a Tumour Board.Informed consent was obtained from all the patients prior to their participation in this study.All techniques were conducted at University of Chile.RESULTS Twenty-six patients were studied with the techniques and then evaluated by the Tumour Board to determine the specific CMS.Among them,23%(n=6),19%(n=5),31%(n=8),and 19%(n=5)were classified as CMS1,CMS2,CMS3,and CMS4,respectively.Additionally,8%of patients(n=2)could not be classified into any of the four CMS categories.The median overall survival of the total sample was 28 mo,and for CMS1,CMS2,CMS3 and CMS4 it was 11,20,30 and 45 mo respectively,with no statistically significant differences between groups.CONCLUSION A molecular biology workflow and clinical consensus analysis can be used to accurately classify mCRC patients.This classification process,which divides patients into the four CMS categories,holds significant potential for improving research strategies and targeted therapies tailored to the specific characteristics of mCRC.

乳杆菌活菌胶囊协同人干扰素α-2b凝胶治疗HSIL患者CKC术后伴HR-HPV感染的效果及对IL-4、IL-10及TNF-α水平的影响

目的探讨乳杆菌活菌胶囊协同人干扰素α-2b凝胶治疗高度鳞状上皮内病变(HSIL)患者宫颈冷刀锥切术(CKC)术后伴高危型人乳头瘤病毒(HR-HPV)感染的效果及对白细胞介素4(IL-4)、白细胞介素10(IL-10)及肿瘤坏死因子-α(TNF-α)水平的影响。方法选取2019年1月至2022年12月于北京市通州区妇幼保健院因HSIL行CKC术后伴HR-HPV感染者161例为研究对象,依据治疗方式差异分为对照组79例(予人干扰素α-2b凝胶治疗)与研究组82例(予乳杆菌活菌胶囊协同人干扰素α-2b凝胶治疗)。对比两组临床疗效、阴道微生态评分(Nugent)、宫颈局部微免疫指标水平[IL-4、IL-10、TNF-α、白细胞介素-2(IL-2)、干扰素-γ(IFN-γ)]、宫颈病变组织中相关组织阳性表达率[吲哚胺2,3-双加氧酶(IDO)、IL-10、IL-4、TNF-α]。结果治疗后,对照组总有效率为83.54%,研究组总有效率为93.90%,对照组总有效率比研究组低,差异有统计学意义(P<0.05);研究组阴道微生态环境恢复率(92.68%)比对照组(82.28%)高,pH值与Nugent评分均比对照组低,差异均有统计学意义(P<0.05);治疗后两组IL-2、IFN-γ细胞因子水平均上升,且研究组比对照组高;两组IL-4、IL-10、TNF-α水平均下降,且研究组比对照组低,差异均有统计学意义(P<0.05);两组IDO、IL-10、IL-4、TNF-α阳性表达率均比治疗前低,且研究组比对照组低,差异有统计学意义(P<0.05)。结论在应用乳杆菌活菌胶囊协同人干扰素α-2b凝胶治疗HSIL患者CKC术后伴HR-HPV感染的疗效更佳,有利于维持稳定宫颈微生态环境,提高免疫调节,降低炎症反应。

子午流注开穴法联合干扰素治疗持续性宫颈HR-HPV感染的临床研究

目的:本项目基于病例–对照研究设计,通过中西医结合的方法提高持续HR-HPV感染的转阴率,从而降低宫颈癌的发病率,为临床治疗持续性宫颈HR-HPV感染提供新的中西医疗法和理论依据。方法:收集2021年10月至2022年12月于我院妇科门诊就诊的宫颈HR-HPV感染患者,且参照诊断标准,选择符合纳入标准的病人共计60人;将60例患者随机分为试验组(n = 30)及对照组(n = 30),对试验组患者进行子午流注开穴法联合重组人干扰素α2b阴道泡腾片治疗进行治疗,对照组患者给予重组人干扰素α2b阴道泡腾片治疗,分别比较两组患者HPV转阴率、中医证候及阴道微生态的改善情况。结果:治疗后两组患者的HPV转阴率、中医证候及阴道微生态均比治疗前有所提高。1) 治疗后试验组30例中有21例转阴,转阴率为70%,对照组30例中11例转阴,HPV转阴率为36.67%,两组HPV转阴率的比较有显著统计学差异(P < 0.01)试验组优于对照组;2) 两组中医证候评分进行配对T检验,P < 0.01,有统计学意义,试验组改善中医证候方面较为显著。3) 两组阴道微生态各项指标均有改善,试验组的白细胞酯酶、乙酰氨基葡萄糖苷酶及PH值改善优于对照组,差异具有统计学意义(P < 0.05)。4) 试验组临床总有效率为90%,对照组临床总有效率60%,两组差异有统计学意义(P < 0.001)。结论:子午流注开穴法联合干扰素治疗宫颈HR-HPV感染,临床疗效确切,该法与单纯西药治疗相比较,能明显改善患者的阴道微生态及中医证候,提高HR-HPV转阴率,其安全可靠,建议推广应用。

TCT联合HR-HPV检测在宫颈癌及癌前病变早期筛查中的应用价值

目的探讨在宫颈癌及癌前病变早期筛查中选择液基薄层细胞检测(TCT)联合高危型人乳头状瘤病毒(HRHPV)检测的实际价值及有效性。方法选择2000例行宫颈癌及癌前病变早期筛查的患者,研究对象均取自2020年1月-2023年1月。均行TCT、HR-HPV检查。诊断金标准以病理结果为依据,对比TCT、HR-HPV单项及联合检测与病理结果的一致性。结果病理检查结果显示,2000例患者中,阳性共396例,阴性共1604例。TCT+HR-HPV联合检测的灵敏度94.41%、特异性98.50%及准确率98.80%均明显高于TCT单项检测80.00%、87.83%、86.95%、HR-HPV单项检测82.10%、94.81%、92.40%,具统计学意义(P<0.05)。TCT+HR-HPV检查的阳性、阴性预测值93.93%、98.62%明显高于TCT单项检测45.45%、97.19%和HR-HPV单项检测78.78%、95.76%,误诊率、漏诊率5.58%、1.51%明显低于TCT单项检测20.00%、12.17%和HR-HPV单项检测17.89%、5.18%,具统计学意义(P<0.05)。结论通过TCT+HR-HPV检测进行宫颈癌及癌前病变早期筛查,可显著提升诊断准确率,有助于临床早期诊治,提升诊疗质量,且对患者生存周期具有延长作用。

全子宫切除术中阴道残端电灼对HR-HPV感染转阴率的临床研究

目的:探讨全子宫切除术中阴道残端电灼对HR-HPV感染转阴率的临床效果。方法:选择2015年1月1日至2021年1月1日就诊于本院,合并HR-HPV感染的子宫病变患者。采用随机数字表方法,将80例患者分成观察组和对照组。两组病人都行筋膜外全子宫切除术,观察组(A组):术中对阴道壁残端采用电刀或电凝棒电灼,对照组(B组)对阴道残端常规缝合未做特殊处理,对两组临床疗效、HPV感染转阴情况、阴道残端薄层液基细胞学检测(TCT)进行比较。结果:治疗后1个月,观察组HR-HPV的转阴率明显高于对照组,有显著性差异(P<0.05);术后6个月,观察组HR-HPV的转阴率和正常组的转阴率分别为87.50%和55.00%,有显著性差异(P<0.05)。治疗期间,观察组无显著毒性副作用。结论:全子宫切除术后采用阴道残端电灼法能有效地改善HR-HPV感染的转阴率,降低HR-HPV的复发率。

HR-HPV载量与高级别鳞状上皮内病变患者术后复发的相关性分析

目的分析高危型人乳头瘤病毒(HR-HPV)载量与高级别鳞状上皮内病变(HSIL)患者术后复发的相关性。方法选取2021年1月至2022年5月在我院行宫颈锥切手术治疗的80例HSIL患者,入院时检测其HR-HPV载量,术后随访12个月,统计患者术后复发情况并进行分组,比较复发组和未复发组的基线资料,分析HR-HPV载量与HSIL患者术后复发的相关性。结果80例HSIL患者术后复发18例,占比22.50%;复发组与未复发组的年龄、孕次、产次、流产史、切缘情况、病理类型、TCT检测结果比较无统计学差异(P>0.05);复发组入院时的HR-HPV载量高于未复发组(P<0.05)。Logistic回归分析结果显示,HSIL患者入院时的HR-HPV载量异常过表达是其术后复发的危险因素(OR>1,P<0.05)。结论HSIL患者术前HR-HPV载量与其术后复发有一定相关性,可能是复发高风险因子。

TCT联合HR-HPV基因检测对宫颈癌及癌前病变筛查的作用

旨在分析宫颈癌及其癌前病变筛查中相关检测项目的应用价值,主要围绕宫颈液基薄层细胞学(TCT)与高危型人乳头瘤病毒(HR‐HPV)基因检测展开研究。研究时间跨度是2022年全年和2023年全年,共有4500例受检者,均接受本次研究应用的联合检验方式,对数据结果进行比较和分析。结果 联合检测检出率明显高于单一检测,同时诊断效能更高(P<0.05)。结论 想要获得更精准的宫颈癌及癌前病变筛查结果,应联合应用两种检查项目,能够相互补充,在实际临床工作中应积极推广。