Systematic review of single stage revision for prosthetic joint infection

While advanced technology,increased medical knowledge and improved surgical technique has improved patient outcomes in total joint arthroplasty,prosthetic joint infection still remains one of the leading causes of increased healthcare costs,medical resources and societal burdens in orthopaedic care.Two stage arthroplasty revision remains the gold standard for treatment of prosthetic joint infection.Proponents of single stage revision arthroplasty for infection argue that it results in lower healthcare costs while improving patient reported functional outcomes and with equivalent success rates.Here we review the history of single stage revision arthroplasty,discuss the key principles,highlight the indications and contraindications,and review the reported outcomes with a focus on future developments of single stage revision arthroplasty for hip and knee periprosthetic joint infections.

Efficacy of 2LPAPI®, a Micro-Immunotherapy Drug, in Patients with High-Risk Papillomavirus Genital Infection

Human papillomaviruses (HPVs) are well known for being linked to the development of cervical cancers, most of them being caused by the high-risk (HR) oncogenic genotypes, mainly 16 and 18. The efficacy of 2LPAPI® (Labo’Life), a micro-immunotherapy homeopathic drug, has been evaluated in HR-HPV infected women (n = 18), in a private gynecology practice, by comparing them to an untreated control group (n = 18). Patients were 20 to 45 years old and had cytology with Atypical Squamous Cells of Undetermined Significance (ASCUS) or Low grade Superficial Intra Lesions/ Cervical Intraepithelial Neoplasia Grade I (LSIL/CINI). Patients freely chose to be treated with the drug or not. Those deciding not to take the drug remained untreated and were followed as a control group. The drug was taken at the regimen of one capsule per day during 6 months. HR-HPV and cytology were evaluated at 6 and 12 months. After 12 months, HR-HPV was cleared in 78% of the patients taking the drug versus 44% in those not taking it (p = 0.086). In patients over 25 years, HR-HPV clearance in the treated group was significantly higher (81.3%) than in the control group (20%) (p = 0.004). The difference in the regression of the lesion grades almost reached statistical significance (p = 0.053). This follow-up confirms that the micro-immunotherapy drug 2LPAPI® is a safe and effective therapeutic approach to treat HR-HPV cervical lesions in women over 25 years.

What's new in hepatitis C virus infections in children?

The number of hepatitis C virus(HCV) infection cases is relatively low in children. This low number may be connected with the lack of screening tests and the asymptomatic course of infection. Currently,mother-toinfant transmission is the most common cause of HCV infection amongst children in developed countries. It is important to introduce routine screening tests for HCV in pregnant women. The risk of vertical transmission of HCV is estimated at approximately 5%(3%-10%). Currently,we do not have HCV transmission prevention methods. Some factors could potentially be eliminated by elective caesarean section. Currently,the method of prevention of perinatal HCV infection is the early identification and effective treatment of infections in young women in the preconception period. We describe genetic tests(IL-28 B single nucleotide polymorphisms) to identify children with an increased chance of spontaneous clearance or sustained virologic response achievement and vitamin D level as a potential predictor of treatment response in children. It is also important to develop non-invasive tests that can predict liver fibrosis. The existence of differences in the mechanisms leading to liver injury between children and adults creates new perspectives of action to reduce liver disease progression in children in the early years of life.

Role of genetic polymorphisms in hepatitis C virus chronic infection

AIM: To analyze the host genetics factors influencing the clinical course and the response to antiviral treatment in patients with chronic hepatitis C(CHC).METHODS: We conducted an electronic search on the Pub Med and MEDLINE(2000-2014) databases and Cochrane library(2000-2014). A total of 73 articles were retrieved and their data were extensively evaluated and discussed by the authors and then analyzed in this review article.RESULTS: Several studies associated polymorphisms in the interleukin 28 B gene on chromosome 19(19q13.13) with a spontaneous viral clearance in acute hepatitis C and with the response to pegylated interferon(PegIFN)-based treatment in chronic hepatitis C patients. Other investigations demonstrated that inosine triphosphate pyrophosphatase genetic variants protect hepatitis C virus-genotype-1 CHC patients from ribavirin-induced anemia, and other studies that a polymorphism in the patatin-like phospholipase domain-containing protein 3 was associated with hepatic steatosis in CHC patients. Although not conclusive, some investigations suggested that the vitamin D-associated polymorphisms play an important role in the achievement of sustained virologic response in CHC patients treated with Peg-IFN-based antiviral therapy. Several other polymorphisms have been investigated to ascertain their possible impact on the natural history and on the response to treatment in patients with CHC, but the data are preliminary and warrant confirmation. CONCLUSION: Several genetic polymorphisms seem to influence the clinical course and the response to antiviral treatment in patients with CHC, suggesting individualized follow up and treatment strategies.

Relationship between interleukin-6 polymorphism and susceptibility to chronic hepatitis B virus infection

AIM:To identify the relationship between tag single nucleotide polymorphisms(tag SNPs) of interleukin-6(IL-6) gene and susceptibility to chronic hepatitis B virus(HBV) infection in a Han Chinese population.METHODS:We performed a case-control study of501 Chinese patients with chronic HBV infection and301 self-limiting HBV-infected individuals as controls.Genomic DNA was isolated from the whole blood of all subjects using phenol/chloroform with MaXtract highdensity tubes. Tag SNPs were identified using genotype data from the panel(Han Chinese in Beijing) of the phase II HapMap Project. Four tag SNPs in IL-6(rs17147230A/T,rs2066992G/T,rs2069837A/G and rs2069852A/G) were genotyped by the Multiplex Snapshot technique. The genotype and allele frequencies were calculated and analyzed.RESULTS:Five haplotypes were involved in the analysis,with frequencies higher than 0.03. One of the haplotypes,TTAA,was significantly different between the two groups. Overall haplotype P values were:ATAA,P = 0.605,OR(95%CI) = 1.056(0.860-1.297); TGAG,P = 0.385,OR(95%CI) = 1.179(0.813-1.709); TGGG,P = 0.549,OR(95%CI) = 1.087(0.827-1.429); TTAA,P = 0.004,OR(95%CI) = 0.655(0.491-0.873); TTAG,P = 0.266,OR(95%CI) = 1.272(0.832-1.944). However,the four SNPs showed no significant genotype/allele associations with susceptibility to chronic HBV infection. Overall allele P values were:rs17147230,P = 0.696,OR(95%CI) = 1.041(0.850-1.276); rs2066992,P = 0.460,OR(95%CI)= 1.090(0.868-1.369); rs2069837,P = 0.898,OR(95%CI) = 0.983(0.759-1.274); rs2069852,P = 0.165,OR(95%CI) = 0.859(0.693-1.064). Overall genotype P values were:rs17147230,P = 0.625; rs2066992,P= 0.500; rs2069837,P = 0.853; and rs2069852,P =0.380.CONCLUSION:The four tag SNPs of IL-6 gene may be associated with susceptibility to chronic HBV infection in the Han Chinese population.

No association between IRF3 polymorphism and susceptibility to hepatitis B virus infection in Chinese patients

AIM:To investigate the association between three tag single nucleotide polymorphisms (tagSNPs) in inter-feron regulatory factors (IRF3) and the genetic suscep-tibility to chronic hepatitis B virus (HBV) infection.METHODS:We performed a case-control study of 985 Chinese cases of chronic HBV infection and 294 self-limiting HBV-infected individuals as controls.Three tagSNPs in IRF3 (rs10415576,rs2304204,rs2304206) were genotyped with the Multiplex SNaPshot technique.The genotype and allele frequencies were calculatedand analyzed.RESULTS:The three SNPs showed no significant geno-type/allele associations with chronic HBV infection.Overall allele P values were:rs10415576,P=0.0908,odds ratio (OR) [95% confidence interval (CI)]=1.1798 (0.9740-1.4291);rs2304204,P=0.5959,OR (95% CI)=1.0597 (0.8552-1.3133);rs2304206,P=0.8372,OR (95% CI)=1.0250 (0.8097-1.2976).Overall genotype P values were:rs10415576,P=0.2106;rs2304204,P=0.8458;rs2304206,P=0.8315.There were no statisti-cally significant differences between patients with chron-ic HBV infection and controls.Haplotypes generated by these three SNPs were also not significantly different between the two groups.CONCLUSION:The three tagSNPs of IRF3 are not asso-ciated with HBV infection in the Han Chinese population.

Genetic variants of innate immune receptors and infections after liver transplantation

Infection is the leading cause of complication after liver transplantation, causing morbidity and mortality in the first months after surgery. Allograft rejection is mediated through adaptive immunological responses, and thus immunosuppressive therapy is necessary after transplantation. In this setting, the presence of genetic variants of innate immunity receptors may increase the risk of post-transplant infection, in comparison with patients carrying wild-type alleles. Numerous studies have investigated the role of genetic variants of innate immune receptors and the risk of complication after liver transplantation, but their results are discordant. Tolllike receptors and mannose-binding lectin are arguably the most important studied molecules; however, many other receptors could increase the risk of infection after transplantation. In this article, we review the published studies analyzing the impact of genetic variants in the innate immune system on the development of infectious complications after liver transplantation.

Dual antibiotic loaded bone cement in patients at high infection risks in arthroplasty: Rationale of use for prophylaxis and scientific evidence

In view of the demographic changes and projected increase of arthroplasty procedures worldwide,the number of prosthetic joint infection cases will naturally grow.Therefore,in order to counteract this trend more rigid rules and a stricter implementation of effective preventive strategies is of highest importance.In the absence of a"miracle weapon"priorities should lie in evidence-based measures including preoperative optimization of patients at higher infection risks,the fulfilment of strict hygiene rules in the operating theatre and an effective antibiotic prophylaxis regimen.Instead of a"one size fits all"philosophy,it has been proposed to adjust the antibiotic prophylaxis protocol to major infection risks taking into account important patient-and procedure-related risk factors.A stronger focus on the local application mode via use of high dose dual antibioticloaded bone cement in such risk situations may have its advantages and is easy to apply in the theatre.The more potent antimicrobial growth inhibition in vitro and the strong reduction of the prosthetic joint infection rate in risk for infection patients with aid of dual antibiotic-loaded bone cement in clinical studies align with this hypothesis.

Regulatory polymorphism of CXCL10 rs1439490 in seronegative occult hepatitis C virus infection

AIM To examine the relationship between the single nucleotide polymorphism CXCL10 rs1439490 and seronegative occult hepatitis C virus(HCV) infection(OCI).METHODS One hundred and three cases of seronegative OCI and 155 cases of seropositive chronic HCV infection(CHC) were diagnosed at five Liver Centers in Northeastern China, from 2012 to 2016. CXCL10 rs1439490, rs1440802, and IL-28 B rs12979860 were analyzed by sequencing. Serum CXCL10 was measured by ELISA. Intrahepatic CXCL10 was determined by quantitative PCR and immunohistochemical semi-quantitative scoring. Liver necroinflammation and fibrosis were scored according to the METAVIR system.RESULTS CXCL10 rs1439490 G/G was more prevalent in OCI patients(n = 93/103; 90.3%) than in CHC patients(n = 116/155; 74.8%; P = 0.008). OCI patients had lower serum CXCL10 levels than CHC patients(192.91 ± 46.50 pg/mL vs 354.78 ± 102.91 pg/mL, P < 0.0001). Of IL-28 B rs12979860 C/C patients, OCI patients with rs1439490 G/G had lower serum and liver levels of CXCL10 and lower levels of liver necroinflammation and fibrosis than non-G/G patients. OCI patients had higher alanine aminotransferase normalization rates after Peginterferon treatment than CHC patients(P < 0.05) and serum CXCL10 decreased significantly(P < 0.0001). Liver necroinflammation and fibrosis were alleviated in 8 OCI patients after treatment. Multivariate analysis indicated that rs1439490 G/G significantly influenced the occurrence of OCI in HCV infection(OR = 0.31, 95%CI: 0.15-0.66, P = 0.002).CONCLUSION CXCL10 rs1439490 G/G is positively associated with OCI in HCV infection and antiviral outcome.

Distribution of High-Risk Human Papillomavirus Genotypes among Women with Colposcopic Diagnosis of Cervical Intraepithelial Neoplasia in Bangladesh

Background: The incidence of cervical cancer is high in Bangladesh and there is a high prevalence of preinvasive lower genital tract disease among women of reproductive age. Persistent high-risk Human Papilloma Virus (HPV) infection is the main underlying cause of cervical cancer and its precursor, cervical intraepithelial neoplasia (CIN). Objective: The aim of the study was to identify the subtypes of high-risk HPV infection among women with the colposcopic diagnosis of cervical intraepithelial neoplasia in Bangladesh. Methods: This cross-sectional observational study was conducted in the colposcopy clinic of Dhaka Medical College Hospital over a six-month period. A total of 100 participants were enrolled. Married women, between 30 - 60 years of age with colposcopically diagnosed cervical intra epithelial neoplasia were enrolled. Women with chronic illness, pregnancy, and women unable to consent were excluded from this study. After counselling, colposcopically directed punch biopsies were taken from each CIN case concurrently with high-risk HPV testing by polymerase chain reaction (PCR). Results: The mean age of the patients was 38.69 (SD ±7.76) years. CIN 1 was diagnosed in 57% of participants, while 24% had CIN II and 19% had CIN III lesions. High-risk HPV was present in 52 patients. HPV 16 was the most common identified in 28 (53.84%) and HPV 18 was the second most common with 20 (38.46%) either singly or in combination with other high-risk subtypes. The other HPV strains, HPV 31, 33, 35, 52, 56 and 58, were also detected either as mono or co-infections. Out of the 52 HPV positive cases, 29 (55.8%) had mono infection and 23 (44.2%) had co-infection with several subtypes. The highest incidence (50%) of oncogenic HPV infections was present among women aged 35 - 45 years. Risk factors associated with HPV positive cases were high parity (P 0.05), early age at marriage (P = 0.754) and early age of first child. Conclusion: This study identified a high prevalence of HPV 16 and 18 genotypes. HPV vaccination with the current 9-valent HPV vaccine, which contains HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. Will be an effective public health measure to eradicate cervical cancer in Bangladesh.

2020~2022年北京地区男性患者人乳头瘤病毒感染情况分析

目的了解本地区男性患者人乳头瘤病毒(HPV)感染情况,为其预防与治疗提供数据支持。方法回顾性分析2020~2022年3年中的临床男性患者HPV感染情况,利用多通道实时荧光定量聚合酶链反应(PCR)进行HPV DNA分型检测,检测型别包括15种HPV高危型(HPV 16、18、31、33、35、39、45、51、52、56、58、59、66、68、82)及2种HPV低危型(HPV 6&11),统计分析不同年龄、不同疾病状态下男性患者HPV感染情况,以及不同HPV亚型单独感染及混合感染情况。结果2020~2022年3年间共收集7024例男性患者的分泌物标本开展HPV DNA分型检测,其中HPV阳性2793例,检出率为39.76%;不同疾病状态中以皮肤感染和病毒性疣为主;不同年龄段中,以21~30岁感染占比最高为1143例(16.27%),其次为31~40岁1109例(15.79%),与其他年龄段相比,差异具有统计学意义(χ^(2)=27.342,P<0.001);在不同HPV感染亚型中,单一亚型感染病例最多为1744例(24.83%)(χ^(2)=20.431,P<0.001),二重感染619例(8.81%),三重感染249例(3.54%),四重及以上感染181例(2.58%);在HPV亚型单独感染中,以HPV 6&11亚型(低危型)最高(445例,6.34%),其次为16亚型(229例,3.26%)、52亚型(211例,3.00%);在HPV亚型多重感染中,以高低危混合亚型感染多见,二重感染以HPV 6&11/16最高(135例,1.92%),三重感染以HPV 6&11/16/52最高(29例,0.41%),四重感染以HPV 6&11/51/52/58最高(10例,0.14%)。结论2020~2022年3年间,男性HPV感染高发于21~40岁,主要感染的HPV亚型以6&11、16、52、58、51为主,以单一感染为主,混合感染中以低危和高危混合感染为主。这为本地区男性HPV感染的预防与治疗提供了可靠的数据支持。

TNIP1基因单核苷酸多态性及其mRNA表达水平与老年慢性心力衰竭患者肺部感染的相关性分析

目的探讨肿瘤坏死因子诱导蛋白3相互作用蛋白1(TNFAIP3-interacting protein 1,TNIP1)基因单核苷酸多态性及其mRNA表达水平与老年慢性心力衰竭患者肺部感染的相关性。方法选择2019年10月至2022年10月于上海建工医院重症医学科就诊的130例老年慢性心力衰竭患者作为研究对象,根据是否于院内发生肺部感染分为感染组(32例)和未感染组(98例)。对TNIP1基因的两个SNP位点rs6889239(T>C)、rs17728338(A>G)进行基因分型,并检测外周血TNIP1基因的mRNA表达水平。结果TNIP1基因rs6889239位点在感染组和非感染组之间的基因型分布以及等位基因频率的差异均无统计学意义(P>0.05);两组的rs17728338位点AA、AG、GG基因型分布比较差异有统计学意义(P<0.05),且感染组等位基因G的频率显著高于未感染组(P<0.05)。相较于未感染组,感染组患者的外周血TNIP1基因mRNA表达水平显著增加,差异有统计学意义(P<0.001)。受试者工作特征(Receiver operating characteristic,ROC)曲线分析结果显示外周血TNIP1基因表达水平预测慢性心力衰竭患者发生肺部感染的灵敏度和特异度分别为71.9%和95.9%。感染组和非感染组TNIP1基因rs6889239位点不同基因型患者的外周血TNIP1基因的表达水平比较差异均无统计学意义(P>0.05),而rs17728338位点不同基因型患者的外周血TNIP1基因表达水平比较差异有统计学意义(P<0.05)。结论TNIP1基因rs17728338表达水平与老年慢性心力衰竭患者发生肺部感染有关。

连云港地区女性人乳头瘤病毒感染情况及基因型分布研究

目的分析连云港地区女性人乳头瘤病毒(HPV)感染情况及基因型分布特点,以期为疫苗接种、宫颈癌防治提供参考。方法选取2020年1月至2022年12月在东海县人民医院妇科门诊就诊的8981例女性,均进行HPVDNA分型检测,分析HPV感染情况及基因型分布特点。结果连云港地区HPV总感染率为25.71%,高危型HPV感染率为21.01%,单一HPV感染率高于多重HPV感染率。高危型HPV基因型前5位分别为HPV16(5.78%)、HPV52(4.81%)、HPV58(3.29%)、HPV53(2.65%)、HPV51(2.09%),低危型HPV基因型以HPV42(2.41%)为主,其次是HPV81(2.07%)。年龄≤20岁和51~60岁年龄段中出现感染率峰值。结论连云港地区女性HPV感染以单一HPV感染为主,其中以HPV16和HPV52高危型HPV基因型为主。

单细胞转录组测序在病原微生物肺部感染研究中的应用

肺部感染是指在终末气道、肺泡腔及肺间质中由细菌、真菌和病毒等病原体诱发的炎症,是威胁人类健康的全球十大问题之一。2019年,世界卫生组织数据显示肺部感染致全球近260万死亡,位列第四大死因^([1]),而且,成人肺部感染的发作次数呈上升趋势,特别是≥70岁的男性患者数量增幅最为显著^([2])。病原微生物的感染是病原体与免疫相互作用的结果,不同病原体引起的肺部感染作用机制不同,感染的病原体可激活免疫信号通路和诱导炎症风暴,诱发急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)^([3]),导致预后不佳,甚至死亡。

高危型人乳头瘤病毒基因亚型感染与宫颈病变的相关性研究

目的 分析高危型人乳头瘤病毒(HR-HPV)基因亚型感染与宫颈病变的关系。方法 选取行HPV分型检测及活组织病理检查,符合标准的872例宫颈病变患者,分析HR-HPV单一感染型别、多重混合感染型别、亚型数与宫颈病变的发生及分布情况。结果 符合标准的872例宫颈病变患者,单一感染597例,占比68.46%,检出最高的5种基因亚型依次为16、52、58、18(33)、31,其中宫颈炎组检出前5种高危亚型依次为16、52、58、53、59;CIN1组检出前5种高危亚型依次为16、58、 52、18、31;CIN2及CIN3组检出前5种高危亚型依次为16、52、58、33、18,宫颈癌组以16为主,其次为33,单一感染中HPV16随病变程度的加重,感染率明显增高,4组比较差异有统计学意义(P<0.05)。多重感染275例,占比31.54%,检出最高的5种基因亚型依次为16、52、58、18、53,其中宫颈炎组检出前5种高危亚型依次为58、52、16、53、18;CIN1组检出前5种高危亚型依次为16、52、58、53、51;CIN2及CIN3组检出前5种高危亚型依次为16、52、 58、18、33,宫颈癌组主要为16,其次为18,多重感染中HPV16随病变程度的加重,感染率明显增高,4组比较差异有统计学意义(P<0.05)。结论 单一感染和多重感染检出最高的前3种亚型均为16、52、58,其中HPV16检出率与病变程度呈正相关,不同宫颈病变中单一感染高于多重感染,多重感染并不影响病变程度。

含大剂量复方倍他米松鸡尾酒注射液在一期翻修治疗假体周围感染中的应用及安全性研究

目的研究一期翻修治疗假体周围感染(PJI)中局部应用含大剂量复方倍他米松鸡尾酒注射液的疗效及安全性。方法回顾性比较2015年1月至2020年12月于我院接受一期翻修治疗并在术中使用两种不同配方鸡尾酒注射液的170例PJI病人,其中A组72例,其鸡尾酒配方中含有复方倍他米松,B组98例,配方中不含复方倍他米松。比较两组术后的疼痛视觉模拟量表(VAS)评分、阿片类药物需求,以及术后恶心和呕吐(PONV)、感染复发、深静脉血栓形成(DVT)、肺栓塞(PE)和切口愈合不良等并发症的发生率。结果术后12、24、48 h,A组的VAS评分均显著低于B组(P<0.05),但两组术后72 h的VAS评分差异无统计学意义(P>0.05)。B组关节液白细胞计数在术后24 h明显高于A组(P<0.05),但在48 h后两组差异无统计学意义(P>0.05);B组的C反应蛋白(CRP)在术后48 h内明显高于A组(P<0.05),但在术后72 h两组差异无统计学意义(P>0.05)。A组的PONV发生率和阿片类药物使用率较B组显著较低(P<0.05)。值得注意的是,两组之间感染复发率、DVT形成、PE和切口愈合不良等并发症情况比较,差异无统计学意义(P>0.05)。结论含有大剂量复方倍他米松的鸡尾酒注射液作为一期翻修术后早期的多模式局部浸润麻醉镇痛方案,可以有效减轻术后疼痛、减少阿片类药物的消耗以及PONV发生率,但对再感染和其他并发症没有影响。

阴道链球菌感染孕妇产前干预治疗与产后新生儿单独治疗对新生儿感染发生率影响

目的:探讨阴道链球菌感染孕妇产前干预治疗与产后新生儿单独治疗对新生儿感染发生率影响。方法:回顾性分析2020年1月至2023年12月在南丰县人民医院就诊的70例阴道链球菌感染孕妇临床资料进行研究。按照治疗时机前后分组,将进行产前干预治疗的孕妇分为产前组(n=35),将进行产后新生儿单独治疗的孕妇分为产后组(n=35)。比较两组的新生儿感染发生率、新生儿出生质量以及孕妇不良反应率。结果:两组新生儿感染率无统计学差异,两组新生儿出生1min、5min的Apgar评分比较差异无统计学意义;产后组孕妇不良反应率低于产前组(P<0.05)。结论:阴道链球菌感染孕妇产前干预治疗与产后新生儿单独治疗效果接近,新生儿单独治疗可弥补产前干预治疗局限性,避免孕妇不良反应,临床应根据实际情况选择合适的治疗方法。

单颗粒本地排放源谱在上海新冠感染防控期间的监测应用

采用单颗粒飞行时间质谱分析上海市2022年3月—5月新冠感染防控期间大气颗粒物来源,重点关注移动排放源的时空分布规律,并对防控期间、春节期间和防控前正常生产生活期间的监测结果做比对分析。结果表明,防控期间细颗粒物质量浓度较春节期间和正常生产生活时段下降了23.3%;受防控减排措施影响明显的移动源、扬尘、燃煤和工业工艺源排放的细颗粒物质量浓度相较另外两个时段都有不同程度的降低。

HPV多重感染与单一高危感染对宫颈病变的影响分析

目的分析人乳头瘤病毒(HPV)多重感染与单一高危感染对宫颈病变的影响。方法选取68例宫颈病变患者,均开展HPV检测和阴道镜宫颈组织病理学检查,根据检查结果将患者分为A组(15例,HPV单一高危感染)、B组(24例,HPV多重感染)及C组(29例,HPV高低危混合感染)。比较三组患者的检测结果。结果A组、B组及C组HPV感染患者对比,差异有统计学意义(P<0.05)。A组与B组比较,其宫颈组织病理学结果,差异有统计学意义(P<0.05);A组与C组比较,其宫颈组织病理学结果,差异无统计学意义(P>0.05);B组与C组比较,其宫颈组织病理学结果,差异有统计学意义(P<0.05)。结论HPV多重感染与单一高危感染对宫颈病变的影响有着明显的差异,且多重感染对宫颈病变的影响更大,值得临床引起重视。

Single cell metabolic phenome and genome via the ramanome technology platform:Precision medicine of infectious diseases at the ultimate precision?

Due to the limitations of existing approaches,a rapid,sensitive,accurate,comprehensive,and generally applicable strategy to diagnose and treat bacterial and fungal infections remains a major challenge.Here,based on the ramanome technology platform,we propose a culture‐free,one cell resolution,phenome‐genome‐combined strategy called single‐cell identification,viability and vitality tests and source tracking(SCIVVS).For each cell directly extracted from a clinical specimen,the fingerprint region of the D2O‐probed single cell Raman spectrum(SCRS)enables species‐level identification based on a reference SCRS database of pathogen species,whereas the C‐D band accurately quantifies viability,metabolic vitality,phenotypic susceptibility to antimicrobials,and their intercellular heterogeneity.Moreover,to source track a cell,Raman‐activated cell sorting followed by sequencing or cultivation proceeds,producinging an indexed,high coverage genome assembly or a pure culture from precisely one pathogenic cell.Finally,an integrated SCIVVS workflow that features automated profiling and sorting of metabolic and morphological phenomes can complete the entire process in only a few hours.Because it resolves heterogeneity for both the metabolic phenome and genome,targets functions,can be automated,and is orders‐of‐magnitude faster while cost‐effective,SCIVVS is a new technological and data framework to diagnose and treat bacterial and fungal infections in various clinical and disease control settings.