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.

Application Analysis of High Risk HPV Detection Combined with Cervical Cytology, Colposcopy and Pathology in Cervical Lesions of Women in Tiandeng County

Purpose: To understand the application of high-risk HPV detection combined with cervical cytology, colposcopy and pathology in cervical lesions of women in Tiandeng County. Method: Women in the outpatient and inpatient departments of our hospital from January 2021 to October 2022 were collected for high-risk HPV testing, TCT, colposcopy and pathological examination according to their personal wishes, to understand the application of relevant examinations in cervical lesions. Result: In 2021, the number of patients was 5801, among whom 1743 patients had received cervical cancer examination in the past, accounting for 30.05% of the total number of patients, and 5795 who had volunteered for TCT examination this time, accounting for 99.90% of the total;A total of 289 cases of atypical squamous cells with unclear significance (ASC-US) were detected, excluding 11 cases of high-grade squamous intraepithelial lesions (ASC-H), 122 cases of low-grade squamous intraepithelial lesions (LSIL), 16 cases of high-grade squamous intraepithelial lesions (HSIL), 2 cases of squamous cell carcinoma (SCC), and 4 cases of atypical adenocyte (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of people who volunteered for high-risk HPV testing was 4237, and the number of positive cases was 740, accounting for 17.47% of the screening population;Among 740 HPV-positive patients, 488 high-risk HPV-positive patients were selected for TCT examination, and 87 patients were found to be TCT positive;From 401 high-risk HPV-positive and TCT negative patients, 287 patients with possible lesions were screened out for colposcopy;The results showed that 60 patients may have certain cervical lesions and need further pathological examination and the results showed that 28 patients had CTN1 and 18 patients had CIN2 - 3. In 2022, 8840 patients received medical treatment, among which 3188 patients had received cervical cancer examination in the past, accounting for 36.06% of the total number of patients, and 8314 patients voluntarily underwent TCT examination, accounting for 94.05% of the total number of patients. 434 cases of atypical squamous cells with ambiguous meaning (ASC-US) were detected, excluding 13 cases of high-grade squamous intraepithelial lesions (ASC-H), 217 cases of low-grade squamous intraepithelial lesions (LSIL), 35 cases of high-grade squamous intraepithelial lesions (HSIL), 1 case of squamous cell carcinoma, and 4 cases of atypical adenocarcinoma (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of volunteers for high-risk HPV testing was 3871 cases, and the number of positive cases was 654 cases, accounting for 16.89% of the screening number. 527 high-risk HPV-positive patients were selected from 654 HPV-positive patients for TCT examination, and the number of TCT-positive patients was found to be 49. From 478 high-risk HPV-positive patients with TCT negative, 276 patients with possible lesions were screened out for colposcopy;The results showed that 66 patients may have certain cervical lesions and need further pathological examination;and then the results showed that 31 cases of CTN1 and 6 cases of CIN2 - 3. Conclusion: Gynecological high-risk HPV examination can provide better etiological sources for cervical cancer screening;Cervical cytology examination has high sensitivity;Colposcopy examination has high specificity;Pathological examination can be used as an effective supplement for cervical cytology examination and colposcopy;So high-risk HPV combined with cytology examination, colposcopy examination and pathological examination has high clinical application value;It is worth popularizing and applying.

Relationship between the high-risk HPV infection and the expression of oncogenes, anti-oncogenes in cervical dysplasia

Objective:To study the relationship between the infection of high-risk HPV in cervical precancerous lesion and the expression of oncogene, anti-oncogene.Methods:218 cases ofcervical intraepithelial neoplasia patients in our hospital during May 2014–May 2016 were chosed and divided into high-risk HPV group (n=107), low-risk HPV group (n=111) according to cervical tissue HPV test;another 100 cases of patients received cervical biopsy and confirmed as benign lesions were enrolled in the control group. RT-PCR method was used to detect the mRNA expression of proto-oncogene and anti-oncogene in three groups, Western-blot method was used to detect the protein expression of Sox-2 and Wnt/β-catenin signal pathway.Results: mRNA expression of oncogene DEK, Bmi-1, c-fos, K-ras, Prdx4 in high-risk HPV group were higher than low-risk HPV group and control group (P<0.05);mRNA expression of anti-oncogene P27, P16, DAPK, PTEN, eIF4E3 in high-risk HPV group were lower than low-risk HPV group and control group (P<0.05);expression of Sox-2 and Wnt/β-catenin signaling pathway protein Sox-2,β-catenin, wnt-1, wnt-3a in high-risk HPV group were higher than low-risk HPV group and control group (P<0.05).Conclusions:High-risk HPV infection can increase the expression of oncogenes and reduce the expression of anti-oncogenes in cervical dysplasia tissues on Sox-2- and Wnt/β-catenin signaling pathway manners.

Relationship of high-risk HPV infection with MEKK3 and NF-κB expression in cervical intraepithelial neoplasia tissue

Objective:To study the relationship of high-risk human papilloma virus (HPV) infection with mitogen-activated protein kinase/extracellular signal-regulated kinase 3 (MEKK3) and nuclear factorκB (NF-κB) expression in cervical intraepithelial neoplasia tissue.Methods:125 cases of cervical biopsy specimens between May 2013 and March 2016 were collected. The cervical inflammation specimens, cervical intraepithelial neoplasia specimens and cervical cancer specimens were included in inflammation group, CIN group and malignant group respectively. HPV-DNA typing detection kits were used to determine HPV typing, immunohistochemical kits were used to determine MEKK3 and NF-κB protein expression, and fluorescent quantitative PCR kits were used to determine the mRNA expression of MEKK3, NF-κB and downstream molecules.Results: MEKK3 and NF-κB protein expression in high-risk HPV-positive cervical tissue were significantly higher than those in high-risk HPV-negative cervical tissue (P<0.05), and MEKK3, NF-κB, Bcl-2, XIAP, Bmi-1, TGF-β and Vimentin mRNA expression in high-risk type HPV-positive cervical tissue were significantly higher than those in high-risk HPV-negative cervical tissue (P<0.05);Bcl-2, XIAP, Bmi-1, TGF-β and Vimentin mRNA expression in tissue with positive MEKK3 and NF-κB expression were significantly higher than those in tissue with negative MEKK3 and NF-κB expression (P<0.05).Conclusions:High-risk HPV infection will increase the expression of proliferation genes Bcl-2, XIAP and Bmi-1 as well as invasion genes TGF-β and Vimentin in cervical intraepithelial neoplasia tissue through MEKK3/NF-κB pathway.

Correlation of HPV infection with TLRs pathway activation and downstream gene expression in cervical precancerous lesions

Objective: To study the correlation of HPV infection with TLRs pathway activation and downstream gene expression in cervical precancerous lesions. Methods: Cervical precancerous lesion tissues from surgical resection or cone biopsy in Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University between June 2014 and May 2017 were collected and divided into HR-HPV positive group and HR-HPV negative group according to the condition of high-risk HPV infection;normal cervical tissues surgically removed due to fibroid in Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University during the same period were collected as the control group. The contents of TLRs pathway molecules as well as the expression of apoptosis-related genes and invasion-related genes in the cervical precancerous lesion tissues and normal cervical tissues were determined. Results:TLR2, TLR3, TLR4, TLR9 and NF-κB contents as well as CyclinD1, PCNA, iNOS, Gal-9, N-cadherin, HIF-1α and VEGF mRNA expression in HR-HPV positive group and HR-HPV negative group were significantly higher than those in control group whereas p53, Beclin1, LC3-II and SFRP2 mRNA expression were significantly lower than those in control group, and TLR2, TLR3, TLR4, TLR9 and NF-κB contents as well as CyclinD1, PCNA, iNOS, Gal-9, N-cadherin, HIF-1α and VEGF mRNA expression in HR-HPV positive group were significantly higher than those in HR-HPV negative group whereas p53, Beclin1, LC3-II and SFRP2 mRNA expression were significantly lower than those in HR-HPV negative group. Conclusion: HPV infection in cervical precancerous lesions can regulate downstream apoptosis and invasion gene expression by activating multiple TLRs pathways.

Photodynamic Therapy for Low-grade Cervical Intraepithelial Neoplasia(CIN1):A Case Report

As a drug-mechanical combination technology,photodynamic(PDT)can achieve accurate and taurgeted therapy for maligmant tumors and benign diseases through the production of reactive oxygen species,oxygen free radicals or singlet oxygen by photosensitizers at specific wavelengths.Compared with traditional surgery,it has the advantages of selective killing.repeatable teatment,preserving target organ fiunction and so on.The purpose of this study was to explore the clinical value of photodynamic therapy in cervical precancerous lesions by taking the patients with low-grade cervical intaepithelial neoplasia(CIN1)with high-risk human papillomavinus(HR HPV)persistent infection diagnosed by"three-step diagnosis and teatment procedure"as an example.Using HiPorfn as a photosensitizer,photodynamic therapy was performed 48 hours after intavenous drip.Set laser wavelength 630nm,light dose density 137.58J/cm^2,ansmission efficiency 1.42,output power 2w.3cm columnar optical fber was placed around the 2cm in the cervical canal to cover all the lesions,and the inadiation time was 900s(600s in the cervical canal and 300s outside the cervical canal).The patients were given oxygen inhalation for 6 hours after operation,and the patients were observed for itching and other discomfort,and paid attention to avoid light.Photodynamic therapy was performed again in the same way on the second day.After two months of treatment,pathological biopsy showed chronic cervicitis,indicating that the disease had been effectively controlled.Theoretically,although the patient is not the absolhute indication of photodynamic therapy(hat is,meeting CIN Ⅱ or CIN Ⅲ,having fertility requirements and not undergoing surgery),this therapy can remove not only the superficial lesions inside and outside the cervix,but also the potential lesions not found under colposcopy.It can also block the persistent infection of HPV by.inhbting the expression of HPV18,E6 and E7mRNA in Hela cells.In combination with Baofukang suppository,it can block HPV infection.Increase the negative conversion rate of cervical HPV and reduce the probablity of recurence after CIN1 cure.For youmng female patients with persistent HR-HPV infection and fertility requirements,photodynamic therapy is an effective choice for clinical treatment of CIN1.

Evaluation of HPV Molecular Tests in Primary Screening for Cervical Cancer in Brazil

Background: Incorporation of HPV tests into cervical cancer screening programs may be advantageous over conventional cytology, especially in developing nations, where the largest burden of cervical cancer is observed. Objectives: To conduct an evaluation of commercially available molecular HPV tests in Brazilian women. Study design: Two groups were recruited: group A was composed of 511 women referred to the clinics because of a previous abnormal Pap test while group B consisted of 2464 subjects under routine screening. Cervical samples were collected using SurePath liquid cytology (LBC) device, and split into aliquots which were submitted to molecular testing by Hybrid Capture and cobas HPV. Colposcopy and biopsies were made according to the standard guidelines, directed by cytological diagnosis. Results: Prevalence of HSIL was 5.97% and 0.7% in Group A and B respectively. High-Risk HPV DNA was found in about 9% of group B women, while in group A this frequency was 24%. Having CIN3+ as the study end-point, the negative predictive values for molecular methods were above 99.8%. All “in-situ” and invasive cervical carcinomas were detected by both HPV nucleic acid assays. Conclusion: Use of HPV DNA testing was feasible and highly sensitive in cancer screening settings of Brazil.

Clinical significance of extended high-risk human papillomavirus genotyping and viral load in cervical cancer and precancerous lesions

Persistent infections with specific high-risk human papillomavirus(HR-HPV)strains are the leading cause of cervical cancer and precancerous lesions.HPV-16 and HPV-18 are associated with more than 70%of cervical cancer.However,with recent widespread vaccination efforts against cervical cancer,the infection rates of HPV-16 and HPV-18 have decreased across all age groups,while the infection rates of other HR-HPV strains have increased.The non-16/18 HR-HPV strains play an important role in cervical lesions.These strains can be identified with extended genotyping,and the 2019 American Society for Colposcopy and Cervical Pathology(ASCCP)guidelines recommended an HPV-based testing to assess the risk of cervical disease in patients.We reviewed and analyzed the clinical benefits of applying extended HR-HPV genotyping,which was published by the International Agency for Research on Cancer(HPV-16,18,31,33,35,39,45,51,52,56,58,59,66,and 68),to cervical cancer screening.This review concluded that cervical cancer screening needs to include extended HR-HPV genotyping.The examination of extended HR-HPV genotyping in cervical intraepithelial lesions and cervical cancers can help guide clinical practices.

Prevalence and Determinants of High-risk HPV Infection among 11549 Women from an Opportunistic Screening in Hubei Province

High-risk human papillomavirus (hrHPV) infection plays an important role in the development of cervical intraepithelial neoplasia and cervical cancer.A total of 11 549 women were enrolled from the Maternal and Child Health Hospital of Hubei Province.Each participant accepted hrHPV testing and completed a self^administered questionnaire about basic information and potential risk factors.The univariable and multivariable logistic regression model was used to explore the associations between variants and hrHPV infection.Our results showed that hrHPV prevalence was 16.09% in Hubei Province,among which,hrHPV was more likely to be positive in women aged 51 years or above (OR=1.65,95% CI:1.28-2.14),and in women who had symptoms of bleeding after intercourse (OR=1.32,95% CI:1.17-1.50),had first sexual intercourse at the age of 18 years or below (OR=1.33,95% CI:1.07-1.64),had at least three male sexual partners (OR=2.50,95% CI:2.07-3.03),and who had been diagnosed with sexually transmitted infections (OR=1.50,95% CI:1.12-2.03).Married women (OR=0.66,95% CI:0.55-0.78) and women who frequently used condoms (OR=0.75,95% CI:0.67-0.84) had a relatively lower hrHPV prevalence.This study confirms that hrHPV infection was associated with age,marital status,symptoms of intercourse bleeding,history of sexually transmitted infections,and sex-related behaviors.Above all,this study provides a baseline database prior to obtaining vaccinations for dynamic tracking of the changes in hrHPV prevalence.

紧急宫颈环扎术联合吲哚美辛、黄体酮阴道缓释凝胶治疗宫颈功能不全的临床效果观察

目的 探讨紧急宫颈环扎术联合吲哚美辛、黄体酮阴道缓释凝胶治疗宫颈功能不全的临床效果。方法 选择2019年6月至2022年6月在淮安市妇幼保健院行紧急宫颈环扎术的52例患者资料作为分析对象,26例接受单纯紧急环扎术+吲哚美辛治疗作为对照组,26例接受紧急宫颈环扎术联合吲哚美辛、黄体酮阴道缓释凝胶治疗作为观察组,比较两组患者治疗成功率与延长孕周时间(周),药物不良反应发生率、新生儿Apgar评分的差异。结果 观察组治疗成功率高于对照组(P <0.05),延长孕周时间长于对照组(P <0.05);两组间不良反应发生率差异无统计学意义(P> 0.05);观察组新生儿Apgar评分高于对照组(P <0.05)。结论 紧急宫颈环扎术联合吲哚美辛、黄体酮阴道缓释凝胶治疗宫颈功能不全可以提高治疗成功率,改善妊娠结局,不增加不良反应发生率。

卧式间歇牵引与坐式持续牵引治疗颈椎病疗效比较

目的观察卧式间歇牵引与坐式持续牵引治疗颈椎病的疗效。方法 64例颈椎病患者随机分为卧式间歇牵引组与坐式持续牵引组 ,各 3 2例。两组患者分别行卧式间歇牵引与坐式持续牵引治疗 ,牵引后均配合电脑中频电治疗 ,疗程结束后进行疗效评定及组间比较。结果两组显效率、有效率分别为 5 9 3 8%、96 88%和 46 88%、93 75 % ,组间比较无显著性差异 (P >0 0 5 )。结论卧式间歇牵引及坐式持续牵引治疗均是治疗颈椎病的有效方法。

氟尿嘧啶缓释剂对外生型年轻宫颈癌患者的疗效

目的探讨氟尿嘧啶缓释植入剂对外生型年轻宫颈癌患者的临床疗效及不良反应。方法将同期30例ⅠB2-ⅡA期年轻宫颈癌患者随机分为3组,A组10例采用组织间插植,B组10例采用TP方案静脉化疗,C组10例采用瘤内氟尿嘧啶缓释植入剂。监测患者放化疗后的不良反应及卵巢功能,观察治疗3周后局部肿瘤的消退情况。结果治疗3周后,3组肿瘤体积平均缩小率分别为60%、50%、60%,3组比较差异无显著性(P>0.05);B组不良反应最大,C组未出现不良反应,A组治疗后FSH、LH水平升高,E2水平下降,出现卵巢功能减退,与其余2组比较,有统计学差异(P<0.05)。结论氟尿嘧啶缓释植入剂对外生型宫颈癌的疗效较好,不良反应轻,特别是未减弱卵巢功能。

术中颈椎持续牵引的有限元分析

目的分析在颈椎术中持续牵引的安全性。方法采集志愿者颈椎薄层CT扫描数据,以DICOM格式保存,使用医学三维重建软件进行全颈椎三维有限元模型建立,应用模型优化软件对模型进行优化,以STL格式文件导入到有限元分析软件进行有限元分析,对模型施加10Nm纯扭矩模拟颈椎中立位、前屈位及过伸位,再施加50~300N的牵引力,测量不同三维运动状态下颈椎管长度、椎管横径及矢状径的变化。结果在颈椎中立、前屈及后伸三种不同运动状态下,随着牵引重量的增加,颈椎后伸位椎管长度的增量最大,中立位增量最小;所有体位各节段颈椎椎管横径、矢状径均减小,中立位下颈椎椎管横径、矢状径下降幅度最小,后伸位下降幅度最大。在中立位50N牵引力作用下,与前屈、后伸位无牵引状态相比,其椎管长度增加1.76%;各节段椎管横径小于前屈位,基本大于后伸位;椎管矢状径略小于上述两种体位,但是横矢状径增(减)量均小于1 mm。结论小重量牵引对于颈椎手术而言并无因颈脊髓牵拉及椎管狭窄加重而出现颈脊髓损伤的风险,是安全可行的。

氟尿嘧啶缓释植入剂治疗宫颈巨大菜花样肿块的临床分析

目的探讨氟尿嘧啶缓释植入剂对以巨大菜花样肿块为表现的宫颈癌患者的疗效及其不良反应。方法选择53例巨大宫颈菜花样肿块患者,采用氟尿嘧啶缓释剂(中人氟安)局部治疗,监测患者的不良反应和临床症状变化情况,观察治疗后4周局部肿块的消退情况。结果 13例患者达到完全缓解(CR),20例达到部分缓解(PR),总有效率为62.3%。阴道流血、阴道排液、疼痛等症状的缓解率为84.9%。治疗过程中未见不良反应。结论氟尿嘧啶缓释植入剂对巨块型宫颈癌具有较好的疗效,不良反应轻。

醋酸戈舍瑞林缓释植入剂对早期宫颈癌和卵巢恶性肿瘤患者化疗所致卵巢功能损伤的预防作用

目的探讨醋酸戈舍瑞林缓释植入剂对早期宫颈癌和卵巢恶性肿瘤患者化疗所致卵巢功能损伤的预防作用。方法纳入2018年1月至2019年12月于郑州大学第一附属医院妇科化疗的43例早期宫颈癌和47例早期卵巢恶性肿瘤术后患者(保留卵巢),根据患者是否接受促性腺激素释放激素激动剂(GnRHa)即醋酸戈舍瑞林缓释植入剂治疗分为对照组(45例)和GnRHa组(45例)。给予对照组常规化疗,给予GnRHa组常规化疗联合GnRHa。比较两组化疗前后血清卵泡刺激素(FSH)、黄体生成素(LH)、雌激素(E_(2))、抗米勒管激素(AMH)、FSH/LH水平以及化疗后月经恢复情况,采用健康状况调查量表(SF-36)评价两组患者生活质量,采用Kupperman绝经指数(KMI)评价两组患者围绝经期症状。结果与化疗前比较,化疗结束后6个月GnRHa组FSH、FSH/LH上升程度均低于对照组,AMH下降程度低于对照组(P<0.05),GnRHa组E_(2)水平甚至已经恢复至化疗前水平。化疗结束后3、6个月时,GnRHa组FSH、FSH/LH水平均低于对照组,E_(2)、AMH水平均高于对照组(P<0.001)。化疗后,GnRHa组月经恢复时间较对照组短,月经恢复者占比较对照组高,月经稀发者占比较对照组低(P<0.05)。化疗结束后6个月,GnRHa组SF-36评分高于对照组,KMI评分低于对照组(P<0.001)。结论GnRHa可预防早期宫颈癌、卵巢恶性肿瘤患者化疗所致的卵巢功能损伤。

中医治疗颈椎病的特色疗法

目的:探讨中医特色疗法治疗颈推病的可持续性。方法:回顾分析我院2001～2010年间通过三组对照的方式,观察中医特色疗法是否具有可持续性。结果:B组(中医治疗组)62例,治愈50例,占80.65%好转11例,占17.74%,无效1例,占1.61%;B组62例,有5例复发,复发率8.06%。结论:中医特色疗法治疗颈椎病应该大力推广。

人工流产术后放置曼月乐或吉妮宫内节育器女性子宫内膜微环境变化

目的:探讨人工流产术后放置左炔诺孕酮宫内缓释系统(曼月乐)与吉妮宫内节育器(IUD)对子宫内膜微环境的影响。方法:随机选择2019年11月-2021年5月仙居县人民医院自愿接受人工流产手术者共92例进行随机对照观察,在顺利完成人工流产术后分别采用曼月乐或吉妮IUD避孕,每组46例,随访术后6个月时避孕效果及不良反应,检测术前3d及术后3个月时子宫内膜冲洗液及宫颈粘液中各因子水平变化。结果:随访术后6个月时两组均未出现妊娠,不良反应总发生率曼月乐组(15.2%)低于吉妮IUD组(32.6%)(P<0.05)。人工流产术前3d两组宫颈粘液中细胞因子IFN-α2、IFN-γ、IL-6、IL-8,趋化因子CCL5、MCP-1α、MIP-1β、MIP-1水平均无差异(P>0.05),术后3个月时曼月乐组IFN-α2、IFN-γ水平高于吉妮IUD组,IL-6、IL-8低于吉妮IUD组,CCL5低于吉妮IUD组,MIP-1β高于吉妮IUD组(均P<0.05),MCP-1、MIP-1α两组无差异(P>0.05)。术后3个月时两组子宫内膜冲洗液样本T细胞密度均增加了,且吉妮IUD组CD3+、CD4+表达水平高于曼月乐组(P<0.05)。两组CD8+表达无差异(P>0.05),子宫内膜组织Foxp3免疫组化染色均显示T细胞高表达。结论:曼月乐与吉妮IUD避孕效果相当,但放置曼月乐后不良反应更低且炎症反应程度更低,更有利于育龄女性长期应用。

ALA-PDT联合干扰素α-2b栓剂治疗宫颈持续高危型HPV感染的疗效探讨

目的探讨5-氨基酮戊酸光动力(ALA-PDT)疗法联合重组人干扰素α-2b栓剂治疗高危型人乳头瘤病毒(HR-HPV)宫颈持续感染的疗效及不良反应的观察。方法选取就诊该院的2017年1月—2019年6月HR-HPV宫颈持续感染且病程>1年的90例患者作为研究对象,按年龄匹配随机分为3组,干扰素组,光动力组,光动力联合干扰素即联合组。治疗选择非月经期,干扰素治疗组隔日予以干扰素α-2b栓剂一枚,每个月经周期使用10次,连续使用3个月;光动力组予以光动力治疗每周1次,连续治疗3次;联合组先予光动力连续治疗3次后再予以干扰素α-2b栓剂治疗3个疗程,治疗方法同上。结果疗程结束后3、6、9个月分别对高危型人乳头瘤病毒转阴率进行随访。光动力组3、6、9个月HR-HPV转阴率分别为26.7%、53.3%、63.3%;干扰素α-2b栓剂组3、6、9个月HR-HPV转阴率分别为16.7%、40.0%、56.7%;联合组3、6、9个月HR-HPV转阴率分别为36.7%、73.3%、86.7%。结果提示联合组转阴率明显高于光动力组及干扰素组,差异有统计学意义(P<0.05);同时光动力组转阴率又高于干扰素组,差异有统计学意义(P<0.05)。结论ALA-PDT治疗联合重组人干扰素α-2b栓剂疗法治疗宫颈持续HR-HPV感染疗效可靠,HPV的阴转率高,转阴时间短,优于单独疗法,且不良反应无明显增加。

双氯芬酸钠缓释片联合羌活胜湿汤治疗神经根型颈椎病的效果分析

目的:探讨并分析用双氯芬酸钠缓释片联合羌活胜湿汤治疗神经根型颈椎病(cervical spondylotic r adiculopathy,CSR)的临床效果。方法:将2018年1月至2019年1月平昌县中医医院接诊的78例CSR患者随机分为联合用药组(CM组,n=39)与双氯芬酸钠组(SD组,n=39)。用双氯芬酸钠缓释片对SD组患者进行治疗,用双氯芬酸钠缓释片联合羌活胜湿汤对CM组患者进行治疗,然后比较治疗患者的临床疗效及用药后其发生不良反应的情况。结果:CM组患者治疗的总有效率高于SD组患者,P<0.05。用药后,两组患者均未出现不良反应。结论:用双氯芬酸钠缓释片联合羌活胜湿汤对CSR患者进行治疗能显著减轻其临床症状,改善其病情,且用药的安全性较高。