目的综合分析抗人乳头瘤病毒(human papillomavirus,HPV)生物蛋白敷料联合藤甲酸氯化钠和重组人干扰素α2b(recombinant human interferonα-2b,rhIFN-α2b)治疗子宫颈鳞状上皮内病变HPV感染的效果。方法选取2022年9月—2023年3月牡丹...目的综合分析抗人乳头瘤病毒(human papillomavirus,HPV)生物蛋白敷料联合藤甲酸氯化钠和重组人干扰素α2b(recombinant human interferonα-2b,rhIFN-α2b)治疗子宫颈鳞状上皮内病变HPV感染的效果。方法选取2022年9月—2023年3月牡丹江医学院附属红旗医院妇科收治的100例子宫颈鳞状上皮内病变HPV感染患者为研究对象,采用随机数表法分为对照组和研究组,各50例。对照组采用rhIFN-α2b栓剂治疗,研究组在对照组的基础上采用抗HPV生物蛋白敷料以及藤甲酸氯化钠进行治疗。观察并比较两组HPV转阴情况、菌群恢复情况、不良反应发生情况以及治疗后白介素-4(interleukin-4,IL-4)、白介素-12(interleukin-12,IL-12)和干扰素-γ(interferon gamma,IFN-γ)水平。结果研究组的HPV转阴率(90.00%)高于对照组(72.00%),差异有统计学意义(χ^(2)=5.263,P<0.05)。研究组的菌群恢复情况、不良反应发生情况以及治疗后的IL-4、IL-12、IFN-γ水平均优于对照组,差异有统计学意义(P<0.05)。结论在子宫颈鳞状上皮内病变HPV感染中使用抗HPV生物蛋白敷料、rhIFN-α2b联合藤甲酸氯化钠具有较为积极的意义,能够提高患者预后。展开更多
AIM:To evaluate the diagnosis of different differentiated gastric intraepithelial neoplasia (IN) by magnifica-tion endoscopy combined with narrow-band imaging (ME-NBI) and confocal laser endomicroscopy (CLE). METHODS:...AIM:To evaluate the diagnosis of different differentiated gastric intraepithelial neoplasia (IN) by magnifica-tion endoscopy combined with narrow-band imaging (ME-NBI) and confocal laser endomicroscopy (CLE). METHODS:Eligible patients with suspected gastric IN lesions previously diagnosed by endoscopy in secondary hospitals and scheduled for further diagnosis and tratment were recruited for this study. Excluded from the study were patients who had liver cirrhosis, impaired renal function, acute gastrointestinal (GI) bleeding, coagulopathy, esophageal varices, jaundice, and GI post-surgery. Also excluded were those who were pregnant, breastfeeding, were younger than 18 years old, or were unable to provide informed consent. All patients had all mucus and bile cleared from their stom-achs. They then received upper GI endoscopy. When a mucosal lesion is found during observation with whitelight imaging, the lesion is visualized using maximal magnification, employing gradual movement of the tip of the endoscope to bring the image into focus. Saved images are analyzed. Confocal images were evaluated by two endoscopists (Huang J and Li MY), who were familiar with CLE, blinded to the related information about the lesions, and asked to classify each lesion as either a low grade dysplasia (LGD) or high grade dysplasia (HGD) according to given criteria. The results were compared with the final histopathologic diagnosis. ME-NBI images were evaluated by two endoscopists (Lu ZS and Ling-Hu EQ) who were familiar with NBI, blinded to the related information about the lesions and CLE images, and were asked to classify each lesion as a LGD or HGD according to the "microvascular pattern and surface pattern" classification system. The results were compared with the final histopathologic diagnosis. RESULTS: The study included 32 pathology-proven low grade gastric IN and 26 pathology-proven high grade gastric IN that were detected with any of the modalities. CLE and ME-NBI enabled clear visualization of the vascular microsurface patterns and microvascular structures of the gastric mucosa. The accuracy of the CLE and the ME-NBI diagnosis was 88% (95% CI:78%-98%) and 81% (95% CI: 69%-93%), respectively. The kappa coefficient of agreement between the histopathology and the in vivo CLE imaging was 0.755; between the histopathology and the in vivo CLE imaging was 0.615. McNemar's test (binomial distribution used) indicated that the agreement was significant (P < 0.05). When patients were diagnosed by MENBI with CLE, the overall accuracy of the diagnosis was 86.21% (95% CI:73%-96%), and the kappa coefficient of agreement was 0.713, according to McNemar's test (P < 0.05). CONCLUSION:Higher diagnostic accuracy, sensitivityand specificity of CLE over ME-NBI indicate the feasibility of these two techniques for the efficacious diagnostic classification of gastric IN.展开更多
文摘目的综合分析抗人乳头瘤病毒(human papillomavirus,HPV)生物蛋白敷料联合藤甲酸氯化钠和重组人干扰素α2b(recombinant human interferonα-2b,rhIFN-α2b)治疗子宫颈鳞状上皮内病变HPV感染的效果。方法选取2022年9月—2023年3月牡丹江医学院附属红旗医院妇科收治的100例子宫颈鳞状上皮内病变HPV感染患者为研究对象,采用随机数表法分为对照组和研究组,各50例。对照组采用rhIFN-α2b栓剂治疗,研究组在对照组的基础上采用抗HPV生物蛋白敷料以及藤甲酸氯化钠进行治疗。观察并比较两组HPV转阴情况、菌群恢复情况、不良反应发生情况以及治疗后白介素-4(interleukin-4,IL-4)、白介素-12(interleukin-12,IL-12)和干扰素-γ(interferon gamma,IFN-γ)水平。结果研究组的HPV转阴率(90.00%)高于对照组(72.00%),差异有统计学意义(χ^(2)=5.263,P<0.05)。研究组的菌群恢复情况、不良反应发生情况以及治疗后的IL-4、IL-12、IFN-γ水平均优于对照组,差异有统计学意义(P<0.05)。结论在子宫颈鳞状上皮内病变HPV感染中使用抗HPV生物蛋白敷料、rhIFN-α2b联合藤甲酸氯化钠具有较为积极的意义,能够提高患者预后。
文摘AIM:To evaluate the diagnosis of different differentiated gastric intraepithelial neoplasia (IN) by magnifica-tion endoscopy combined with narrow-band imaging (ME-NBI) and confocal laser endomicroscopy (CLE). METHODS:Eligible patients with suspected gastric IN lesions previously diagnosed by endoscopy in secondary hospitals and scheduled for further diagnosis and tratment were recruited for this study. Excluded from the study were patients who had liver cirrhosis, impaired renal function, acute gastrointestinal (GI) bleeding, coagulopathy, esophageal varices, jaundice, and GI post-surgery. Also excluded were those who were pregnant, breastfeeding, were younger than 18 years old, or were unable to provide informed consent. All patients had all mucus and bile cleared from their stom-achs. They then received upper GI endoscopy. When a mucosal lesion is found during observation with whitelight imaging, the lesion is visualized using maximal magnification, employing gradual movement of the tip of the endoscope to bring the image into focus. Saved images are analyzed. Confocal images were evaluated by two endoscopists (Huang J and Li MY), who were familiar with CLE, blinded to the related information about the lesions, and asked to classify each lesion as either a low grade dysplasia (LGD) or high grade dysplasia (HGD) according to given criteria. The results were compared with the final histopathologic diagnosis. ME-NBI images were evaluated by two endoscopists (Lu ZS and Ling-Hu EQ) who were familiar with NBI, blinded to the related information about the lesions and CLE images, and were asked to classify each lesion as a LGD or HGD according to the "microvascular pattern and surface pattern" classification system. The results were compared with the final histopathologic diagnosis. RESULTS: The study included 32 pathology-proven low grade gastric IN and 26 pathology-proven high grade gastric IN that were detected with any of the modalities. CLE and ME-NBI enabled clear visualization of the vascular microsurface patterns and microvascular structures of the gastric mucosa. The accuracy of the CLE and the ME-NBI diagnosis was 88% (95% CI:78%-98%) and 81% (95% CI: 69%-93%), respectively. The kappa coefficient of agreement between the histopathology and the in vivo CLE imaging was 0.755; between the histopathology and the in vivo CLE imaging was 0.615. McNemar's test (binomial distribution used) indicated that the agreement was significant (P < 0.05). When patients were diagnosed by MENBI with CLE, the overall accuracy of the diagnosis was 86.21% (95% CI:73%-96%), and the kappa coefficient of agreement was 0.713, according to McNemar's test (P < 0.05). CONCLUSION:Higher diagnostic accuracy, sensitivityand specificity of CLE over ME-NBI indicate the feasibility of these two techniques for the efficacious diagnostic classification of gastric IN.
