ABSTRACT
Objective:To investigate the progress and prognosis of cervical high-grade squamous epithelial lesion (HSIL) in pregnancy and its effects on pregnancy outcome.Methods:Eighty-five pregnant women who were complicated by cervical HSIL and accepted prenatal care and delivered in Shanghai First Maternity and Infant Hospital from January 2013 to December 2017 were retrospectively recruited as case group. Another 85 pregnant women without cervical lesions were recruited as control. The progress and outcome of cervical HSIL in the case group and the association with delivery mode were analyzed. The pregnancy outcomes were compared between the two groups by two independent sample t-test, Chi-square test or Fisher's exact test. Results:In the case group, the regression rate of cervical HSIL was 29% (25/85) with 10 cases regressing to low-grade squamous epithelial lesion or atypical squamous epithelial cells of undetermined significance and 15 to chronic cervical inflammation; the persistence rate was 64%(54/85); and the progression rate was 7%(6/85). All six progressed patients gave birth to alive babies and one case progressed to invasive cervical cancer and five to HSIL with micro-invasive cervical cancer after delivery. There was no significant difference in the progression rate [7%(4/60) vs 8%(2/25)], regression rate [32%(19/60) vs 24%(6/25)] or persistence rate [62%(37/60) vs 68%(17/25)] between vaginal delivery and cesarean delivery women ( χ2=0.509, P=0.775). The incidence of premature birth of the HSIL group was higher than that of the control group [9%(8/85) vs 1%(1/85), Fisher's exact test, P=0.017], while there were no significant differences in the incidence of other complications or adverse pregnancy outcomes such as intrauterine fetal death, preterm premature rupture of membranes, low-lying placenta, amniotic fluid contamination of Ⅱ-Ⅲ degree, placental abruption, oligohydramnios and fetal distress between the two groups (all P>0.05). Conclusions:The progression rate of HSIL during pregnancy is low. Thus, a close follow-up could be conducted if invasive carcinoma is ruled out and the postpartum treatment should base on pathological results. HSIL during pregnancy could increase the risk of preterm labor, but is not an indication of cesarean section.
ABSTRACT
[Objective]To research professor ZHANG's clinical experience in treatment of metrorrhagia. [Methods] By following professor ZHANG diagnosis long time, it summarizes ZHANG's experience of Chinese medicine treatment on uterine bleeding and academics from the etiology and pathogenesis.[Results] ZHANG thinks that the pathogenesis of metrorrhagia, both cold and heat, will cause Chong Ren imbalance, so the method to reconstruct the menstrual cycle as the fundamental purpose, comprehensive use of TCM and western medicine adjuvant hormonal therapy. In the acute hemorrhage, the use of clearing heat and bleeding, liver-spleen -harmonizing remission with artificial cycle therapy according to syndrome differentiation and treatment of hemorrhage, clarifying the source and rectifying the primary on the basis of syndrome making a better clinical effect during the remission. [Conclusion] Professor ZHANG's treatment of uterine bleeding experience, unique, has a strong clinical significance, with learning and promotion of application value.
ABSTRACT
Objective@#To investigate the infectious status, gene type transition and epidemiological features of rotavirus A isolated from infants and children (<59 months-of-age) in sentinel hospitals from 2008 to 2015 in Henan province, China.@*Methods@#In total, 2 541 stool samples (each 3- 5 ml) were collected from infants and children aged less than five years in two sentinel hospitals and group A rotavirus was detected by a double antibody sandwich ELISA. Viral RNA was extracted from positive samples and G/P gene typing was performed using a two-step nested multiplex RT-PCR. Epidemiological information (including demographic information such as age, sex and clinical symptoms) was also collected from the patients and analyzed.@*Results@#Group A rotavirus was detected in 30.9% (785/2 541) of diarrhea samples from children. The detection rate was higher in October (54.8%, 345/629) and lower in July (5%, 5/101) each year from 2008 to 2015. The group A rotavirus infection rate was higher in boys (30.6%, 451/1 476) than in girls (31.4%, 334/1 065) (χ2=0.18, P=0.664). Infection mainly occurred in 4-12 months old patients (61.3%, 481/785) (χ2=196.69, P<0.001), and the infection rate was lower in cities (26%, 258/992) compared with rural areas (34.0%, 527/1 549) (χ2=18.19, P<0.001). G typing of 785 strains of group A rotavirus revealed the following types: G1 (13.5%, 106 strains), G2 (11.1%, 87 strains), G3 (29.7%, 233 strains), and G9 (57.5%, 451 strains); P typing revealed the predominance of P[4] (11.3%, 89 strains) and P[8] (84.7%, 665 strains); gene type combinations comprised mainly G9P[8], G2P[4], G3P[8], G1P[8], respectively accounted for 52.9% (415), 9.7% (76), 17.3% (136), 11.3% (89). Gene type combinations G1 [8] and G3P[8] have been decreasing in prevalence since 2008 and G9P[8] has become the dominant gene type of group A rotavirus in Henan province. Among the group A rotavirus infection samples, the male:female infection ratio was 1.4∶1 (451/334), with no significant difference in the infection rate (χ2=0.18, P=0.664); the infection rate was higher in 4- 12 months old patients (61.3%, 481/785), with a significant difference detected between age groups (χ2=196.69, P<0.001). The rate of detection was lower in cities (26.0%, 258/992) than in rural areas (34.0%, 527/1 549) (χ2=18.19, P<0.001). Clinical analysis revealed a body temperature of below 37 degrees in 75.7% of positive cases (594 patients), 37.0- 37.5 degrees in 17.2% of cases (135 patients), 37.6-38.0 degrees in 2.0% of cases (16 patients), and above 38 degrees in 5.1% of cases (40 patients), with most cases showing no fever or a mild fever. The frequency of episodes of diarrhea among the patients was 0- 3 times (21.1%, 166 cases), 4- 6 times (65.6%, 515 cases), 7- 9 times (8.0%, 63 cases), or 10- 15 times (5.2%, 41 cases), mainly showing mild and moderate diarrhea. Vomiting also varied in frequency among the patients from no vomiting (86.9%, 682 cases), 1-2 times (11.8%, 92 cases), 3 times (6.0%, 47 cases), and more than 3 times (0.4%, 3 cases). The occurrence of dehydration varied from no dehydration (86.9%, 682 cases), mild dehydration of 1%- 5% (12.1%, 95 cases), to severe dehydration of ≥5% (1.0%, 8 cases).@*Conclusion@#A higher infection rate of group A rotavirus was detected in children younger than five years of age with acute diarrhea in sentinel hospitals in Henan province, including part-mixed infection cases. A predominance of cases was detected in the autumn, and secondly the spring of each year. Gene type G9P[8] was most frequently isolated. The majority of patients displayed no fever, vomiting or dehydration. The cases with clinical symptoms of fever, diarrhea, vomiting and dehydration often showed mild disease.
ABSTRACT
Objective To investigate the infection status of human rotavirus,calicivirus,astrovirus and enteric adenovirus in children aged ＜5 years in disease surveillance areas in Henan province from 2013 to 2015.Methods A total of 880 stool samples were collected from four sentinel hospitals and group A rotavirus was detected by ELISA and group A rotavirus G/P genotyping was performed with nested multiplex RT-PCR,while rotavirus (group B,C),calicivirus and astrovirus were detected by two-step multiplex RT-PCR and adenovirus were detected by PCR.The epidemiological data of positive cases were statistically analyzed.Results A total of 594 positive samples were detected,including 24 mixed infection samples,370 rotavirus positive samples (42.0％);162 calicivirus positive samples (18.4％);69 astrovirus positive samples (7.8％) and 17 enteric adenovirus positive samples (1.9％).The overall positive rate of four viruses was significantly higher in urban area than in rural area,but the positive rate of rotavirus was higher in males than in females and in younger age group than in older age group.G9P [8] was the major genotype of group A rotavirus,there were two seasonal infection peaks in autumn and spring.Norovirus Ⅱ was the predominant type of calicivirus and the infection peak was in spring.Viral diarrhea cases were distributed in different age groups,mainly in age groups 0-12 months (rotavirus) and 3-5 years (calicivirus).The main clinical symptoms included fever,diarrhea and vomiting.The etiological characteristics differed with gender and area.Conclusions The infection rate of diarrheal viruses was higher in young children ＜5 years old in disease surveillance areas.The epidemiological and clinical features varied with the type of pathogen.
ABSTRACT
Objective To investigate the infectious status,etiological spectrum and epidemiological characteristics of rotavirus (group A/B/C),calicivirus (novovirus Ⅰ/Ⅱ,sapovirus),astrovirus and enteric adenovirus in diarrhea cases below 5 years old from 2008 to 2015 in Henan provinces.Methods Totally 2541 stool samples were collected from cases below 5 years old in four sentinel hospitals.All stool specimens were tested for group A rotavirus by double antibody sandwich ELISA method.G/P genotyping of group A rotavirus was determined by nested multiplex PCR.Viral RNA was extracted from all samples and rotavirus (group B/C),calicivirus,astrovirus and enteric adenovirus were detected by two-step reverse transcription-polymerase chain reation (RT-PCR)/PCR.Results One thousand four hundred and twenty-one out of 2 541 samples were positive with a total positive rate of 55 .9%,among which,102 were mixed infection.The isolation rate of rotavirus was 36.0% (914 samples)(group A:785 cases,group B:36 cases,group C:93 cases),calicivirus was 12.1 % (308 samples)(novovirus Ⅰ:64 cases,novovirusⅡ:193 cases,sapovirus:51 cases),astrovirus was 5 .9% (151 samples),enteric adenovirus was 1 .9%(48 samples).The group A rotavirus gene type combinations were composed mainly of G9P[8],G2P[4], G3P[8 ],G1P [8 ]and most cases were identified from September to November and March to May. Novovirus Ⅱ was predominant in calicivirus and most cases were identifed between March and May. Rotavirus or calicivirus infection was mainly among children aged 4—12 months or 3—5 years, respectively.Clinical manifestations included fever,diarrhea,vomiting,dehydration.Gender and region distributions differed according to the types of pathogen.Conclusions Group A rotavirus and novovirus Ⅱare the major viral pathogen in diarrhea cases younger than 5 years old in Henan province.Different viral infections exhibit extinct epidemiologic and clinical characteristics.
ABSTRACT
Objective To investigate the infection status of human rotavirus,calicivirus,astrovirus and enteric adenovirus in children aged ＜5 years in disease surveillance areas in Henan province from 2013 to 2015.Methods A total of 880 stool samples were collected from four sentinel hospitals and group A rotavirus was detected by ELISA and group A rotavirus G/P genotyping was performed with nested multiplex RT-PCR,while rotavirus (group B,C),calicivirus and astrovirus were detected by two-step multiplex RT-PCR and adenovirus were detected by PCR.The epidemiological data of positive cases were statistically analyzed.Results A total of 594 positive samples were detected,including 24 mixed infection samples,370 rotavirus positive samples (42.0％);162 calicivirus positive samples (18.4％);69 astrovirus positive samples (7.8％) and 17 enteric adenovirus positive samples (1.9％).The overall positive rate of four viruses was significantly higher in urban area than in rural area,but the positive rate of rotavirus was higher in males than in females and in younger age group than in older age group.G9P [8] was the major genotype of group A rotavirus,there were two seasonal infection peaks in autumn and spring.Norovirus Ⅱ was the predominant type of calicivirus and the infection peak was in spring.Viral diarrhea cases were distributed in different age groups,mainly in age groups 0-12 months (rotavirus) and 3-5 years (calicivirus).The main clinical symptoms included fever,diarrhea and vomiting.The etiological characteristics differed with gender and area.Conclusions The infection rate of diarrheal viruses was higher in young children ＜5 years old in disease surveillance areas.The epidemiological and clinical features varied with the type of pathogen.
ABSTRACT
Objective To explore the association between moxibustion sensation and therapeutic efficacy during moxibustion treatment. Methods By applying Taiyi moxa stick to Shiqizhui (EX-B 8) to treat primary dysmenorrhea, the association between the change of Visual Analogue Scale (VAS) score and the topical moxibustion sensation and transmission types during the 30 min moxibustion treatment was observed. Besides, the occurrence time of transmission, and the transmission distance, width, depth, and direction were recorded. Results Superficial moxibustion sensation occurred in forty patients, of whom, the VAS score changed by (38.50±14.38) mm; heat-penetrating moxibustion sensation occurred in 18 patients, and the VAS score changed by (38.89±12.43) mm; heat-expanding sensation occurred in 6 patients, and the VAS score changed by (45.00±14.10) mm; distant transmission happened in 13 patients, and the VAS score changed by (41.54±13.90) mm. Patients with 4 types of moxibustion sensation had the highest VAS scores both before and after treatment, followed by 3 types, 2 types, and 1 type moxibustion sensation. In comparing the changes of VAS score between 10 min and 20 min treatment and between 20 min and 30 min treatment, the patients with 4 types of moxibustion sensation had the most significant change. Conclusions Different moxibustion sensations occur at different frequencies, and the occurrence of moxibustion sensation is related to the severity of disease condition. The number of moxibustion sensation type can affect the remission process of disease, but can merely influence the treatment result. The single moxibustion sensation (superficial heat only) works faster, usually taking 0~10 min; while the other forms of moxibustion sensation (heat penetrating, heat-expanding, and distant transmission) works slower, usually taking over 20 min.
ABSTRACT
Objective: To compare the therapeutic effects of two different moxibustion methods both with tai-yi moxa stick in treating primary dysmenorrhea. ＜br> Methods: Forty-three patients were randomized into two groups by the random number table according to their treatment orders. The causalgic group was intervened by causalgic stimulation with tai-yi moxa stick while the tepid group was treated by mild thermal stimulation with tai-yi moxa stick. Shiqizhui (EX-B 8) was selected for both groups. Visual analogue scale (VAS) was used for observation before and during the treatment by every 10 min to compare the clinical efficacies between the two groups. ＜br> Results: Before treatment, there was no statistically significant difference in pain intensity between the two groups (P>0.05). After treatment, both groups achieved significant improvements in pain intensity (P＜0.05), but the inter-group difference in pain intensity was still statistically insignificant (P>0.05), but the difference was enlarged comparing with that before treatment. The pain relief during the first 10 min of treatment was slower in the causalgic group than that in the tepid group. However, during the later 20 min, the pain relief in the calsalgia group gradually outpaced that in the tepid group. ＜br> Conclusion: The two moxibustion methods with tai-yi moxa stick both have a good instant analgesic effect in treating primary dysmenorrhea. For patients with primary dysmenorrhea, if 30 min is regarded as the treatment time, mild stimulation was suggested to be used for the first 10 min, and causalgic stimulation for the later 20 min to achieve a better curative effect.
ABSTRACT
Objective To understand the epidemiological characteristics of imported malaria in Luoyang City,so as to pro-vide the evidence for malaria prevention and control in this city. Methods The Epidemic situation data from network reports, as well as the case survey and the epidemiological investigation data of imported malaria were collected and analyzed in Luoyang City from 2010 to 2013. Results A total of 98 imported malaria cases were reported in Luoyang City from 2010 to 2013,includ-ing 35 cases of vivax malaria,57 cases of falciparum malaria,4 cases of ovale malaria and 2 cases of quartan malaria. All the cases were confirmed by laboratory detection. Seventy-one cases(72.44%)returned from African countries,and 27(27.55%) cases returned from Southeast Asian countries. The majority cases were young man,and 78.57%of the cases were diagnosed by different levels of centers for disease control and prevention. There was no significant seasonal variation in onset time. The medi-an time from onset to seeing doctor was 6 days. Conclusions The epidemic situation of imported malaria is quite serious in Luoyang City. It is necessary to further strengthen the professional training and multi-sectoral cooperation ,and take effective pre-vention and control measures to reduce the hazard of imported malaria.
ABSTRACT
Objective:To explore the relationship between the pathophysiological changes in TCM spleen de ciency syndromes and precancerous lesion of gastric mucosa.Method:160 cases with spleen de ciency syndromes accompanied by gastric mucosa intestinal metaplasia,IM and / or atypical hyperplasia,AHP,(spleen de ciency is divided into spleen qi de ciency or SQD,spleen yin de ciency or SyinD and spleen de ciency with qi stagnation or SDQS) and 22 cases in health control group were taken as the study object.The detection was conducted on such trace elements as Zn,Cu of gastric mucosa epithelial cell nuclei and mitochondrion under the direct view of CM200FEG –TEM by adopting 9100/60 -Energy Dispersion X-ray Analyzers;detection was conducted on epithelial cell nucleus DNA by using IBAS2000 image analyzer;detection was conducted on the expression of P53,Ki67,CerbB2,P21ras in gastric mucosa tissue slices by adopting ElivisionTM Plus'.Result:The quantitative changes of gastric mucosa epithelial cell nucleus DNA,Zn,Cu and the positive expression rates of P53,P21ras,CerbB2 and Ki67 increased in the sequence of SQD group,SyinD group and SDQS group,while mitochondrial Cu,Zn decreased in the same sequence,there was signi cant di erence between the groups(P
ABSTRACT
Purpose The aim is to breed a highly productive γ-linolenic acid mutant strain.Methods The original strain Mortierella ramanniance AS 3.3413 was treated by 5-FU,UV,LiCl as mutanting agent.Results A highly productive γ-linolenic acid mutant strain F5 was successfully obtained.The γ-linolenic acid yield of mutant strain F5 was increased by 300% as compared with that of the original strain.Pass-generation test showed that the heredity character of mutant strain F5 was stable.After the optimal medium and culture condition was established, the yield of γ-linolenic acid was up to 1 153.63 mg/L,and was increased by 335.87% as compared with that of the original strain.Conclusion The mutant strain can be used for the industrial production of GLA.