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25 August 2019, Volume 18 Issue 04 Previous Issue    Next Issue

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Establishment and application of thrombophilia gene detection panel based on next generation sequencing in identification of genetic background of Chinese patients with venous thromboembolism LI Lei, WU Xi, XU Guanqun, LIANG Qian, DAI Jing, WU Wenman, DING Qiulan, WANG Hongli, WANG Xuefeng 2019, 18 (04):  394-401.  DOI: 10.16150/j.1671-2870.2019.04.004 Abstract ( 1734 )   HTML ( 7 )   PDF (769KB) ( 203 )   Objective: To develop an accurate, simple and practical method for detecting hereditary risk factors of thrombophilia, which can be used for early diagnosis and treatment guidance in Chinese thrombophilia patients. Methods: Altogether 246 patients with venous thrombosis at our hospital were enrolled. The clinical data and family history were collected. Phenotypic examinations were performed. Eighteen candidate genes related to thrombosis were selected to compose a gene panel through literature searching. Point mutation, small deletion/insertion and copy number variations of this panel were detected by next-generation sequencing and CNVplex® technique. Results: Of the 246 patients with venous thrombosis, 159 patients were identified as having gene mutations. The mutation detection rate was 64.6%. Among them, 69.2% carried a single mutation, 13.2% carried compound heterozygous mutation in one gene, and 17.6% carried mutations of at least two genes. Of the 159 patients carrying gene mutations,144 patients carried mutations of anticoagulant protein genes(SERPINC1, PROS1 and PROC), while 31 patients carried mutations of other 10 genes (F2, F5, F9, F12, PROCR, THBD, SERPIND1, PLG, ADAMTS13 and TFPI), in which some mutations (F2 R384Q and F9 R596Q) had been confirmed to be associated with venous thrombosis. Copy number detection showed that 19 patients had copy number variations, mainly in PROCR and PROS1 genes. In addition, 40 of 61 patients with acquired thrombosis risk factors (antiphospholipid syndrome, surgery or pregnancy, etc.) carried hereditary thrombosis risk factors. Of the 56 patients with normal phenotypic results, 20 of them carried pathogenic thrombotic mutations revealed by genetic analysis. Moreover, of the 72 patients who were in the acute stage of thrombosis or during anticoagulants treatment thus could not take phenotypic examination, 32 were identified as having pathogenic thrombotic mutations. Conclusions: The hemophilia gene detection panel established can screen the hereditary thrombosis risk factors more quickly, effectively and accurately. It is necessary to carry out genetic analysis in patients with acquired risk factors. According to the results of gene analysis, clinicians can provide appropriate preventive treatment to prevent the occurrence or recurrence of thrombosis, and to reduce the occurrence of post-thrombotic syndrome, and is worthy of application in clinical practice. Figures and Tables | References | Related Articles | Metrics

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Screening and identification of clinical molecular targets in papillary thyroid cancers YANG Chihui, ZHANG Jing, MENG Leijun, GONG Liping, CHANG Qing, ZHANG Hong, ZENG Naiyan 2019, 18 (04):  402-411.  DOI: 10.16150/j.1671-2870.2019.04.005 Abstract ( 324 )   HTML ( 2 )   PDF (1558KB) ( 106 )   Objective: To identify the clinical molecular targets in papillary thyroid cancer (PTC) by analyzing the diffe-rential expression of the NF-κB signal pathway related genes and mutations of 52 solid tumor-related genes in PTC against normal adjacent tissue (NAT). Methods: RNA and DNA of tumor and NAT were extracted from formalin-fixed paraffin-embedded (FFPE) tissue of 20 papillary thyroid cases. The mRNA and protein expressions of NF-κB signal pathway related gene CD44, BCL2, CCND2, c-FLIP, IκBα, A20 and ABINs were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and immunohistochemistry, respectively. Mutations in 5 relapse cases were detected by targeted next-generation sequencing (NGS). Results: Expressions of CD44 and CCND2 were significantly higher at both RNA and protein level in PTC tumor tissue than those in NAT. The expressions of NF-κB signal pathway related genes were not significantly different between PTC having and not having lymph node metastasis. Results of NGS showed that ALK, BRAF, FGFR3/4, KIT, MYC and MAPK signal pathway genes HRAS, KRAS, NRAS, RET were mutated in PTC cases with a high frequency. Two cases had 35 and 40 mutation genes, respectively, and having high tumor burden; clinical data showed that these two were relapse cases after operation. BRAF V600E mutation was not always a tumor specific mutation (64%), but also could be a germline mutation (29%). Real-time quantitative PCR (qPCR) and NGS had a high consistent rate (80%) for the detection of V600E mutation. Conclusions: The high expressions of CD44 and CCND2 in PTC tumor tissue and the tumor specific mutations in BRAF, RAS, FGFRs, KIT and MYC genes might be used as clinical molecular markers for selection of targeted therapy of individual PTC patient. NGS and qPCR had high consistence for detection of BRAF V600E, and used jointly could improve the detection rate. Figures and Tables | References | Related Articles | Metrics

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Application of arterial spin labeling magnetic resonance perfusion imaging (MRI-ASL) combined with magnetic resonance angiography (MRA) for the prediction of progress of posterior circulation ischemic (PCI) stroke ZHAO Zongbo, JIA Chuanhai, LIU Hui 2019, 18 (04):  412-417.  DOI: 10.16150/j.1671-2870.2019.04.006 Abstract ( 381 )   HTML ( 1 )   PDF (933KB) ( 68 )   Objective: To investigate the application of arterial spin labeling magnetic resonance perfusion imaging (MRI-ASL) combined with magnetic resonance angiography (MRA) for predicting the progress of PCI stroke. Methods: According to whether there was an increase of ≥3 scores of National Institute of Health Stroke Scale(NIHSS) 72 hours after admission, 57 patients with acute posterior circulation ischemic stroke were divided into progressive group (n=29) and control group (n=28). All patients were examined with standard magnetic resonance scans (T1WI、T2WI、T2-FLAIR), MRA, diffusion weighted imaging(DWI) and MRI-ASL. The patients were also evaluated with the posterior circulation Alberta Stroke Program Early CT Score(pc-ASPECTS). Relative cerebral blood flow（rCBF） and degree of main arterial stenosis were recorded. The differences of these parameters between progressive group and control group were measured, and multivariate logistic regression analysis was performed on parameters with significant differences. Results: The rCBF [（1.25±0.37） vs. (0.69±0.19), P<0.05] and pc-ASPECTS [（8.21±0.74） vs. (7.69±0.93), P<0.05] in control group were significantly higher than those in progressive group, however, there was no correlation between rCBF and pc-ASPECTS. The main arterial stenosis rate in progressive group were significantly higher than that in control group (82.76% vs. 35.71%, P<0.05), and rCBF was correlated with main arterial stenosis rate. However, the rCBF of 10 cases with main arterial stenosis was not decreased. Multivariate logistic regression analysis revealed that only rCBF （OR=3.703, 95%CI 1.971-6.956） was the protective factor of progression of PCI stroke. ROC curve analysis indicated that rCBF（≥1.014） predicted good prognosis. Conclusions: High rCBF is a protective factor of progreesion of PCI. For PCI patients, pc-ASPECT score, MRA detected main arterial stenosis rate could not comprehensively reflect the short term progression of the disease; MRI, MRA combined with MRI-ASL detecting the rCBE could more effectively predicting the progression of early stage PCT. Figures and Tables | References | Related Articles | Metrics

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Analysis of the influence of airway resistance on expiratory flow limitation in COPD patients with stable GOLD stages Ⅱ-Ⅲ CHEN Yuqing, WANG Mingjie, ZHU Dong, LV Chengjian, CHEN Ping 2019, 18 (04):  418-422.  DOI: 10.16150/j.1671-2870.2019.04.007 Abstract ( 308 )   HTML ( 2 )   PDF (547KB) ( 79 )   Objective: To study the correlation between airway resistance (Raw) and expiratory flow limitation (EFL) in patients with chronic obstructive pulmonary disease (COPD). Methods: One hundred and two stable Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages Ⅱ-Ⅲ COPD patients, of them 53 were stage Ⅱ and 49 were stage Ⅲ, were enrolled. Patients were not taking bronchodilator eight hours before examination, then lung function testing and respiratory airway resistance were measured after salbutamol (400 μg) inhalation. Twenty eight healthy subjects were served as controls. Results: The peak expiratory flow (PEF), peak expiratory flow (PEF) and forced expiratory flow at 50% forced vital capacity (FEF50) in stage Ⅲ COPD patients were significantly lower than those in stage Ⅱ COPD patients. Seven (14.3%) patients with stage Ⅲ COPD and only 1 (1.9%) patients with stage Ⅱ COPD revealed inspiratory fraction [ratio of inspiratory capacity and total lung capacity (IC/TLC)] ≤25%. The total airway resistance (Rtot), effective airway resistance (Reff), inspiratory airway resistance/expiratory airway resistance (Rinsp/Rexp) of the two COPD groups were significantly higher than those of the control group. The Rexp of COPD patients had the best correlation with FEV1, PEF and FEF50 (all r>0.80, P<0.01). Conclusions: Raw especially Rexp is already obviously increased in stable moderate to severe COPD patients on account of the severe expiratory flow limitation. Peripheral component of air way resistance might be the main factor of the increment. The symptom of dyspnea would be prone to appear with the deterioration of lung function. Figures and Tables | References | Related Articles | Metrics

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Ultrasounographic finding of thyroid nodule with squamous metaplasia: report of a case and review of literature KUANG Lijun, WANG Yi, LU Caifeng, FAN Jinfang, WU Min, ZHOU Wei 2019, 18 (04):  423-427.  DOI: 10.16150/j.1671-2870.2019.04.008 Abstract ( 620 )   HTML ( 3 )   PDF (1037KB) ( 98 )   Objective: To investigate the ultrasounographic appearance of thyroid nodule with squamous metaplasia in conventional ultrasounography and contrast-enhanced ultrasounography (CEUS), so as to improve the understanding and diagnosis of the disease. Methods: The features on conventional ultrasounography and CEUS of thyroid nodule with squamous metaplasia in a patient were analyzed. The results in combination with pathological findings and relevant literatures were discussed. Results: The nodule was in the lower aspect of the right thyroid, contacting with the capsule. On conventional ultrasounographic examination, it appeared as an inhomogeneous hypoechoic, irregular and ill-defined nodule with microcalcification. CEUS showed slow wash-in and fast wash-out, obviously heterogeneous low enhancement. The final pathological result was nodular goiter with fibrous nodule forming squamous metaplasia. Conclusions: The ultrasounographic appearance of thyroid nodule with squamous metaplasia is not specific, and is similar to the features of papillary thyroid carcinoma. The final diagnosis depends on pathological examination of postoperative specimen. Figures and Tables | References | Related Articles | Metrics

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Ultrasonographic features of proximal deferent duct in congenital absence of vas deferens WANG Zhiqian, LIU Jun, LI Min, ZHAN Weiwei 2019, 18 (04):  428-431.  DOI: 10.16150/j.1671-2870.2019.04.009 Abstract ( 433 )   HTML ( 1 )   PDF (532KB) ( 73 )   Objective: To investigate the specific ultrasonographic changes of proximal deferent duct and diagnostic value of ultrasonography in patient with congenital absence of vas deferens (CAVD). Methods: Fifty eight cases with congenital bilateral absence of vas deferens (CBAVD) and 12 cases with congenital unilateral absence of vas deferens (CUAVD) were observed by high frequency scrotal ultrasonography, and the ultrasonographic features of proximal deferent duct were analyzed retrospectively. Results: All 128 proximal deferent ducts exhibited abnormal ultrasonography. In 42 (32.81%) cases only epididymal head was visible. Epididymal head along with partial body and tail were found in 48 (37.50% ) cases, in which 44 (34.38%) cases showed abrupt tapering and 4 (3.13%) showed cord-like changes. Vas deferens were not found in 31(24.22%) cases with whole process of epididymal head observed, body and tail. Whole epididymis along with partial vas deferens were observed in 7 (5.47%). Tubular ectasia of epididymis were found in CAVD, and the degree of dilation was greater than that of normal epididymis (P<0.01). The absence of epididymal tail-vas deferens ring accompanied with epididymal tubular ectasia was a characteristic change of CAVD. By taking the absence of epididymal tail-vas deferens ring into account, the sensitivity and specificity of scrotal US for diagnosing CAVD were 94.53% and 97.00%, respectively. Conclusions: High frequency scrotal ultrasound demonstrated well the structure of proximal deferent duct, and it is proved to be useful in evaluating the morphology, echo and characteristic dilatation of epididymis. It can provide valuable information for the clinical diagnosis of CAVD and judgment of the missing parts. Figures and Tables | References | Related Articles | Metrics

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Value of CT spectral imaging in the evaluation of Crohn's disease activity CHANG Rui, XU Jiaxu, DONG Haipeng, WU Mengxiong, ZHAO Xuesong, MIAO Fei, YAN Fuhua 2019, 18 (04):  432-435.  DOI: 10.16150/j.1671-2870.2019.04.010 Abstract ( 372 )   HTML ( 1 )   PDF (490KB) ( 82 )   Objective: To investigate the value of CT spectral imaging in evaluation of Crohn's disease activity. Methods: Fifty four patients with Crohn's disease undergone dual phase spectral CT imaging and confirmed by pathology in our hospital from Aug 2015 to Sep 2016 were enrolled. The normalized iodine concentration and normalized water concentration and the slope of spectral curve of bowel wall of arterial phase and portal venous phase at active stage and remission stage were analyzed by t test. And ROC curves of above mentioned variables with statistical difference were calculated and compared. Results: In CT spectral imaging, the arterial phase and portal venous phase normalized iodine concentration at active stage were higher than those at remission stage [(0.228±0.100) g/L vs. (0.097±0.045) g/L, P<0.05; （0.530±0.097） g/L vs. (0.252±0.063） g/L, P<0.05, respectively]. The portal venous phase normalized water concentration at active stage was higher than that of normal control [0.232±0.068） g/L vs. （0.009±0.013） g/L, P<0.05]. The arterial phase and portal venous phase slope of spectral curve at active stage were higher than those at remission stage [2.749±1.051 vs. 1.069±0.457; 3.638±0.724 vs. 1.653±0.687, respectively]. The AUC of arterial phase and portal venous phase normalized iodine concentration for differentiation of active and remission stages were 0.965 and 0.998, respectively; the AUC of portal venous phase normalized water concentration for differentiation of active and remission stage was 0.746 ; the AUC of arterial phase and portal venous phase slope of spectral curve for differentiation of active and remission stage were 0.964 and 0.972,respectively. Conclusions: CT spectral imaging can quantitatively differentiate active and remissive stage of Crohn's disease, and the arterial phase and portal venous phase normalized iodine concentration and the slope of spectral curve in both phases are valuable parameters for differentiation of active and remission stages. Figures and Tables | References | Related Articles | Metrics

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Preliminary study on dynamic contrast-enhanced MRI in identifying vulnerability of carotid atherosclerotic plaques CAO Ye, LIU Xiaosheng, GE Xiaoqian, ZHOU Bin 2019, 18 (04):  436-441.  DOI: 10.16150/j.1671-2870.2019.04.011 Abstract ( 298 )   HTML ( 1 )   PDF (884KB) ( 50 )   Objective: To explore the ability of 3.0T dynamic contrast-enhanced MR imaging (DCE-MRI) in identi-fying the vulnerability of carotid atherosclerotic plaques. Methods: From September 2016 to June 2017, 66 patients with carotid intima thickening ≥2 mm were enrolled in this study. All participants underwent vessel wall MR imaging (VW-MRI) and DCE-MRI. With the classification of plaques according to MRI-modified AHA Lesion-Type (LT), pharmacokine-tic parameters (PPs) of DCE-MRI were measured, including Ktrans, kep, ve and vp. Correlations between PPs and LTs and the ability of these parameters to distinguish stable and vulnerable plaques suspected on MRI were assessed. Results: Signi-ficant positive correlation between Ktrans and LT Ⅲ to Ⅵ was found (P=0.532, P<0.001), so as was the correlation between kep and LT Ⅲ to Ⅵ (P=0.409, P<0.001). Stable and vulnerable plaques suspected on MRI could potentially be distinguished by Ktrans (sensitivity 83%, specificity 100%) and kep (sensitivity 77%, specificity 91%). Conclusions: Ktrans and kep from DCE-MRI can provide quantitative information for the differentiation of vulnerable plaques suspected on MRI from stable ones. These two parameters could be adopted as imaging markers for plaque characterization and risk stratification. Figures and Tables | References | Related Articles | Metrics

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Infection and skin manifestations of four common primary immunodeficiency diseases in children LIU Xiaoyi, CHEN Zhuo, WU Jing, JIN Yingying, CHEN Tongxin, CHEN Ji 2019, 18 (04):  442-447.  DOI: 10.16150/j.1671-2870.2019.04.012 Abstract ( 659 )   HTML ( 2 )   PDF (703KB) ( 127 )   Objective: To investigate the infectious and skin manifestations of four common primary immunodeficiency diseases (PID) for helping the dermatologists to identify and diagnose these four PID diseases. Methods: A retrospective analysis was performed on 87 patients with PID diagnosed in our hospital from January 2003 to July 2016. Among them, 36 patients were diagnosed as chronic granulomatous disease (CGD), 14 patients as hyper-IgE syndrome (HIES), 22 patients as severe combined immunodeficiency (SCID), and 15 patients as Wiskott-Aldrich syndrome (WAS). Results: A total of 87 patients were diagnosed as PID by clinical and genetic diagnosis, including 79 males and 8 females. The main clinical infections were pneumonia (82.76%), organ abscess (52.87%), gastrointestinal tract infection (48.28%), thrush (26.44%), sepsis (25.29%) and EBV or CMV infection (6.90%). The main skin manifestations were skin infections (51.72%), including bacterial infections (42.53%), fungal infections (32.18%). Skin manifestations also included eczematous lesions (42.53%), skin purpura (17.24%) and other characteristic manifestations. Repeated skin bacterial infections were observed in CGD patients early; atopic dermatitis and skin infections in early postnatal period were the main manifestations in HIES patients; opportunistic infections of skin and mucosa were common in SCID patients; skin purpura and ecchymosis and eczema were often seen in WAS patients. Conclusions: Infection is a common feature of PIDs. Skin infection is an important clinical manifestation for early recognition of immunodeficiency, which should be evaluated by dermatologists. Figures and Tables | References | Related Articles | Metrics

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The impact of different diluting media on determination of serum estradiol concentration by using chemiluminescent immunoassay SI Chenchen, XU Bufang, FAN Weimin, ZHANG Aijun 2019, 18 (04):  448-453.  DOI: 10.16150/j.1671-2870.2019.04.013 Abstract ( 489 )   HTML ( 2 )   PDF (815KB) ( 114 )   Objective: To evaluate the impact of different diluting media on determination of serum estradiol (E2) concentration by using chemiluminescent immunoassay. Methods: Fifty serum samples were collected for E2 detection using chemiluminescent immunoassay by an automatic biochemical analyzer (UniCel DXI 800, Beckman Coulter). Four diluting media were used, including standard diluent S0 (Beckman Coulter), pooled low-level E2 serum (PS), E2/progesterone standard diluent (Roche), and calf serum (CS). Samples were manually diluted into 1∶1 or 1∶4 using the above 4 media with two parallel tubes and detected by UniCel DXI 800. Multiple statistical methods were applied to analyze the data. Results: Students't test revealed that the E2 concentration measured by diluting media CS, Roche and PS compared with S0 showed significant differences statistically (P=5.03×10-11, 1.44×10-10 and 2.79×10-13, respectively). Pearson correlation analysis showed that the correlation coefficient r between diluting media S0 and CS, Roche, PS were 0.992 3, 0.971 3, 0.968 0, respectively. After correction with linear regression model, the concentration measured by diluting media CS, Roche and PS compared with S0 showed no significant difference statistically (P=0.998 3, 0.997 9, 0.987 7, respectively). Consistence of E2 concentration measured by diluting media CS, Roche and PS compared with S0 was evaluated by Bland-Altman method, the results showed that 2%, 2% and 8% of the samples exceeded the consistence limit, respectively. The maximum bias of three assessed diluting media were 16.8%, 44.8% and 45.2%, respectively. CS shows the best consistence. Conclusions: Among the three assessed diluting media, CS shows the best performance and could serve as a replacement of manufacturer's standard diluent with high stability and lower cost. Figures and Tables | References | Related Articles | Metrics

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Comparison of results and evaluation of performance of three different ELISA kits for detection of ASCA YU Youyou, ZENG Junxiang, LUO Ting, DENG Lin, PAN Xiujun 2019, 18 (04):  454-459.  DOI: 10.16150/j.1671-2870.2019.04.014 Abstract ( 427 )   HTML ( 4 )   PDF (699KB) ( 115 )   Objective: To compare the results of three brands of ELISA (enzyme-linked immunosorbent assay） kits for detection of serum anti-Saccharomyces cerevisiae antibody ASCA)and to evaluate the performance of each kit for clinical reference. Methods: One hundred and forty patients with inflammatory bowel disease (IBD) were enrolled, including 53 patients with ulcerative colitis (UC), 87 patients with Crohn'sdisease (CD); and 40 other patients were served as disease control group (DC). Three ELISA kits (kid A is a domestic brand, B and C are imported brands) were used to detect ASCA-IgA and ASCA-IgG, and the results were analyzed and compared. Results: The detection rates of ASCA-IgA and/or ASCA-IgG in CD group were higher than those in UC group and DC group (P<0.05), but there was no significant difference between UC group and DC group (P>0.05). In UC group and DC group, the positive rates of three kits had no significant difference (P>0.05); in CD group, the positive rates of kit A and B had no significant difference (P>0.05), but the result of kit C was lower than that of kit A and B (P<0.05). The results of consistency analysis showed that kits A and B had moderate consistency in detecting ASCA-IgA (Kappa: 0.423), kits A and C, kits B and C showed poor consistency (Kappa: 0.111 and 0.074, respectively); kits A and B, kits B and C and kits A and C showed moderate consistency in detecting ASCA-IgG (Kappa: 0.414, 0.447 and 0.584, respectively). The analytical performance of detecting ASCA-IgA, ASCA-IgG by three ELISA kits separately and jointly for the diagnosis of IBD showed that the sensitivity was kit A (37.90%, 27.86%, 43.57%), kit B (20.71%, 45.00%, 51.43%), kit C (9.29%, 22.14%, 25.71%); specificity was kit A (87.5%, 85.00%, 77.50%), kit B (92.50%, 90.00%, 87.50%) and kit C (97.5%, 90.0%, 87.50%). The Youden index was kit A (0.25, 0.12, 0.21), kit B (0.13, 0.35, 0.38), kit C (0.07, 0.12, 0.13). The AUC area obtained by receiver operating characteristic (ROC) curve were kit A(0.72, 0.54, 0.59), kit B (0.54, 0.72, 0.69), kit C (0.64, 0.52, 0.57). Conclusions: All the three kits had high positive rate in CD group, It showed that ELISA detection of ASCA has certain application value for the diagnosis and differential diagnosis of CD. The consistency of test results of different kits was not satisfactory, the consistency of the results of ASCA-IgG was better than that of ASCA-IgA. All three kits have low sensitivity and are not suitable for IBD screening of the population. Detecting ASCA-IgG and ASCA-IgA antibodies simultaneously could improve the detection sensitivity. Test performance showes kit B > A >C. The imported kit is not necessarily superior to the domestic kit, and the brand of kit should be selected according to the actual situation. Figures and Tables | References | Related Articles | Metrics

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Study on human papillomavirus infection in gynecological outpatients in Songjiang District during 2016 to 2017 WANG HONG, HUANG Luyao, YANG Yixiang 2019, 18 (04):  460-465.  DOI: 10.16150/j.1671-2870.2019.04.015 Abstract ( 340 )   HTML ( 2 )   PDF (551KB) ( 45 )   Objective: To analyze the distribution of human papilloma virus (HPV) infection and subtypes in Songjiang District, Shanghai for providing a theoretical basis for prevention of HPV infection. Method: A total of 52 973 gynecological outpatients tested for HPV subtypes by gene chip detection were enrolled in this study. Result: A total of 12 139 patients were infected with HPV. The HBV infection rate was 22.92%. Altogether 16 637 strains of human papilloma virus were detected, and high-risk HPV subtypes accounted for 78.61%. The top five infection subtypes were: HPV16, 58, 52, 51, 68, all of which were high-risk subtypes. Of the infected patients, 8 933 cases were single infection (73.50%), mainly with high-risk subtypes, accounting for 80.48%; 3 206 cases were multiple infection (26.50%), most of which were double infection with high-risk subtype (57.71%), and the common ones were HPV16 and 58. The infection rates of ≤20 years old, 21-30 years old, 31-40 years old, 41-50 years old, 51-60 years old, ≥61 years old groups were 31.83%, 21.48%, 20.66%, 23.69%, 30.35%, 33.88%, respectively. Conclusions: In Songjiang District, HPV infection rate among gynecological outpatients was 22.92%. The most common HPV subtypes were 16, 58, 52, 51, 68. The majority is single infection, and most of which with high-risk subtypes. Among double infection, most were high-risk subtype combination. The age group ≥60 years shows higher infection rate. Figures and Tables | References | Related Articles | Metrics

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Value of intraocular pressure for assessment of ocular safety of intranasal steroids WU Jichang, HE Gangxun, SHI Zhihong, CHEN Yan 2019, 18 (04):  466-469.  DOI: 10.16150/j.1671-2870.2019.04.016 Abstract ( 192 )   HTML ( 0 )   PDF (427KB) ( 119 )   Objective: Many side effects including elevation of intraocular pressure (IOP) due to long-term use of intranasal steroids were reported, especially with the first generation intranasal steroids, yet the second generation intranasal steroids were believed only having a minimal impact on IOP because of low bioavailability. The object of this study was to assess the value of IOP for assessing the ocular safety of two intranasal steroids (the first generation and the second generation) for treatment of 12-week period. Methods: Fifty two allergic rhinitis patients were divided randomly into two groups using either the first or second generation intranasal steroids for 12 weeks, respectively. IOPs were measured before treatment and after the 3rd, 6th, 9th, and 12th weeks of treatment. The IOPs of the two groups were compared. Results: The IOP of the first-generation intranasal steroids at 3, 6 and 9 weeks after treatment were not statistically different from those before treatment, while the IOP at 12 weeks after treatment were statistically different from those before treatment. Meanwhile, there were no statistically significant differences between the IOP at various stages of treatment and that before treatment with the use of second generation intranasal steroids. Conclusions: For patient with long standing use of nasal steroids, IOP could be considered as an important index for assessing the ocular safety. Figures and Tables | References | Related Articles | Metrics