超声治疗动脉粥样硬化性心血管疾病研究进展

超声干预治疗动脉粥样硬化性心血管疾病（atherosclerotic cardiovascular disease,ASCVD）是一种非侵入性治疗方法，其应用于临床治疗的前景广阔。超声波在身体组织中产生的机械、空化及生化等一系列作用可以有效清除血管中的斑块或血栓。但是，安全性是超声疗法应用于临床中亟需解决的首要问题。超声波在身体组织中的传播会引起组织损伤。另外，安全处理因超声刺激而产生的斑块或血栓碎片也是超声疗法应用中面临的挑战。除了确保安全性，合理制定治疗方案及治疗参数从而提高超声疗法疗效是超声疗法应用于临床中有待解决的重要问题。本文结合近年来超声干预治疗动脉粥样硬化性心血管疾病方面的各种临床、动物及体外模型实验研究结果，综述了超声干预治疗的机制、不同治疗方法和治疗参数的效果、如何确保安全性，以及提高超声疗法疗效需解决的一系列问题，进而提出可能的解决方案。     

Bonafide,type-specific human papillomavirus persistence among HIV-positive pregnant women: predictive value for cytological abnormalities,a longitudinal cohort study

This study investigated the rate of human papillomavirus (HPV) persistence, associated risk factors, and predictors of cytological alteration outcomes in a cohort of human immunodeficiency virus-infected pregnant women over an 18-month period. HPV was typed through L1 gene sequencing in cervical smears collected during gestation and at 12 months after delivery. Outcomes were defined as nonpersistence (clearance of the HPV in the 2nd sample), re-infection (detection of different types of HPV in the 2 samples), and type-specific HPV persistence (the same HPV type found in both samples). An unfavourable cytological outcome was considered when the second exam showed progression to squamous intraepithelial lesion or high squamous intraepithelial lesion. Ninety patients were studied. HPV DNA persistence occurred in 50% of the cases composed of type-specific persistence (30%) or re-infection (20%). A low CD4⁺T-cell count at entry was a risk factor for type-specific, re-infection, or HPV DNA persistence. The odds ratio (OR) was almost three times higher in the type-specific group when compared with the re-infection group (OR = 2.8; 95% confidence interval: 0.43-22.79). Our findings show that bonafide (type-specific) HPV persistence is a stronger predictor for the development of cytological abnormalities, highlighting the need for HPV typing as opposed to HPV DNA testing in the clinical setting.