细菌性阴道炎合并HPV16感染患者阴道菌群分布与局部免疫的关系

探究细菌性阴道炎（BV）合并人乳头瘤病毒16（HPV16）感染患者阴道菌群分布与局部免疫的关系。

选取2019年1月到2023年1月我院收治的83例BV合并HPV16感染患者和81例单纯BV患者,分别作为研究组和对照组,检测两组患者阴道菌群分布和宫颈阴道分泌物中T淋巴细胞亚群（CD4⁺、CD8⁺、CD4⁺/CD8⁺）和炎症因子（IL-1β、IFN-γ、IL-2）水平。

研究组乳酸杆菌数量低于对照组,加德纳菌、大肠埃希菌、无乳链球菌、金黄色葡萄球菌、铜绿假单胞菌、白假丝酵母菌数量高于对照组（P＜0.05）;研究组阴道菌群密集度Ⅲ+Ⅳ级、多样性Ⅱ+Ⅲ级、微生态失调比例均高于对照组（P＜0.05）;研究组宫颈CD4⁺、CD4⁺/CD8⁺比值低于对照组（P＜0.05）;研究组宫颈IL-1β、IFN-γ、IL-2水平低于对照组（P＜0.05）。

合并HPV16感染可使BV患者阴道乳酸杆菌数量减少,阴道微生态失衡,局部免疫功能下降,应尽早检测此类患者阴道菌群和宫颈阴道局部免疫情况,进行针对性干预。

     

Distinct distribution of HPV types among cancer-free Afro-Caribbean women from Tobago

Human papillomavirus (HPV), a sexually transmitted virus causes cervical carcinomas, and is associated with ～36% of oropharyngeal tumours where HPV16 is the predominant genotype. The cervical cancer incidence rate in Trinidad and Tobago is about two times higher than the worldwide rate. We have for the first time determined the prevalence and type distribution of cervical HPV infections among cancer-free Afro-Caribbean women from Tobago, and compared it with the HPV subtypes observed in their oral cavity. Thirty-five per cent of the women were cervical HPV positive. The most common high-risk type detected in the cervix was HPV45 rather than HPV16 and 18. The prevalence of HPV infection in the oral mucosa was 6.6%. The distribution of HPV genotypes in healthy Tobagonian women is different from that reported in studies conducted in European and North American populations. This may have important implications for vaccine introduction in this and other Afro-Caribbean countries.     

A High-throughput Bead-based Affinity Assay Enables Analysis of Genital Protein Signatures in Women At Risk of HIV Infection

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Highlights

• •Genital samples were analyzed using a high-throughput bead-based affinity assay.
• •Proteins were validated by tandem mass spectrometry with concordant results.
• •Genital epithelial proteins were increased in HIV-serodiscordant women.

     

宫颈冷刀锥切术治疗宫颈上皮内瘤变的疗效观察及术后切缘阳性的危险因素分析

目的:探讨宫颈冷刀锥切术(CKC)治疗宫颈上皮内瘤变(CIN)的疗效,并分析术后切缘阳性的危险因素。方法:回顾性分析2009年1月至2017年12月在广州医科大学附属第三医院接受治疗的509例CIN患者的临床资料,其中行CKC治疗的患者318例记为CKC组,行宫颈环形电切术(LEEP)治疗的患者191例记为LEEP组,对比两组患者的手术指标、术后并发症发生率、切缘阳性率以及复发率,根据所有患者术后病理检查结果将其分为切缘阳性组和切缘阴性组,采用单因素和多因素Logistic回归分析方法分析CIN患者术后切缘阳性的危险因素。结果:CKC组患者的手术时间、住院时间均长于LEEP组患者,术中出血量多于LEEP组患者,组间比较差异有统计学意义(P<0.05)。CKC组患者的术后并发症发生率、切缘阳性率、复发率均低于LEEP组患者,组间比较差异有统计学意义(P<0.05)。单因素分析显示,切缘阳性组的手术方式、人类乳头状瘤病毒(HPV)感染、CIN病变分级、有无宫颈上皮腺体受累与切缘阴性组比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,手术方式为LEEP、HPV感染呈阳性、CIN病变分级为Ⅲ级、有宫颈上皮腺体受累是CIN术后切缘阳性的危险因素(P<0.05)。结论:采用CKC治疗CIN能够降低患者术后切缘阳性率和复发率,安全可靠。手术方式为LEEP、HPV感染呈阳性、CIN病变分级为Ⅲ级、有宫颈上皮腺体受累是CIN术后切缘阳性的危险因素,在治疗过程中应重视以上危险因素,并采取针对性措施以降低CIN术后切缘阳性的发生率。     

mir-26a对子宫肌瘤细胞周期和增殖的影响

目的:近年来许多报道表明,miRNA与一些肿瘤的发病息息相关,其其表达失调直接或间接的影响肿瘤的进展。检测mir-26a在子宫肌瘤组织和肌层组织中的表达,并进一步探究其对子宫肌瘤细胞周期和增殖的影响。方法:收集第二军医大学长海医院妇产科2009年12月至2011年10月手术治疗并经病理检查确诊为子宫肌瘤的患者肌瘤组织和成对肌层组织标本13例,Realtime PCR检测这13例成对组织中mir-26a的表达情况。建立可稳定传代的子宫肌瘤平滑肌细胞系后,将mir-26a转入肌瘤细胞中使其高表达,流式细胞仪检测高表达mir-26a后子宫肌瘤细胞周期的变化,同时用cck-8方法验证细胞增殖活性。结果:Realtime PCR结果显示,与相应肌层组织相比,肌瘤组织mir-26a的表达均显著降低(P0.05)。流式检测结果显示,24 h时,与对照组相比,mir-26a高表达的肌瘤细胞G1期比例增高。增殖实验显示种植细胞第二天开始,mir-26a高表达的子宫肌瘤细胞增殖速度显著降低。结论:与正常子宫肌层组织相比,mir-26a在子宫肌瘤组织中表达下调,这种表达失调直接影响肌瘤细胞的增殖速度和周期比例,提示mir-26a在子宫肌瘤的发生发展过程中发挥了重要的调控作用。     

High iNOS mRNA and protein levels during early third trimester suggest a role for NO in prelabor cervical ripening in the bovine

Nitric oxide (NO) plays a key role in the processes leading to cervical softening prior to labor. Inducible nitric oxide synthase (iNOS) contributes most to the increased production of NO during labor, as demonstrated in the rat cervix, or at term pregnancy in women. Changes in expression of iNOS during late gestation have not yet been studied longitudinally in any species, because repeatedly taking biopsies could not be performed. iNOS mRNA (n = 6) and protein expression (n = 3) in serial cervical biopsies of pregnant pluriparous cows taken around days 225, 250, and 275 of pregnancy and within 1.5 hr after calving (d225, d250, d275 and parturition biopsies, respectively) were measured using quantitative RT-PCR and Western blotting. iNOS mRNA expression decreased from the d225 biopsy onwards, differences being significant between the d250 and d275 (P < 0.05) and between the d275 and parturition biopsies (P < 0.05). iNOS protein expression decreased from d225 to d250 onwards. Immunohistochemical analysis of biopsies showed, besides positive staining in endothelium and epithelium, which remained unchanged at different time points, that iNOS expressing cells in the connective tissue cells of early biopsies were predominantly spindle shaped (mostly smooth muscle cells and some fibroblasts). In the parturition biopsies, iNOS reactivity was mainly found in mononuclear leucocytes. These results lead us to suggest that iNOS from spindle shaped cells is involved in prepartum cervical ripening, while iNOS in mononuclear inflammatory cells may be important for local tissue repair mechanisms during postpartum cervical involution.     

Towards automated cancer screening: Label‐free classification of fixed cell samples using wavelength modulated Raman spectroscopy

The ability to provide quantitative, objective and automated pathological analysis would provide enormous benefits for national cancer screening programmes, in terms of both resource reduction and improved patient wellbeing. The move towards molecular pathology through spectroscopic methods shows great promise, but has been restricted by spectral quality, acquisition times and lack of direct clinical application. In this paper, we present the application of wavelength modulated Raman spectroscopy for the automated label‐ and fluorescence‐free classification of fixed squamous epithelial cells in suspension, such as those produced during a cervical smear test. Direct comparison with standard Raman spectroscopy shows marked improvement of sensitivity and specificity when considering both human papillomavirus (sensitivity +12.0%, specificity +5.3%) and transformation status (sensitivity +10.3%, specificity +11.1%). Studies on the impact of intracellular sampling location and storage effects suggest that wavelength modulated Raman spectroscopy is sufficiently robust to be used in fixed cell classification, but requires further investigations of potential sources of molecular variation in order to improve current clinical tools.      

The Cervex: an ectocervical brush sampler

The performance of a new ectocervical brush sampler--the Cervex--was compared with the Ayre spatula in 280 paired cervical smears. The Cervex smears were superior in quality of spread, transformation zone sampling in all degrees of cervical patency and in detection of histologically proven epithelial abnormalities, with a false negative rate of 10.9% compared with 20% for the Ayre. Improvement in predictive value was noted in atrophic samples, with increased cellularity and transformation zone representation. Difficulty has been encountered in obtaining adequate samples from the older woman and from those with iatrogenic scarring of the cervix. Although two-sampler techniques may be used, submission of high quality pan-cervical material from a single sampler onto one slide is economically and organizationally attractive. The Cervex seems capable of producing such samples and deserves further evaluation for routine screening.     

A large proportion of afferent neurons innervating the uterine cervix of the cat contain VIP and other neuropeptides

Summary Axonal tracing techniques were used in combination with immunohistochemistry to examine the distribution of neuropeptides in afferent pathways from the uterine cervix of the cat. Primary afferent neurons innervating the uterine cervix were identified by axonal transport of the dye, fast blue, injected into the cervix. Fifteen to twenty-five days after the injection, dorsal root ganglia (L1–S3) were removed and incubated for 48–72 h in culture medium containing colchicine to increase the levels of peptides. Calcitonin gene-related peptide (CGRP), cholecystokinin (CCK), leucine-enkephalin (LENK), somatostatin, substance P and vasoactive intenstinal polypeptide (VIP) were identified by use of indirect immunohistochemical techniques. Eighty-four percent of uterine cervix afferent neurons were identified in the sacral dorsal root ganglia (S1–S3), and 16% in the middle lumbar dorsal root ganglia (L3–L4). In sacral dorsal root ganglia, VIP was present in the highest percentage of dye-labeled cells (71%), CGRP in 42%, and substance P in 18% of the cells. CCK and LENK were present in 13% of the cells. In lumbar dorsal root ganglia, CGRP (51%) was most prominent peptide followed by VIP (34%), substance P (28%), LENK (17%) and CCK (13%). Somatostatin was present in the ganglia but did not occur in dye-labeled neurons. In conclusion, the uterine cervix of the cat receives a prominent VIP-and CGRP-containing afferent innervation. The percentage of neurons containing VIP is three to five times higher than the percentage of these neurons in afferent pathways to other pelvic organs. These observations coupled with the results of physiological studies suggest that VIP is an important transmitter in afferent pathways from the cervix.