Team:Shanghai-United/Human Practices

The characterization protein and early diagnosis of cervical cancer

Here we demonstrate specific protein expression variations related to NFX1 over-expression, a gene found to be closely associated with cervical cancer.

Integrated HP

Survey Section\

Introduction
The human practice group aims to introduce the concept of HPV vaccines and cervical cancer to the general public. We realized the importance of understanding society's perceptions of the HPV vaccines and cervical cancer since it will best prepare us for our other social activities in the following weeks. It is also one of our missions to advocate for the understanding of cervical cancer and HPV in order to arouse the general public's awareness of cervical cancer and HPV virus. To make our speech more effective, it is also important to get an idea from the current methods of cervical cancer education. 

In order to learn about the level of knowledge of people from different background, we crafted a survey and collected 282 responses in a total of the same survey from both the medical faculty, the general public, specialists, and the medical care staff. The range of our subjects also included age, gender, locations as well as marriage status in order to reduce bias, allowing our team to yield results closer to the general public's true perception of HPV and cervical cancer. In the survey, we asked our subjects their extent of knowledge on HPV virus, cervical cancer, and HPV vaccine.

 

Marriage:
According to our survey,72 percent of respondents are married,and the others are not.

 

Gender:
Our survey was answered mainly by women, which was shown in the pie chart below.

 

 

Age:
We combined the statistics from the questionnaire and online survey results together. Therefore, we reached a conclusion that up to 80% of people in our poll are greater than or equal to 26.

 

Level of knowledge

• General Public and Medical Faculty’s Knowledge on Cervical Cancer

After analyzing the surveys, we concluded that the medical faculty’s knowledge on the Cervical cancer was superb. From the data in the survey, 93% of medical faculty surveyed stated that they had a good or excellent level of understanding of cervical cancer and its causes, which indicates that most medical faculty have strong background knowledge of cervical cancer and HPV virus. Many routinely take or perform examinations and precautions to prevent or treat cervical cancer. To the contrast, public understanding is satisfactory with a large number of civilians who confirmed that they have somewhat knowledge about what cervical cancer is. However,compared with medical faculty, the general public's understanding of cervical cancer is lower due to their insufficient  knowledge on biology and medical science.

 

• General Public and Medical Faculty’s Knowledge on HPV

For the general public, 50% of the people mostly understand cervical cancer and HPV and the other half have only a slight understanding of it. However, 85% of medical faculty have a satisfactory understanding of cervical cancer and the HPV . The survey of this part yields a similar result as above that medical faculty have a more thorough understanding of the disease and its relevant information, which creates a significant contrast between the knowledge level of the medical faculty and the general public.
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• ​​​Typical Relevance of Cervical Cancer

Based on our data, only 10% of the general public has frequently heard about cervical cancer and the HPV. However, for people who work in a medical science environment, 98% of their social circle has mentioned or discussed cervical cancer and the HPV, showing that a medical science environment will significantly arouse people’s attention to cervical cancer and HPV  inside it than those  in the general public.

Education method
On the basis of our data, we find that about 50% of people learn about cervical cancer from official sources, and 49.87% of them access the knowledge by themselves in other ways such as relevant books, friends and families. More than expected, only a few people do not hear about it. From these results, we draw the conclusion that most people have at least some knowledge of cervical cancer and the HPV  in some ways. However, only half the people have retrieved information from official sources such as the government, news, and relevant books.

In comparison, 92% of people have no much understanding of HPV , which is similar to the survey results of  sources of understanding cervical cancer.

Current vaccination situation
From the results, there are totally 85 % out of 283 respondents think that it is necessary to get vaccination. However, only 7% of the subjects have already been vaccinated. The results reflect a current condition that there is a large need of vaccine injections in our country and a lot of people have realized the importance of vaccination. However, most people cannot receive vaccination due to various reasons. Therefore, it is necessary to promote the vaccination in our country at the moment.

• Conclusion

After surveying the general public, we realized that the public has not developed a good knowledge on cervical cancer or the HPV. Therefore, it is necessary for us to popularize the concept of cervical cancer and the HPV  to the general public as well as introduce our research to them. In order to create a speech suitable for audiences with no basic knowledge on cervical cancer  theor HPV , we plan the following activities to achieve our goal. Based on the current education methods in the survey, we want to create a series of activities that not only contain professional knowledge but also entertain the general public.
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Purpose：

Dr. Li Min
Medical Doctor

Inorder to obtain more professional information, we interview Dr. Li Min, a medicine professor who currently works as a chief physician in XU HUI Central hospital. As a member of AAGL Elevating Gynecologic Surgery, Dr. Li has rich clinical and research experience, and has more chance to get direct interaction with those patients infected with HPV. Talking about the current situation about the prevalence rate and influence factor about cervical cancer in China, Dr. Li gave us a more comprehensible understanding of the prevalence of HPVin current patients.

 

Design：
According to the statistics, the number of people infected with HPV is increasing gradually. However, according to Dr. Li, with the popularization of the basic education about HPV and vaccine towards the public, the rate will decrease step by step. Just like what those western countries did in the past, whose morbidity was initially high and then decreased with the invention and popularization of HPV vaccine. Of course, there are some difficultiesduring our process of generalizing the basic information to the whole society, for instance, it would be easy to spread information in a modern city such as Shanghai, but it could be challenging to give people fundamental education about HPV in those remote areas because of conservativeness of regional values.

Dr. Li thought that regarding the flaws and difficulties in current treatments, besides innovation of medicine, HPV, unlike any other virus, can hardly be cultured in vitro because as long as HPV moved out of the human body, it’ll die quickly. Due to this unique property, the scientists cannot really find the right pathway or valid antigen corresponding to it. Moreover, current data indicates that the host HPV cells are mainly epithelial squamous cells. Then in which way could this virus influence the cell? Whether it will change the gene or the expression of the protein? All those questions remain unknown. Those two factors above are the main reasons that prevent us from making further progress in developing effective treatment.
What's more, we are still unsure about whether HPV could infect other mammals due to that we only document the infection on the human body for now.

According to the CDC (Center For Disease Control And Prevention) of America, sexual intercourse is the only way for humans to be infected by HPV. However, medical scholars in China hold a different opinion. Not limited to sexual intercourse, a form of direct contact with the HPV, indirect contact, such as using public toilet seats used by an HPV carrier, is also suspected to be another way of getting an HPV infection.
There is also a common misunderstanding that the use of condoms during sexual intercourse could prevent the HPV virus from entering the human uterus. However, the truth is, no statistic evidence supports such a claim.

Wan Qingjuan

Purpose:
Being aware that the distribution of HPV vaccines and basic education are mainly related to government policies in China, we decided to interview Ms.Wan, the chief of TianShui female health section, to gain a more comprehensive understanding of the public attitude towards HPV and vaccines.

Design:
In the aim of getting more people to acknowledge the hazard and severity of HPV virus, the government has done a lot, for instance, government personnel popularized the fundamental information about HPV house by house, and help them to have a better understanding of inoculating vaccines face to face.

At our request, Ms. Wan provided a detail set of statistics regarding the incident trend of cervical cancer that in 2018, the prevalence rate of cervical cancer was 0.02893%, and 2019 this number declined to 0.02812%. She suggested that the gradual declining trend recent years, should be led by the enhanced public's awareness of HPV and the introduction of HPV vaccines.

Helping people to avoid the hazard of getting infected by HPV, an virus that could later aggravate the illness and finally lead to cervical cancer from the origin, the government has offered several relevant free physical examination policies. For example, women whose age from 3-64 are not required to pay any extra fee to do HPV test (i.e. a HPV test is included in the social insurance).

However, Ms. Wan made it clear that the quantity of HPV vaccines available in China, especially in TianShui, is insignificant in comparison with the demand for it. For example, there are only 50 HPV vaccines available in TianShui, whereas the demand for it in Tianshui far exceeds beyond it. This is explained by the fact that, China's CDC is not yet capable of mass producing the HPV vaccines independently and is restricted by a quota given by foreign producers of HPV vaccines. This quota varies between months and the CDC is responsible for deciding how to distribute the quota to each province of China every month. That is why each provinceonly gets a limited quantity of HPV vaccines each month.

An Interview with Prof. Han

First, we still wondered more related knowledge of HPV after our interview with Dr. Min Li; second in order to resolve the concerns we have regarding the technical concepts of HPV and cervical cancer, we decided to interview professor Han, a renowned professor in virology in Wuhan. Although our experiments had a clear direction towards the goal, we still found it necessary to consult some experts to obtain valuable suggestions for the future of the experiments from the professor.

Currently, the research of HPV is based on the development of a similar virus that exists in animals, especially mammals. First, according to the common knowledge, the HPV is transmitted by sexual intercourse. Humans would not be infected by open-wound infection because as soon as the HPV enters into the blood, it will be killed by immunocytes (that defend human immune system). Prof. Han also claimed that although condoms could not prevent people from being infected by HPV, according to the statistics, condoms successfully provide against the virus invasion at 70% time. 

Professor Han explained to our team how the HPV infects the protein in human cells as well as how the virus causes cancer. First, the structure and electron negativity of proteins L1, L2 of the HPV virus exactly match those of its hosts' proteins in human cells, allowing the HPV to enter those cells. After its entrance, L1 protein will dissolve the most powerful antioncogene, P53, of the human body, while L2 protein will enhance a certain determiner that would stimulate diseased cells to replicate wildly, causing cancer or tumor.

International experts pay more attention to HPVand cervical cancer than SARS and Moss virus. Among all tumors and carcinogenic viruses, HPV research is relatively successful. For professor Han, the pathogenicity of HPV is the weakest. Now there are two points about the research of cervical cancer, one is what the pathogenesis is, the second is the research on its vaccine.

Prof. Han advocated that our research and experiments are significantly crucial and insightful when it comes to screening those target proteins related to HPV-infected cervical cancer. The primary reason is that current target proteins whichwe have already identified are relatively inefficient in interdicting the HPV virus replicate gene information. 

For the purpose of further developments of our experiments, Prof. Han suggests that the scientific approaches to investigate virus are identical. Therefore, it is also significantto pay attention to the general approaches to target differentvirus in order to further our research in the long run. Prof. Han also identified the value of our experiments through which we could acquire a basic understanding of the ways to target virus.

A COMIC BOOK

P1

 

 

 

P2

 

P3

 

 

 

P4

1.purpose

As we dived deeper into the research of HPV, we realized that it is essential to let all of the population have a basic idea about what is HPV. To achieve our goal of covering all the points, we used various promotion techniques depending on the audiences. For instance, with the old people, who are less likely to understand the importance of preventing HPV, we joined the actual neighbourhood and introduced them to our topic. The main benefiting population of the HPV vaccines, which are teenagers, is our top target audience. Considering comics are rather popular and accepted, especially for the youth.  So we used comics as media to present the basic education about how HPV affects the human body system.

2 perspectives
We drew 2 similar storylines of a female named Emma being infected by the HPV from microcosmic and macrocosmic perspectives: the HPV perspective and the woman's perspective.

From the virus's perspective, we have the HPV as our protagonist: a fierce-looking spherical virus with flowers, representing the bulge on the actual HPV. First, he entered the female uterus and encountered a few white blood cells. Since not a lot of white blood cells are present in the female endometrium, the HPV easily wins the battle against the human body's immune system. From the perspective of the virus itself, readers can vividly learn how the HPV virus invades into the female uterus microscopically and what kinds of damage they could do. 

While the HPV  is invading the female body, the woman being infected, Emma, is physically suffering. Her symptoms include abnormal vaginal bleeding and secretion. Luckily, She noticed these aberrations very early and consulted a doctor, Dr. Fox for help. Dr. Fox diagnosed her with HPV and started educating her on what's going to happen if she found this out late: The HPV virus would "intermarry"- exchange DNA- with epithelial cells, and the new cells created by this process might cause cervical cancer in women. Due to the potential damage of HPV and cervical cancer, Dr. Fox advised Emma and others to get HPV vaccines.

From Emma's perspective, readers can learn the symptoms of all the stages of HPV and cervical cancer, reminding them of maintaining vigilant when those symptoms appear. By reading through those warnings that Dr. Fox gave to Emma, our audience could learn the hazards of the HPV virus and the significance of vaccination.

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