Search

To assess the risk of cervical cancer and high grade cervical intraepithelial in women with negative human papillomavirus (HPV) and cytology atypical squamous cells of undetermined significance (ASC-US) and to provide evidence for clinical management.We pooled 17 population-based cross-sectional studies which were conducted across China from 1999 to 2008. Totally, 30 371 women aged 17-59 were included in these studies. All women received liquid-based cytology test (LBC), HPV testing (hybrid capture 2 test, HC2) and visual inspection with acetic acid test (VIA). Women with any positive result from above tests were referred to colposcopic examination. Totally, 28 810 women with complete results from HPV, cytology and pathology were included in the final analysis. Women with negative HPV (LBC-/HPV-) or negative cytology (LBC-) results served as the control, respectively. Risk on high grade cervical intraepithelial neoplasia (CIN2+) was calculated for women with HPV negative and ASC-US results (ASC-US/HPV-).There were 22 003 women with LBC-/HPV-, 24 139 women with LBC-, and 1 834 with ASC-US/HPV- indentified in our study. CIN2+prevalence rates to the above women appeared as 0.05%, 0.36% and 0.16%, respectively. Compared with women with LBC-/HPV- and women with LBC-, the odds ratios (ORs) for CIN2+in women with ASC-US/HPV-were 3.00 (95%CI: 0.85-10.65) and 0.46 (95%CI:0.15-1.45), with adjusted ORs as 4.00 (95%CI: 1.08-14.87) and 0.47(95%CI: 0.15-1.49), respectively.The risk of CIN2+ in women with ASC-US/HPV- was in between the risks of women with LBC-/HPV- or with LBC-. Based on the "equal risk, equal management" principle, women with ASC-US/HPV- were suggested to be followed under the '3-year interval' program, which was the same as for those cytology negative women. However, in areas with limited health resources, the follow-up interval can be extended to 5 years, similar to the management on women with LBC-/HPV-.

Radiofrequency ablation (RFA) is currently the most widely used thermal ablative technique for unresectable hepatic malignancies. However, microwave ablation (MWA) is also gaining popularity worldwide. With a cooled-tip electrode, MWA produces necrotic effects comparable to RFA without damaging soft tissues along the electrode track. In this study, the authors compared the efficacy of these two ablative modalities in the treatment of primary or secondary liver cancer.Ultrasound-guided MWA was employed to treat 230 cases of liver cancer with a total of 349 nodules and a diameter of 0.8-11.4 cm [mean: 5.7 +/- 2.1 cm]. Meanwhile, ultrasound-guided RFA was performed in 92 cases of liver cancer with 173 nodules in total and a diameter of 2.0-10.2 cm [mean: 5.4 +/- 1.9 cm]. The clinical data were retrospectively analyzed to identify the differences between MWA and RFA in terms of their operative safety, local ablative effect, cost efficiency, and cumulative survival rate.The patient parameters were comparable. The area of coagulative necrosis was similar in both groups. The tumor complete ablation rate was 83.7% (292/349) for the MWA group and 86.7% (150/173) for the RFA group, which showed no significant difference (P = 0.75). The one-year and two-year cumulative survival rate were all comparable between the two groups (P = 0.66, P = 0.41), which were 90.0% (198/220), 81.6% (120/147) for the MWA group, and 91.8% (78/85), 81.0% (34/42) for the RFA group, respectively. Moreover, both the tumor type and number had no influence on survival rate for the two methods. In addition, there was no significant difference in complication rates between the two groups. The cost for performing one MWA procedure was about 40% lower than that of RFA ($1200 vs $2000).Both MWA and RFA are safe and effective ablative treatments for liver cancer. Additionally, MWA has the advantage of cost efficiency.

To evaluate the prophylactic effect of artesunate in high-risk populations who had contacted the infested water.From the 7th day post-exposure to infested water, a total of 17,031 people who had contacted the infested water for more than 20 days had been treated with artesunate at a dose of 300 mg once a week for three successive weeks. On day 17 after the last medication, they were examined for schistosomiasis and followed-up 60 days later.No acute schistosomiasis case was found. ELISA-positive was found in 204(1.20%) and COPT3% was found in 195 cases (1.14%). The side-effects were slight.Artesunate is highly effective and safe for the prevention of schistosomiasis.

Inspecting twenty-four hours dynamic blood pressure of sixty-two essential hypertension patients with Ganyang shangkangzheng or Gan-shengyinxuzheng in normal conditions and analysing blood pressure's dynamic regularity of the two groups with different traditional Chinese medicine Zheng type, we found that the blood pressure of Ganyang shangkangzheng patients was higher in the daytime than that at night, and the Gan-Shengyinxuzheng patients had the reverse results. The results suggest that the dynamic blood pressure value may be an objective index for differential diagnosis of traditional Chinese medicine Zheng types of patients with essential hypertension.

Clinical presentation of aortic dissection is similar to that of acute myocardial infarction (AMI). Clinical differential diagnoses from lethal chest pain in emergency department include AMI, aortic dissection, pulmonary embolism, tension pneumothorax, etc. Thrombolytic therapy for recanalization of thrombotic occluded coronary artery in AMI must be considered, but it is absolutely contraindicated for aortic dissection. However, AMI secondary to aortic dissection is a rare condition, which might be caused by compression of the coronary arteries by a hematoma or extension of the dissection into the coronary arterial wall. Surgery is the first choice for AMI secondary to aortic dissection caused by extension of dissection into the coronary arterial wall. We present a case of inferior wall AMI caused by type I aortic dissection with presentation of chest pain and hemiparaplegia of right lower limb.

Laparoscopic cholecystectomy (LC) has rapidly become the procedure of choice for the management of patients with gall-bladder stones. This contrasts with patients who have common bile duct and intrahepatic duct stones who still usually need an open operation. On the basis of experience of a number of LC by one surgeon and animal experiments, we have completed laparoscopic exploration of both intra- and extrahepatic ducts and T-tube drainage of 57 patients with intra- and extrahepatic bile duct calculi over 13 months during 1992-1993 with satisfactory results. The average operating time was 150 min, with a range of 100 to 220 min. Most patients were mobile and on oral fluids within 24 h postoperative. Average hospital stay was 4 days. Retained stones were found via T-tube cholangiography in four patients (7%) and for each patient these were removed by fibre-optic choledochoscope 2 weeks postoperatively. Laparoscopic exploration of intra- and extrahepatic bile ducts is achievable by experienced surgeons and may be particularly helpful for patients who are not a good operative risk.

The results of the Be-induced leukocyte migration inhibition test (Be-MIT), the lymphocyte transformation test (LI), the E-rosette formation test (E-RFC), the old tuberculin test (OT), and sero-immunoglobulin (IgG, IgA, IgM) measurements on 13 cases of berylliosis, 44 members of the observation group, and 51 members of the contact group are reported. In the Be-MIT, 2 of the berylliosis patients were new cases that had been diagnosed and treated for a long time, and both tested positive (18%). Fourteen patients from the observation group tested positive (32%), and 15 from the contact group tested positive (30%). The 8 cases in the control group tested negative; 7 patients from the observation group and 3 of the berylliosis cases tested negative after being treated. The lymphocyte transformation rates of the observation group and the berylliosis group were significantly lower than that of the control group (P less than 0.01). Both Et-RFC and Ea-RFC contents in the group with berylliosis were much lower than those in the control group (P less than 0.01). OT tests were performed on 8 berylliosis patients and 10 healthy men. Seven patients showed negative reactions and one showed a positive reaction. All the healthy men showed positive reactions. The IgG and IgA levels of the observation group were significantly higher than those of the control group (P less than 0.01). The Be-MIT could detect active beryllium disease at an early stage as well as Be-sensitive individuals. This test could be used as a supplementary diagnostic index for the differential diagnosis of berylliosis and for the evaluation of a curative effect.