Fertility-preserving treatment and pregnancy outcomes in the early stage of endometrial carcinoma / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>This study aimed to review the available literature on fertility-preserving treatment and pregnancy outcomes in patients with early-stage endometrial carcinoma who desired to preserve their fertility.</p><p><b>DATA SOURCES</b>The PubMed database (1992-2012) was searched for the words "conservative "OR" fertility sparing "OR" fertility preserving" AND "endometrial neoplasms" (MeSH). All relevant articles in English and the relevant references were collected.</p><p><b>STUDY SELECTION</b>Data from published articles about fertility-preserving treatment of endometrial cancer, including the response and recurrence rate of conservative treatment, strategies of infertility treatment, pregnancy, and obstetric outcomes, were selected. Data were mainly extracted from 41 studies, which are listed in the reference section of this review.</p><p><b>RESULTS</b>Hormone therapy was the most common method used for early-stage endometrial carcinoma in patients who wished to preserve fertility. Sixty percent of the patients became pregnant after remission of the carcinoma. The percentage of patients who conceived in the assisted reproductive technology group was higher than that of the natural pregnancy group (80.0% vs. 43.2%, P < 0.01). A higher rate of preterm labor and multiple pregnancies was observed in the assisted reproductive technology group than that in the natural pregnancy group. The majority of pregnancies (71.4%) in the assisted reproductive technology group were achieved by in vitro fertilization-embryo transfer. The clinical pregnancy rate of transfer cycles in patients with endometrial carcinoma was 34.1%.</p><p><b>CONCLUSIONS</b>Assisted reproductive technology is a good option in well-selected patients with early-stage endometrial carcinoma who have completed conservative treatment. In vitro fertilization-embryo transfer offers an opportunity to achieve an immediate pregnancy.</p>

Safety and efficacy on cerebral protection with filter devices during carotid artery stenting in Chinese patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the efficacy, safety, procedural success and long-term clinical outcome in patients underwent percutaneous carotid stenting with distal device.</p><p><b>METHODS</b>Percutaneous carotid stents with distal device were implanted to 58 patients with 59 significant (> 75%) carotid artery stenosis (49 men, mean age 68 years) between January 2000 to December 2005. Forty-five out of 58 patients were symptomatic, 35 had coronary artery diseases and 10 had previous strokes.</p><p><b>RESULTS</b>Sixty one carotid stenting were implanted to 59 lesions in 58 patients. Stents with filter devices were successfully implanted in 57 out of 58 (98%) patients. Angioplasty success rate was 100%. Aspirin (300 mg/d) and Clopidogrel (75 mg x 2/d) were administered 3 days prior operation and clopidogrel was discontinued 30 days post stenting and aspirin was continued at dose of 100 mg/d. The percentage of stenotic carotid artery reduced from 85.3% to 6.2% after stenting and the diameter increased from 1.3 +/- 0.9 mm to 5.2 +/- 1.1 mm. Two minor strokes (3.4%) occurred during operation and at 14 days post stenting. All patients were discharged from the hospital after an average of 2.5 days hospitalization. At 14 +/- 2 months follow up, all patients survived and there were 2 asymptomatic restenosis (50% and 70% and the latter underwent successful balloon angioplasty), 2 myocardial infarctions (1 non-Q wave and 1 Q wave myocardial infarction, all underwent successful emergent PCI) and 2 minor strokes occurred at 6 and 8 months post stenting.</p><p><b>CONCLUSION</b>Carotid stenting with distal device appears to be safe and effective in treating patients with carotid artery stenosis.</p>

Safety and efficacy of carotid artery stenting / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of carotid artery stenting (CAS).</p><p><b>METHODS</b>We prospectively evaluated the safety and efficacy of 76 carotid artery stenting (CAS) procedures in a consecutive series of 70 Chinese patients. This series represented a high-risk group that included patients with unstable angina, previous ipsilateral CEA, contralateral carotid artery occlusion, post-radiation carotid artery stenosis and other severe co-morbid conditions. The patients had independent neurological examinations before and after the procedure and follow-up cerebral angiography at 6 month.</p><p><b>RESULTS</b>The procedural success rate was 100%. The mean carotid artery stenosis was (82+/-18) % before and (5+/-10) % after the procedure. During the initial hospital period and 30 days after CAS, there was no major stroke but 3 minor strokes (5.7%). No myocardial infarctions or deaths occurred during or within 30 days following CAS. At a mean follow-up of 20+/-12 months, 2 patients (2.8%) had asymptomatic restenosis, and 2 non-Q wave myocardial infarction. Death occurred in 2 cases, but none of them was attributed to a neurological cause. Three patients had minor strokes and no major strokes occurred during the follow-up period.</p><p><b>CONCLUSION</b>Percutaneous carotid artery stenting is feasible for performance in Chinese patients and may lower the restenosis rate.</p>