Application status of HPV vaccine in China / 中国实用妇科与产科杂志

The coverage rate of HPV vaccination in China is still very low,and the main reason may be related to people's confusion about the choice of vaccine types,the best age of vaccination,vaccination procedures and prices and other factors.This paper briefly describes the etiology of cervical cancer,the approval of HPV vaccine,the application status of HPV vaccine in foreign countries,and the current situation and challenges in the use of cervical cancer vaccine in China,and advocates that obstetrics and gynaecology experts/disease control experts actively promote the prevention and control of cervical cancer,so that young girls and their parents understand the knowledge related to cervical cancer and HPV vaccine,and young girls can be vaccinated with HPV vaccine as early as possible,so as to improve the coverage rate of HPV vaccination and eliminate cervical cancer.

Effect of Short-Term Partial Enteral Nutrition on the Treatment of Younger Patients with Severe Crohn's Disease

BACKGROUND/AIMS: To analyze the effect of short-term supportive temporary partial enteral nutrition therapy for treating severe pediatric Crohn's disease (CD). METHODS: We conducted a prospective, open-label study in pediatric patients with CD (n=78) from January 2007 to December 2011. The CD patients were divided into three groups according to disease severity (mild, moderate, and severe). Seventeen patients with severe CD received short-term partial enteral nutrition (SPEN) in addition to their general diet for 4 weeks after the induction of remission with medical treatment. This SPEN group was further divided into two groups by age ( or =13 years). Nutritional parameters and Pediatric Crohn's Disease Activity Index scores were analyzed at the initial enrollment and following 1 year of treatment for all groups. RESULTS: Nutritional status improved substantially after 1 year of treatment in the severe CD group. Nutritional status in the SPEN group improved considerably more than that in the non-SPEN group. Additionally, the or =13-year-old group. CONCLUSIONS: SPEN may be effective in pediatric patients with severe CD for improving nutritional status and moderating disease severity.

Causes of Failure after Total Knee Arthroplasty in Osteoarthritis Patients 55 Years of Age or Younger

PURPOSE: To identify the modes of failure after total knee arthroplasty (TKA) in patients >55 years of age and to compare with those >55 years of age in patients who underwent revision TKA. MATERIALS AND METHODS: We retrospectively reviewed 256 revision TKAs among patients who underwent TKA for knee osteoarthritis between January 1992 and December 2012. The causes of TKA failure were analyzed and compared between the groups. RESULTS: Thirty-one revision TKAs were performed in patients 55 years of age at primary TKA. In the < or =55 years of age group, the most common cause of TKA failure was polyethylene wear (45%) followed by infection (26%) and loosening (17%). The interval from primary TKA to revision was 8.6 years (range, 1 to 17 years). There were relatively lower infection rate and higher loosening rate in patients < or =55 years of age, but the difference was not statistically significant. CONCLUSIONS: The main causes of failure after TKA in patients < or =55 years of age were polyethylene wear, infection and loosening, and there was no significant difference in the modes of failure after TKA between the two groups.

Infarto agudo al miocardio en pacientes menores de 40 años: características clínicas, angiográficas y alternativas terapéuticas / Acute myocardial infarction in patients under 40 years of age: clinical and angiographic characteristics: therapeutic options

Objetivos: Analizar comparativamente las características clínicas y angiográficas, y el tratamiento utilizado, en pacientes jóvenes cursando un infarto agudo del miocardio (IAM) con supradesnivel del segmento ST (SDST). Métodos: Análisis retrospectivo de los pacientes que se presentaron con un IAM con SDST y fueron sometidos a angiografía coronaria durante el período entre enero de 2009 y diciembre de 2011. Se identificó a los pacientes menores de 40 años y se registraron sus características clínicas y angiográficas, las terapias utilizadas y sus resultados a mediano plazo. Estos datos fueron comparados con los pacientes de 40 o más años atendidos durante el mismo período. Resultados: De 613 IAM con SDST, 40 (6,5 por ciento) casos correspondieron a menores de 40 años (edad promedio 36,6 años). De éstos, 7 (17,5 por ciento) fueron mujeres, 32 (80 por ciento) fumadores y 17 (42,5 por ciento) referían uso de cocaína. La mayoría presentó alta carga trombótica (TIMI Thrombus Grade 4/5 en 87,5 por ciento), pero con enfermedad de baja severidad anatómica (Syntax Score promedio 13,1 (DE 5,8)). Treinta (75 por ciento) pacientes recibieron an-gioplastía con stent y 21 (52,5por ciento) aspiración de trombos. El seguimiento tardío reveló 5 (12,5 por ciento) eventos mayores. Comparado con los pacientes mayores de 40 años, la mortalidad al año fue marcadamente inferior: 2,5 por ciento versus 12 por ciento, p<0,01. Conclusiones: En menores de 40 años con IAM con SDST, el tabaquismo, uso de cocaína, fueron los principales factores asociados. Aunque la enfermedad coronaria anatómica no fue severa, hubo una gran carga trombótica en la mayoría de los pacientes. Esto se asoció a escasos eventos cardiovasculares y una mortalidad menor a la de los pacientes mayores.

Aim: To analyze clinical and angiographic characteristics and the treatment provided to young patients admitted with an ST-elevation myocardial infarction (STEMI). Methods: Retrospective analysis of patients with STEMI who were invasively studied from January 2009 through December 2011. Clinical and angiogra-phic data, as well as phone follow-ups and mortality registries were reviewed for each patient younger than 40 years old. These results were compared with those from STEMI patients who had 40 or more years of age during the same time period. Results: From 613 STEMI patients, 40 (6.5 percent) had less than 40 years (average age 36.6 years). Among these, 7 (17.5 percent) were females, 32 (80 percent) were active smokers and 17 (42.5 percent) recognized cocaine abuse. Whereas most patients presented with high thrombus content (TIMI Thrombus Grade 4/5 in 87.5 percent), the burden of atherosclerotic coronary disease was markedly low (average Syntax Score 13.1 (SD 5.8)). Coronary stents were used in 30 (75 percent) patients and thrombus aspiration in 21 (52.5 per cent). Late follow-up showed 5 (12.5 percent) major cardiovascular events. In comparison with older patients, 1-year mortality was significantly lower for young patients: 2.5 percent versus 12 per cent, p<0.01. Conclusions: Younger patients with STEMI frequently smoke and use cocaine. Although the burden of coronary disease was low, most patients had a high thrombus content. Cardiovascular events and mortality were lower compared to older patients.

Intraocular Pressure Change After Secondary Intravitreal Triamcinolone Acetonide Injection

PURPOSE: To evaluate the change of intraocular pressure (IOP) after first and second injection of intravitreal triamcinolone acetonide for the treatment of macular edema and the factors that influence these changes. METHODS: A prospective, non-comparative study was performed in 41 eyes at Kangnam Sacred Heart Hospital from October 2003 to November 2005. All of the patients received injection of intravitreal triamcinolone acetonide (4 mg) twice. The IOPs before and after triamcinolone injection were measured with non-contact tonometer and Goldmann applanation tonometer. RESULTS: Mean IOP after the first and second injections were elevated from the day after injection and peaked after 3 months. Younger age (p=0.042), male (p=0.050) and the history of IOP elevation after first injection (p=0.004) were a statistically significant predictive factor for IOP elevation after second injection. Younger age (p=0.000) and male (p=0.010) were a significant predictive factor for IOP elevation after first and second injection. CONCLUSIONS: Clinicians should consider checking IOP especially for the patients who with the history of IOP elevation after first injection, male and relatively younger age.

Intraocular Pressure Elevation after Intravitreal Triamcinolone Acetonide Injection

PURPOSE: This study investigated firstly the change of intraocular pressure (IOP) after injection of intravitreal triamcinolone acetonide (IVTA) for the treatment of macular edema and secondly the factors that influence these changes. METHODS: A prospective, non-comparative study was performed in 60 patients at Kangnam Sacred Heart Hospital from October 2003 to September 2004. All the patients received 4-mg IVTA injection. RESULTS: Mean IOP was elevated from the day after injection and peaked at 20.5 mmHg after 2 months (p=0.000). Twenty-six eyes (43.3%) showed significant IOP elevation. IOP was not controlled despite full glaucoma medication in 7 (11.7%) eyes. Two eyes underwent filtering surgery. Younger age was a statistically significant predictive factor for IOP elevation (p=0.009). CONCLUSIONS: In this study, patients who needed filtering surgery developed an IOP spike within one week after the injection. Therefore, clinicians should consider checking IOP at the end of the first week. Furthermore, greater cautions is mandatory with relatively younger patients.