RESUMO
To perform a systemic review and meta-analysis of the diagnostic accuracy of PET (CT) and metaiodobenzylguanidine (MIBG) for diagnosing neuroblastoma (NB),electronic databases were searched as well as relevant references and conference proceedings.The diagnostic accuracy of MIBG and PET (CT) was calculated for NB,primary NB,and relapse/metastasis of NB based on their sensitivity,specificity,and area under the summary receiver operating characteristic curve (AUSROC) in terms of per-lesion and per-patient data.A total of 40 eligible studies comprising 1134 patients with 939 NB lesions were considered for the meta-analysis.For the staging of NB,the per-lesion AUSROC value of MIBG was lower than that of PET (CT) [0.8064±0.0414 vs.0.9366±0.0166 (P＜0.05)].The per-patient AUSROC value of MIBG and PET (CT) for the diagnosis of NB was 0.8771±0.0230 and 0.6851±0.2111,respectively.The summary sensitivity for MIBG and PET (CT) was 0.79 and 0.89,respectively.The summary specificity for MIBG and PET (CT) was 0.84 and 0.71,respectively.PET (CT) showed higher per-lesion accuracy than MIBG and might be the preferred modality for the staging of NB.On the other hand,MIBG has a comparable diagnosing performance with PET (CT) in per-patient analysis but shows a better specificity.
RESUMO
The impact of prior cesarean section (CS) on the pregnancy and neonatal outcomes of in vitro fertilization and embryo transfer (IVF-ET) was investigated.A retrospective analysis was performed on 144 patients with prior CS between January 2013 and December 2015.The pregnancy,delivery,and neonatal outcomes of patients who had previous CS delivery and received IVF-ET were analyzed.The control group comprised 166 patients who had only previous vaginal delivery (VD) and received IVF-ET during the same period.The results showed that the basal follicle stimulating hormone level,estradiol level on human chorionic gonadotropin (hCG) day,gonadotrophin dosage,duration of stimulation,retrieved oocytes,fertilization rate,high-quality embryo rate,multiple birth rate,abortion rate and ectopic pregnancy rate had no significant difference between the two groups (P＞0.05).The pregnancy rate (40.28％ vs.54.22％) and implantation rate (24.01％ vs.34.67％) were significantly lower (P＜0.05),and the ratio of embryo difficulty transfer (9/144 vs.0/166) was significantly higher in CS group than in VD group.The risk of pernicious placenta previa and postpartum hemorrhage in twin deliveries was significantly increased in CS group as compared with that in VD group (P＜0.05),and gestational age and neonatal birth weight were significantly reduced in twin deliveries as compared with singleton deliveries in both groups (P＜0.05).It was suggested that the existence of CS scar may impact embryo implantation and clinical pregnancy outcome,and increase the difficulty of ET.We should limit the number of transfer embryos to avoid multiple pregnancies and strengthen gestational supervision in patients with cesarean scar.