Different dose series of human papillomavirus vaccine in young females: a pair-wise meta-analysis and network meta-analysis from randomized controlled trials.

Objective: To investigate the application value of different dose of HPV vaccine in young females. Data sources: The following databases were searched: Cochrane Library, PubMed, Embase, Web of Science, SINOMED, and Wanfang Data, from the establishment of the database to August 1st, 2022. Study eligibility criteria: The inclusion criterias were: healthy young women younger than 25 years old as the research object, randomized controlled study as the research type, and the efficacy and safety of single-dose, two-dose or three-dose HPV vaccines as the intervention measures and research endpoints. Study appraisal and synthesis methods: Meta-analysis was performed to analyze the protective effects of single-dose, 2-dose and 3-dose HPV vaccine series on young females. Results: A total of eight eligible studies involving 16 publications were included. There is no difference in the immunogenicity between the 2-dose and 3-dose series within 12 months after the last dose of HPV vaccine. However, 3-dose series was better than the 2-dose series, which performed better than the single-dose vaccine, after 12 months. With respect to the prevention of HPV16/18 infection or HPV31/33/45 infection, the single-dose vaccine worked better than 2-dose or 3-dose series. Conclusions: The present study showed that the immunogenicity of low-dose HPV vaccine was significantly less, but it reduced the risk of high-risk HPV infection. The low-dose HPV vaccine series may not offer a preventive effect on cervical lesions, though it needs to be further confirmed by additional studies.

First-line monodrug chemotherapy in low-risk gestational trophoblastic neoplasia: a network meta-analysis.

Objective: The efficacy of the first-line monodrug chemotherapy has been generally established for low-risk GTN. Most patients can achieve a complete response after the first-line monodrug chemotherapy. However, which monodrug chemotherapy regimen is better for individual patients with GTN is not yet certain. This study aimed to assess the efficacy of first-line monodrug chemotherapy in low-risk gestational trophoblastic neoplasia (GTN). Method: Databases, including PubMed, Embase, Web of Science, and Cochrane Library, were searched from inception to November 1, 2022, for case-control studies on first-line monodrug chemotherapy in GTN. Network meta-analysis was performed to compare the efficacy outcome of six monodrug chemotherapy regimens in GTN, with a complete response rate as the endpoint. Result: Twenty-four studies were considered eligible, including 9 randomized controlled trials (RCTs) and 15 non-RCTs. A total of 3344 patients with low-risk GTN were involved. Six monodrug chemotherapy regimens were included and analyzed. In descending order of efficacy, these six regimens were VP-16 (5 days), ACT-D (5 days), MTX (5 days), ACT-D (1.25 mg/m2), MTX (8 days), and MTX (30-50 mg/m2) in all study, and five regimens were ACT-D (5 days), MTX (5 days), ACT-D (1.25 mg/m2), MTX (8 days), and MTX (30-50 mg/m2) in RCT. Conclusion: Among the six first-line monodrug chemotherapy regimens for low-risk GTN in all study, VP-16 (5 days) was the best in terms of efficacy. And five regimens in RCT, ACT-D was the best. However, the finding needs to be validated through more high-quality clinical studies.

Monotherapy for low-risk gestational trophoblastic neoplasia with score 5-6.

Objective: To investigate the monotherapy for gestational trophoblastic neoplasia (GTN) patients with FIGO/WHO prognostic score of 5-6. Methods: The low-risk GTN patients from 2012 to 2019 were enrolled. The study is a retrospective report to analyze the efficacy and safety of single-agent chemotherapy and combination chemotherapy in patients with a high FIGO/WHO prognostic score of 5-6. Results: 75 cases (33.5%) were included. Complete remission was in all patients. Among the 29 cases taking single-agent chemotherapy, 22 cases (75.9%) developed drug resistance. Among the 46 cases taking combination chemotherapy, 7 patients (15.2%) developed drug resistance. There was a statistically significant difference in the drug resistance rate between these two subgroups (P < 0.05), but there was not statistically significant difference in the total number of chemotherapy courses (<2mIU/ml) (P < 0.05). Conclusion: Monotherapy showed remarkable advantages in GTN patients with FIGO/WHO prognostic score of 5-6.

National screening programs for cervical cancer in Asian countries / 부인종양

Cervical cancer is still one of the most common female cancers in Asia and the leading cause of cancer-related deaths in low- and middle-income countries. Nowadays, national screening programs for cervical cancer are widely provided in Asian countries. We reviewed the National Cancer Screening Program (NCSP) in China, India, Indonesia, Japan, Korea, and Thailand. The NCSP were established at varying times, from 1962 in Japan to 2014 in Indonesia. The primary screening method is based on cytology in all countries except for India and Indonesia. In India and Indonesia, visual inspection of the cervix with acetic acid (VIA) is mainly used as a primary screening method, and a “see and treat” strategy is applied to women with a positive VIA result. The starting age of NCSP ranges from 18 years in China to 30 years in Thailand. The screening interval is 2 years in all countries except for China and Indonesia, in which it is 3 years. Uptake rates of NCSP vary from 5.0%–59.7%. Many women in low- and middle-income countries still do not participate in NCSP. To improve uptake rates and thereby prevent more cases of cervical cancer, Asian countries should continue to promote NCSP to the public using various approaches.

A new pathogenic mutation of the BRCA1 gene in a patient with ovarian cancer: A case report.

RATIONALE: The breast cancer susceptibility gene (BRCA) is an important tumor suppressor gene and tumor susceptibility gene. Germ line BRCA1/2 mutations significantly increase the risk of breast cancer and other cancers in women. PATIENT CONCERNS: A 48-year-old woman was diagnosed with breast cancer at the age of 42 and subsequently diagnosed with ovarian cancer at the age of 48. Her sister had a history of breast cancer and her mother died from ovarian cancer. DIAGNOSES: The patient has a family history of tumors. BRCA1/2 mutations was proved in this family members. INTERVENTIONS: Sanger sequencing was used to evaluate the BRCA1/2 gene status of the patient and her sister to identify the genetic mutation sites. OUTCOMES: They had the same genetic mutation, namely, the c.3487_3488insA (p.Thr1163AsnfsX2) mutation in the BRCA1 gene, which is a novel mutation. LESSONS: This novel mutation may be a new pathogenic mutation of the BRCA1 gene. Its relationship to breast and ovarian cancers needs to be further verified in more patient cases. Moreover, mutant protein functions in both cell and animal models are also needed.

BAEP and SEP for prediction of prognosis in brain stem hemorrhage patients / 中国基层医药

ObjectiveTo investigate the correlation of brainstem auditory evoked potentials(BAEP) and somatic evoked potentials (SEP) with therapeutic outcome of brain stem hemorrhage patients.MethodsBAEP and SEP were detected in the early period of 25 caees with brain stem hemorrhage by evoked potential instrument,and were surveilled dynamically.ResultsThere was good prognosis in the patients whose BAEP and SEP were normal in the first time and repeated detection.Poor prognosis happened in ones whose BAEP and SEP were abnormal in the first time and repeated detection.The difference was significant between them(P＜0.05).ConclusionCombined detection and dynamic surveillance of BAEP and SEP could predict accurately the curative result of patients with brain stem hemorrhage.

Analsis on the risk factor of hospital infection for hypertensive intracerebral hemorrhage / 中国基层医药

Objective To explore the risk factors of hospital infection for hypertensive intracerebral hemorrhage ( HIGH). Methods 408 patients from Department of Neurology whose length of stay equaled or exceeded 72 hours and who fitted in with the criterion for the diagnosis of hospital infection were chosen as the HICH infection group while HICH patients without hospital served as the control group. The risk factors for HICH were studied by means of both single factor analysis and multifactor analysis. Results Of more than 30 possible risk factors that were studied by means of single factors analysis, more than 20 manifested marked difference (P < 0.05). Uncondition Logistic regression analysis of the more than 20 variables indicated that rise of inhalation of food resulting from indwelling, stomach tube,kinds of antibiotics used,spray inhalation and fasting blood-glucose,accidental were the risk factors of HICH infection. Conclusion HICH infection results from the synergetic action of various factors and hospital infection could be controlled and reduced by strengthening supervision.

The clinical application of standard craniotomy with large bone flap for frontal-temporal severe craniocerebral in jury patients / 中国基层医药

Objective To explore the curative effect of standard craniotomy with large bone flap of the treatment for frontal-temporal severe craniocerebral injury patients.Methods Standard craniotomy with large bone flap was performed on 63 patients with frontal-temporal severe craniocerebral injury.All postoperative patients were followed up.The curative effect was assessed according to GOS.Results All patients were followed up for 1 year.According to the GOS,28 cases recovered well,12 cases became moderately disabled,4 cases were severely disabled,3 cases was in vegetative state and 16 cases died.The mortality rate was 25.4%.Conclusions Standard craniotomy with large bone flap is the best method of the treatment for frontal-temporal severe craniocerebral injury.Timely and thoroughly standard craniotomy with large bone flap for frontal-temporal severe craniocerebral injury patients can significantly improve the the curative effect of the patients and reduce the rate of mortality.

Expression of PDCD5 in tissues of normal cervix, CIN Ⅰ-Ⅲ and cervical cancer / 北京大学学报(医学版)

Objective: To investigate the expression of PDCD5 in tissues of normal cervix, CIN Ⅰ-Ⅲ,cervical cancer and explore the relationship between PDCD5 and cervical cancer.Methods: After we defined the most fitful condition, tissues from 18 cases of normal cervix, 19 of CIN Ⅰ, 18 of CIN Ⅱ, 20 of CIN Ⅲ and 18 of cervical cancer were defined by indirect immunohistochemical technique. Positive expression rates and intensity of PDCD5 protein were investigated by observing under microscope and analyzing with computer imaging technique. The results were analyzed with one way anova. Results: The results of immunohistochemical staining showed that the percentage of strong positive cells in normal cervical tissue and CIN Ⅰ were significant higher than those of CIN Ⅱ, CIN Ⅲ and cervical cancer. On the whole of the condition of immunohistochemical staining, the expressions of PDCD5 were downregulated along the progression of cervical atypical epithelia, but that in CIN Ⅰ was upregulated.The ODs of normal cervix,CIN Ⅰ-Ⅲ,cervical cancer were 0.322,0.366,0.287,0.252,and 0.206 respectively.The intensity of each group showed obvious differences.Conclusion: We found that the expression of PDCD5 was upregulated in CIN Ⅰ and downregulated in CIN Ⅱ, CIN Ⅲ and cervical cancer. It suggests that PDCD5 is an important apoptosis regulating factor in the occurrence of cervical cancer.

Analysis of cervical lesions in pregnancy / 中华围产医学杂志

Objective To discuss the diagnosis, treatment and following up of the cervical lesions(CIN～cervical carcinoma Ia 1) during pregnancy. Methods Fifteen pregnant women with cervical lesions were reviewed from Jan 1998～Oct 2003 in our hospital. Results Among the fifteen cases, 11 were diagnosed as CIN～ cervical carcinoma Ia 1 based on biopsy results under copolscopy. Ten of the 11 cases had copolscopy repeated every 8 weeks and delivered at term. The left one woman terminated the pregnancy in the first trimester due to carcinoma in situ (CIS) invasion to glands. Among those 10 cases who progressed to term, four were stable during pregnancy (CINⅡ,CINⅢ,CIS and cervical carcinoma Ia1, one for each) and had the same pathology postpartum as antepartum; three had CIN I during pregnancy but changed to inflammation postpartum;one had CIS involved in glands prepartumly while CINⅡ～Ⅲ postpartumly; one had CINⅢ prepartumly and progressed to CIS involved in glands confirmed after conization postpartumly. One woman was missing after delivery. Conclusions Cervical lesions (CIN～Ia 1) less likely get worse during pregnancy. Conservative management is possible if regular cytology, copolscopy and bioposy when necessary are available. Re examination is necessary within two months after birth. Routine examination for women who have no pap smear within the last one year period would be helpful in detecting cervical lesions during pregnancy.