Objective:To explore the therapeutic effects of different anticoagulant therapies on intracranial venous si-nus thrombosis.Methods:A total of 150 patients with intracranial venous sinus thrombosis in our hospital from Jan 2011 to Jun 2013 were selected.According to random number method,they were divided into low molecular weight heparin (LMWH)group (n=50),unfractionated heparin group (UFH group,n=50)and interventional thrombol-ysis group (n=50,received interventional thrombolysis,patients received LMWH anticoagulant therapy after their conditions were stable).Therapeutic effects and incidences of complications were observed and compared among three groups.Results:After three-month treatment,total effective rate of interventional thrombolysis group was significantly higher than those of LMWH group and UFH group (98% vs.82.0% vs.72.0%),P <0.05 or <0.01;compared with LMWH group and UFH group,there were significant reductions in Rankin scale (mRS)score [(1.3 ±0.3)scores,(1.6±0.4)scores vs.(1.0±0.2)scores]and incidence rate of adverse reactions (16.0%,18.0%vs.4.0%)in interventional thrombolysis group (P <0.05 or <0.01),and there were no significant difference be-tween LMWH group and UFH group (P >0.05).Conclusion:Anticoagulant therapeutic effect of LMWH is better than that of UFH,but pure anticoagulant therapy cannot relieve patient′s condition completely.Interventional thrombolysis combined anticoagulant therapy possess good therapeutic effect,which is worthy of extension in clinic.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Middle Aged ; Papillomavirus Infections ; epidemiology ; Prevalence ; Risk Factors ; Uterine Cervical Neoplasms ; diagnosis ; epidemiology ; Young Adult

OBJECTIVETo compare the clinical characteristics of three subcategories of laparoscopic hysterectomy: total laparoscopic hysterectomy (TLH) and two subcategories of laparoscopic-assisted vaginal hysterectomy (LAVH): LAVHs and LAVHb.

METHODSWe retrospectively analyzed the clinical data of 393 patients underwent laparoscopic hysterectomy, including TLH (n=178), LAVHa (n=177), and LAVHb (n=38), in our hospital from September 2002 to September 2005.

RESULTSMyoma and adenomyosis of uterus were the most common diseases in this study, accounting for 66.9%, 38.4%, and 52.6% in TLH group, LAVHa group, and LAVHb group, respectively. The mean surgery duration and blood loss were not significantly different between TLH group and LAVHa group (P > 0.05), but were significantly less in TLH group than in LAVHb group (P < 0.05). The bulk of uterus in TLH group was significantly bigger than in other two groups (P < 0.05). The incidence of major complications in the TLH group (9. 0%) was lower than in LAVHa group (14.1%) and in LAVHb group (18.4%), but without statistical significance. Conclusion Compared with LAVH, TLH is feasible to deal with bigger uterus with less blood loss and shorter surgery duration and without more frequent complications.

Endometriosis ; surgery ; Female ; Humans ; Hysterectomy ; adverse effects ; methods ; Hysterectomy, Vaginal ; adverse effects ; methods ; Laparoscopy ; adverse effects ; methods ; Myoma ; surgery ; Retrospective Studies ; Uterine Neoplasms ; surgery

BACKGROUNDHuman papillomavirus (HPV) is believed to be the most common sexually transmitted infection. However, little is known about the prevalence and distribution of HPV types in China. We aimed to assess the prevalence and the distribution of HPV types as well as risks for abnormal cervical cytology in women who reside in the Tibetan Autonomous Region of China.

METHODSA cross-sectional study was performed involving a sample of 3036 women. An epidemiological questionnaire was applied and cervical specimens were obtained for liquid-based cytology and HPV DNA detection. Statistical analysis included chi-square and Logistic regression model.

RESULTSIn this population, 3.66% (111/3036) had atypical squamous cells of undetermined significance (ASCUS), 1.45% (44/3036) low-grade squamous intraepithelial lesions (LSIL) and 1.09% (33/3036) had high-grade squamous intraepithelial lesions (HSIL). Tibetan women (5.74%, 137/2387) exhibited lower abnormal cytology rates than non-Tibetan women (8.01%, 52/649, P = 0.03). The overall prevalence of HPV infection was 9.19% (279/3036). We failed to identify any differences in HPV prevalence by age. In the groups with normal, ASCUS, LSIL and HSIL, the overall HPV prevalences were 7.41% (211/2847), 24.32% (27/111), 56.82% (25/44) and 45.45% (15/33), respectively. HPV 16 (1.52%, 46/3036) was the most common type, and was also the most prevalent in women with ASCUS (8.11%, 9/111) and HSIL (15.15%, 5/33). The most common HPV type for Tibetan women was HPV 16 (1.42%, 34/2387), whereas for non-Tibetan individuals it was HPV 33 (2.31%, 15/649). Of the 279 HPV-infected women, 40 individuals (14.34%) presented with multiple HPV positivity. Women who had two pregnancies were more likely to have abnormal cytology smear (OR = 1.67; 95%CI: 1.07 - 2.61).

CONCLUSIONSA low prevalence of HPV positivity was observed in women who reside in the Tibetan Autonomous Region of China. The prevalence of abnormal cervical cytology and HPV type distributions were different between Tibetan and non-Tibetan women.

Adult ; Age Distribution ; Cervix Uteri ; virology ; China ; Cross-Sectional Studies ; Female ; Humans ; Middle Aged ; Papillomaviridae ; classification ; isolation & purification ; Papillomavirus Infections ; epidemiology ; Risk Factors ; Surveys and Questionnaires

BACKGROUNDThe primary ovarian sarcoma is a very rare malignancy. The objective of this study was to further investigate the clinicopathologic features and outcome in patients with primary sarcoma of the ovary.

METHODSBetween 1988 and 2007, 24 patients with primary ovarian sarcoma who underwent treatment at Peking Union Medical Hospital were reviewed retrospectively. Response to treatment, progression and overall survival were analyzed.

RESULTSPatients with ovarian sarcoma had a mean age of (54.3 ± 10.3) years, and 16 of them were postmenopausal. The most common symptom was abdominal pain, present in 14 patients. Of the 24 patients, 16 patients were pathologically diagnosed as carcinosarcoma (known as malignant mixed mesodermal tumor (MMMT)), 2 as ovarian leiomyosarcoma (LS) and 6 patients as ovarian endometrial stromal sarcoma (ESS). The patients in optimal debulking group had a median survival period of 28 months and 1-year survival rate of 71%. The patients in suboptimal debulking group had a significantly lower median survival of 6 months (P = 0.02) and 1-year survival rate of 29%. Among the patients, 23 patients received chemotherapy and most of regimens were based on platinum, 3 patients received chemoradiation. The mean number of courses of combined chemotherapy was 6.6 ± 5.0, and the response was unsatisfactory. The median survival for the entire group was 18.7 months. The one-year survival rate was 58%, and two-year survival rate only 29%.

CONCLUSIONSOvarian primary sarcoma has a poor overall prognosis. Optimal debulking surgery appears to be of prognostic significance. There is a clear need for further study to explore the role and the regimen of platinum-based chemotherapy in primary ovarian sarcoma.

Adult ; Aged ; Female ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Ovarian Neoplasms ; diagnosis ; drug therapy ; radiotherapy ; surgery ; Retrospective Studies ; Sarcoma ; diagnosis ; drug therapy ; radiotherapy ; surgery ; Survival Rate

OBJECTIVES: This study aimed to develop susceptible-exposed-infectious-recovered-vaccinated (SEIRV) models to examine the effects of vaccination on coronavirus disease 2019 (COVID-19) case trends in Malaysia during Phase 3 of the National COVID-19 Immunization Program amidst the Delta outbreak. METHODS: SEIRV models were developed and validated using COVID-19 case and vaccination data from the Ministry of Health, Malaysia, from June 21, 2021 to July 21, 2021 to generate forecasts of COVID-19 cases from July 22, 2021 to December 31, 2021. Three scenarios were examined to measure the effects of vaccination on COVID-19 case trends. Scenarios 1 and 2 represented the trends taking into account the earliest and latest possible times of achieving full vaccination for 80% of the adult population by October 31, 2021 and December 31, 2021, respectively. Scenario 3 described a scenario without vaccination for comparison. RESULTS: In scenario 1, forecasted cases peaked on August 28, 2021, which was close to the peak of observed cases on August 26, 2021. The observed peak was 20.27% higher than in scenario 1 and 10.37% lower than in scenario 2. The cumulative observed cases from July 22, 2021 to December 31, 2021 were 13.29% higher than in scenario 1 and 55.19% lower than in scenario 2. The daily COVID-19 case trends closely mirrored the forecast of COVID-19 cases in scenario 1 (best-case scenario). CONCLUSIONS Our study demonstrated that COVID-19 vaccination reduced COVID-19 case trends during the Delta outbreak. The compartmental models developed assisted in the management and control of the COVID-19 pandemic in Malaysia.

OBJECTIVE: To evaluate the clinical outcomes of reverse total shoulder arthroplasty as a revision procedure for the failed fixation of proximal humeral fractures in the elderly patients. METHODS: A retrospective analysis was performed on 8 patients with failed internal fixation of proximal humeral fractures from May 2014 to March 2020, including 3 males and 5 females, aged from 65 to 75 years old. All 8 patients underwent reverse total shoulder arthroplasty, and the mean time between initial fixation and reverse total shoulder arthroplasty ranged from 8 to 16 months. Range of motion(ROM), University of California at Los Angeles(UCLA) shoulder score, visual analogue scale (VAS), self-rating anxiety scale(SAS), and Constant-Murley score of shoulder function were assessed pre-operatively and at the last follow-up. Complications relating to the surgery were recorded. RESULTS: All 8 patients successfully followed up. The mean follow-up after reverse total shoulder arhroplasty ranged from 16 to 28 months. The range of motion (forward flexion, external rotation, abduction and internal rotation) of the affected shoulder was significantly improved after surgery, and the post-operative VAS, SAS and UCLA scores were also significantly improved. For the Constant-Murley score of shoulder joint function, the total scores and the subscores of pain, daily activities, range of motion and strength test at the last follow-up were all significantly improved. Scapular glenoid notch was observed in patient, which was evaluated as grade 1 on imaging. All the other patients did not develop specific or non-specific complications. CONCLUSION Reverse total shoulder arhroplasty is an appropriate treatment as a revision surgery for failed fixation of proximal humeral fractures. It has shown satisfactory clinical outcomes, accelerating the rehabilitation of shoulder function and improving the quality of life.
Male ; Female ; Humans ; Aged ; Shoulder/surgery* ; Arthroplasty, Replacement, Shoulder/methods* ; Retrospective Studies ; Treatment Outcome ; Quality of Life ; Shoulder Joint/surgery* ; Shoulder Fractures/surgery* ; Humerus/surgery* ; Range of Motion, Articular