Objective To explore the related factors to influence the curative effect of focused ultrasound treatment for non neoplastic epithelial disorders of vulva. Methods A total of 382 patients with non neoplastic epithelial disorders of vulva were included in this study and treated by focused ultrasound. During and after the treatment, the symptoms and physical signs of the subjects were observed, and the efficacy was evaluated. We analyzed the relation between pathologic type, age, course, area, or itch degree and curative effect. Results Symptoms of all patients were relieved, and appearance and color of the vulva became normal after the ultrasound treatment, with a total effective rate of 99.74%. The cure ratios of patients with different pathologic types, ages, courses, areas, and itch degrees were significantly different (χ2=9.58, P<0.01; χ2=22.385, P<0.01; χ2=32.260, P<0.01; χ2=57.99,P<0.01; χ2=42.13,P<0.01, respectively). Conclusion Focused ultrasound treatment is safe and effective for the nonneoplastic epithelial disorders of the vulva and the efficacy is associated with the pathologic type, age, course, area, and itch degree.

Objective To investigate the clinical effect of dysmenorrhea in patients with adenomyosis treated by high intensity focused ultrasound (HIFU) ablation combined with gonadotropin-releasing hormone agonist (GnRH-a) and levonorgestrel-releasing intrauterine system (LNG-IUS). Methods From April 2012 to December 2015, 477 cases of adenomyosis patients with dysmenorrhea were treated by HIFU in the Third Xiangya Hospital. Among them, some patients were treated with HIFU alone, some of them were treated with HIFU combined with GnRH-a and (or) LNG-IUS, thus were classified as H group, H+G group, H+M group and H+G+M group. The improvements of clinical results were compared among the four groups and the influencing factors of HIFU treatment for adenomyosis were also analyzed. Results During the follow-up period, the overall effective rates of the treatment decreased with time, 3 months 89.4% (345/386), 12 months 84.0%(221/263), 24 months 74.2%(98/132), and the overall recurrence rate was 12.9%(39/303). The significant difference in the curative at 3 months [H group 83.7%(170/203), H+M group 95.0%(95/100), H+G group 100.0%(43/43), H+G+M group 96.8%(30/31)], 12 months [H group 79.4%(123/155), H+M group 93.2%(69/74), H+G group 11/12, H+G+M group 15/17], and 24 months [H group 68.0%(51/75), H+M group 96.4% (27/28), H+G group 6/12, H+G+M group 15/15] after HIFU treatment and recurrence rate [H group 19.0%(29/153), H+M group 3.3%(3/90), H+G group 19.4%(6/31), H+G+M group 4.5%(1/22)] were observed among the four groups (P<0.05). Pairwise comparison further showed that, in 3 months after the treatment, the effect of H group was significantly lower than those of H+M group and H+G group (P=0.003, P=0.005);in 12 months after the treatment, the effect of H group was significantly lower than that of H+M group (P=0.006);while in 24 months after treatment, the effect of H group was significantly lower than that of H+G+M group (P=0.005), and the effect of H+G group was lower than that of H+G+M group (P=0.001); and the recurrence rate of H group was significantly higher than that of H+M group (P<0.008). In patients of group H, the effect of HIFU was related to uterine size, the effect of patients with large uterine volume was significantly higher than that of small volume of uterine of patients (P=0.017, OR=2.739, 95%CI:1.200-6.251); with increasing of age, the improvement of dysmenorrhea had a increasing trend (P<0.05). Conclusions HIFU combined with GnRH-a and (or) LNG-IUS could improve the treatment effect in relief of dysmenorrhea. Based on our results, individual treatment protocol should be selected for different patients.

OBJECTIVE: To investigate the expression of high risk human papilloma virus (HPV) 16-E6 protein in non-neoplastic epithelial disorders of the vulva (NNEDV) and squamous cell carcinoma of the vulva (VSCC), and to explore whether HPV16-E6 protein is the etiological factor in NNEDV and its correlation with squamous cell carcinoma of the vulvae. METHODS: We detected HPV16-E6 protein expression in 15 normal vulvae cases, 40 NNEDV cases and 45 VSCC cases by immunohistochemistry SP method. RESULTS: The positive rate of HPV16-E6 in different vulva tissues: was 0% in the normal vulva, 30% in NNEDV and 66.67% in VSCC, respectively. The overall positive rate and two two comparison had statistical significance. In the NNEDV group, the positive rate of squamous hyperplasia type and lichen sclerosus type was 35% and 25%, respectively, with no statistical significance (P>0.05), but higher than that in the normal vulva skin group (P<0.05) and lower than that in the VSCC group (P<0.05). The positive rate of HPV16-E6 in VSCC was 66. 67%. The positive rate increased with the clinical stage. The positive rate between Phase I and Phase II, and that between Phase I and Phase III had statistical significance (P<0.017), but that between Phase II and Phase III had no statistical significance (P>0.017). The positive rate gradually decreased with the tumor differentiation. The difference in well-differentiated and poorly differentiated, moderately and poorly differentiated had statistical significance (P<0.017), but that of well-differentiated and moderately differentiated had no statistical significance (P>0.017). The positive rate of lymph node metastasis VSCC was significantly higher than that of non-lymph node metastasis VSCC (P<0.05). CONCLUSION HPV infection may be an etiological factor for NNEDV. The rise of HPV16-E6 positive rate may be related to the occurrence and development of vulvar squamous cell carcinoma.
Carcinoma, Squamous Cell ; metabolism ; virology ; Female ; Humans ; Hyperplasia ; Oncogene Proteins, Viral ; metabolism ; Papillomavirus Infections ; metabolism ; Precancerous Conditions ; metabolism ; virology ; Repressor Proteins ; metabolism ; Vulvar Diseases ; metabolism ; virology ; Vulvar Neoplasms ; metabolism ; virology

Spontaneous severe ovarian hyperstimulation syndrome-complicated natural pregnancy (SOHSSp) is a rare clinical entity and can be easily misdiagnosed as ovarian tumors. We report a case of SOHSSp in a 26-year-old women with successful delivery, and reviews the clinical data and the diagnosis and treatment of this case. The patient underwent a diagnostic laparoscopy and was followed-up for 1 year with a favorable prognosis.
Adult ; Female ; Humans ; Ovarian Hyperstimulation Syndrome ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome

OBJECTIVE: To study the characteristics of perioperative treatment of functional endoscopic nasal sinus surgery in elderly patients. METHOD: Data of 186 patients above 60 years old with chronic sinusitis were retrospectively analyzed. RESULT: After being received systematics and personal individuality treatment, the rates of curing were 72.5%, the rates of improving were 23.6% and the rates of efficiency were 96%. CONCLUSION The treatment of endoscopic sinus surgery is reliable and safe for elderly patients.
Aged ; Aged, 80 and over ; Chronic Disease ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; surgery ; Retrospective Studies ; Sinusitis ; surgery ; Treatment Outcome

In recent years, the detection rate and incidence of thyroid cancer are increasing, and there is a gap in the number and quality of thyroid surgeons. In order to meet the short-term clinical needs, young surgeons who are interested in thyroid cause and have the foundation of general surgery for 3 to 5 years can be selected to carry out 0.5-1 year thyroid surgery specialist training, while from the long-term demand, it is recommended to carry out thyroid surgery specialist training (2-3 years). Here, this paper puts forward some specific views and suggestions on the goal, content and assessment system of short-term and long-term thyroid surgery specialist training.

OBJECTIVE: To evaluate the genital human papillomavirus (HPV) infection in patients from gynecology clinic, and to investigate the association of persistent HPV infection with cervical lesions. METHODS: From January, 2009 to December, 2013, clinical data of 16 320 patients in Third Xiangya Hospital were collected. A retrospective analysis was carried out to evaluate the overall prevalence of HPV infection. The prevalence of HPV infection in different ages and subtypes were compared. The prevalence of persistent HPV infection and results of cervical cytology were analyzed. RESULTS: The overall HPV prevalence was 26.54%. The lowest overall and high-risk HPV prevalence were found in women at the age of 30-39 years old (P<0.05); the highest ones were found at the age of over 60 years old, with significant difference among the aged groups (P<0.05). There was no significant difference in low-risk HPV prevalence among the aged groups (P=0.693). The clearance rate of HPV was 87.65% one year later. There was no significant difference in high-risk and low-risk HPV infection between the non-persistent positive group and the persistent positive group (P=0.545), but the difference in single and multiple subtypes infection between these 2 groups was significant (P<0.05). In the persistent positive group, the most common genotypes were HPV 16, 52, 58, CP8304, and 33. The incidence of ASC-US, HSIL or SCC was significantly increased in the persistent positive group. CONCLUSION Persistent HPV infection mainly consists of multiple and high-risk HPV infection. It is necessary to focus on the prevention of HPV 16, 52 and 58 persistent infection in our region.
Adult ; Female ; Genotype ; Humans ; Middle Aged ; Papillomaviridae ; classification ; Papillomavirus Infections ; epidemiology ; Prevalence ; Retrospective Studies ; Vaginal Smears

Objective:To investigate the clinical effect of focused ultrasound ablation surgery (FUAS) combined with suction curettage for mass-type cesarean scar pregnancy (CSP) and to analyze the influencing factors of vaginal bleeding and readmission.Methods:From January 2014 to December 2020, 88 patients with mass-type CSP were treated by FUAS combined with suction curettage in the Third Xiangya Hospital of Central South University. The clinical results and the influencing factors of bleeding and readmission for mass-type CSP were analyzed.Results:All the patients underwent one time FUAS treatment successfully. Immediately after FUAS treatment, color Doppler ultrasound showed obvious necrosis and no perfusion area in all lesions, and the blood flow in the mass-type CSP tissue significantly decreased. The median volume of blood loss in the procedure was 20 ml (range: 5-950 ml). Thirteen patients (15%, 13/88) had vaginal bleeding≥200 ml, and 15 patients (17%, 15/88) were hospitalized again. The average time for menstruation recovery was (28±8) days (range: 18-66 days). The average time needed for serum human chorionic gonadotropin-beta subunit to return to normal levels was (22±6) days (range: 7-59 days). The risk of large vaginal bleeding of patients were related to the blood supply of the mass ( OR=5.280, 95% CI: 1.335-20.858, P=0.018) and the largest diameter of the mass ( OR=1.060, 95% CI: 1.010-1.120, P=0.030). The risk of readmission were related to the largest diameter of the mass ( OR=1.055, 95% CI: 1.005-1.108, P=0.030) and the depth of the uterus cavity ( OR=1.583, 95% CI: 1.015-2.471, P=0.043). No serious complications such as intestinal and nerve injury occurred during and after FUAS treatment. Conclusions:FUAS combined with suction curettage is safe and effective in treating patients with mass-type CSP through this preliminary study. The volume of vaginal bleeding are associated with the blood supply of the mass and the largest diameter of the mass, the risk of readmission are related to the largest diameter of the mass and the depth of the uterus cavity.

Objective:To analyze the risk factors of the number of central lymph node metastasis (CLNM) >5 in papillary thyroid microcarcinoma (PTMC) with clinical lymph node negative (cN0) .Methods:A total of 1567 cases of unilateral cN0 PTMC patients undergoing surgery at Endocrine and Breast Surgery Department of the First Affiliated Hospital of Chongqing Medical University from Jan. 2013 to Dec. 2018 were analyzed retrospectively. There were 405 cases of male and 1162 cases of female among them. According to the CLNM, they were divided into 0-5 and ≥5 groups. Clinicopathological characteristics of two groups were compared with Chi-square test and χ 2 test, et al. Results:The case of CLNM>5 involved was 4.1% (65/1567) .Univariate analysis showed that male, age ≤50 years old, tumor diameter> 8 mm, multifocal cancer all were related to CLNM>5 involved ( P<0.05) , multivariate logistic regression analysis found that male ( OR=1.886, P=0.017) , age ≤50 years ( OR=3.778, P=0.002) , tumor diameter>8 mm ( OR=2.483, P<0.001) and multifocal cancer ( OR=2.362, P=0.005) were independent risk factors for CLNM>5. Subgroup analysis showed that the number of Delphian lymph nodes metastasis≥1 ( OR=13.475, P<0.001) , pretracheal lymph nodes metastasis≥2 ( OR=41.695, P<0.001) , and Delphian+pretracheal lymph nodes metastasis≥2 ( OR=28.750, P<0.001) were also independent risk factors for CLNM>5. Conclusions:Unilateral PTMC patients who are male and age ≤50 years old with tumor diameter>8 mm, multifocal cancer have higher risk of central lymph nodes more than 5 involved, surgical treatment and prophylactic central neck dissection are recommended to such patients instead of long-term follow-up observation.Total thyroidectomy should be selected appropriately according to the intraoperative situation.

Objective:To analyze the relationship between body mass index (BMI) and clinicopathological characteristics of papillary thyroid carcinoma (PTC) .Methods:The clinicopathological data of 1025 PTC patients who underwent surgery therapy in Department of Endocrine and Breast surgery of the First Affiliated Hospital of Chongqing Medical University from Jan. 2016 to Dec. 2017 were retrospectively analyzed. BMI was calculated according to height and weight, and patients were divided into normal weight group (BMI<24 kg/m 2) and overweight and obese group (BMI≥24 kg/m 2) . The differences in clinicopathological characteristics of PTC patients in different BMI groups were compared, and the correlation between BMI and clinicopathological characteristics of PTC patients was studied. In addition, 342 PTC patients who underwent BRAF V600E and TERT gene tests were compared with different BMI groups to explore the relationship between BMI and BRAF V600E and TERT gene mutations. Results:In this research, there were 591 (57.66%) patients in the normal weight group and 434 (42.34%) patients in the overweight and obese group. Univariate analysis showed that BMI was associated with gender, age and Hashimoto’s thyroiditis. There were more male gender ( P<0.001) , and age≥55 years ( P<0.001) in overweight and obese groups, and less with Hashimoto’s thyroiditis ( P=0.045) in overweight and obese groups. There was no correlation between BMI and the clinicopathological features of PTC, such as bilaterality, multiformity, tumor size, etc. Otherwise, BMI was a weak protective factor for numbers of lymph node metastasis>5 of PTC ( OR=0.947, CI95%=0.9900-0.997, P=0.037) , and it was not correlated with extra thyroidal extension. There were no significant correlation between BMI and the clinicopathological characteristics of PTC patients of different genders, such as tumor size, bilaterality, extra thyroidal extension, lymph node metastasis, etc. A significant relationship was found between BMI and BRAF V600E mutation in PTC patients ( P=0.044) , while it was not correlated between BMI and TERT mutation ( P=0.516) . Conclusions:Our study suggests that BMI is associated with age, gender, hashimoto’s thyroiditis and BRAF V600E mutation in PTC patients, while there was no significant correlation with the aggressiveness in PTC. More radical treatment for PTC patients who were overweight or obese is not recommended.