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single-course methotrexate alone or combined with dactinomycin versus multi-course methotrexate for low-risk gestationaltrophoblastic neoplasia: a multi-centric randomized clinical trial

《医学前沿（英文）》 2022年 第16卷 第2期   页码 276-284 doi: 10.1007/s11684-021-0855-4

摘要： We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX+ dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference –5.1%, 95% confidence interval (CI) –19.4% to 9.2%, P=0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P=0.577). For the single-course MTX+ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%–36.6%, P<0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P=0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.

关键词： gestational trophoblastic neoplasia (GTN)     methotrexate (MTX)     dactinomycin (ACTD)    

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Difference between 2 h and 3 h 75 g glucose tolerance test in the diagnosis of gestational diabetes mellitus

Xue-Lian GAO, Yu-Mei WEI, Hui-Xia YANG, Xian-Ming XU, Ling FAN, Jing HE, Ning LIU, San-Cun ZHAO, Ya-Li HU, Zi YANG, Yun-Ping ZHANG, Xing-Hui LIU, Xu CHEN, Jian-Ping ZHANG, Wen-Li GOU, Mei XIAO, Hai-Rong WU, Mei-Hua ZHANG

《医学前沿（英文）》 2010年 第4卷 第3期   页码 303-307 doi: 10.1007/s11684-010-0090-x

摘要： The possibility of the 2 h oral glucose tolerance test (OGTT) as an alternative to the 3 h OGTT was investigated based on data from a national survey on pregnancy-associated diabetes. Data were retrieved from 4179 pregnant women who had OGTT performed after an abnormal 50 g glucose challenge test (GCT). All of the 4 glucose levels during their OGTT were collected and analyzed. According to American Diabetes Association (ADA) gestational diabetes mellitus (GDM) diagnostic criteria, among the 4179 pregnant women who required OGTT, 3429 (82.1%) were normal and 750 (17.9%) were diagnosed as GDM. If the 3rd h glucose levels were omitted from OGTT, 79 cases of GDM (10.5%) would be overlooked. No trend was shown where women with more risk factors were more likely to be overlooked if the 3rd h test was omitted ( for trend= 0.038, >0.05). No significant differences were found in the rate of cesarean section (CS), preterm births or macrosomia between the 79 cases and those with normal OGTT results and in the gestational weeks when OGTT was performed. It shows that in order to diagnose one woman with GDM, another 52 pregnant women would have an innocent 3rd h glucose test. Omission of the 3rd h glucose test in OGTT might be reasonable due to its convenience, better compliance and a small number of possibly miss-diagnosed cases, and their pregnancy outcomes have no significant difference from those of normal pregnant women.

关键词： diabetes     gestational     oral glucose tolerance test    

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Epidemiological studies of women under age 30 infected with human papillomavirus

Zhihua LIU MD, Qing LI BM, Weihong LI BM,

《医学前沿（英文）》 2009年 第3卷 第4期   页码 459-462 doi: 10.1007/s11684-009-0084-8

摘要： The aim of this paper was to investigate the prevalence of human papilloma virus (HPV) infection in women under 30 years old with cervical intraepithelial neoplasia (CIN) or cervical cancer, in order to provide a basis for cervical cancer prevention and treatment. We recruited 2052 female cases from the education system in Futian District, Shenzhen city, from April 2006 to April 2008, with age ranging from 22 to 60 years old. Second-generation hybrid capture test was done for detection of female genital tract HPV and cervical colposcopy for screening CIN or cervical cancer. The prevalence of HPV and cervical precancerous lesions or cervical cancer was evaluated in different age groups of women. The HPV positive rate was 247/2052 (12.00%), and 35/2052 (1.71%) of the cases were≥CIN I by pathological diagnosis. In the 22―29-year-old age group, there were 291 cases, including 39HPV-positive cases (13.40%) and one case of pathological diagnosis≥CIN I (0.34%), and there were 1761 cases in the 30―60-year-old age group, including 208 HPV-positive cases (11.81%) and 34 cases of pathological diagnosis≥CIN I (1.93%). The HPV-positive rate of 22―29-year-old age group was higher than that of 30―60-year-old age group, but the difference was not significant ( = 0.5967, = 0.4398); the CIN and cervical cancer detection rate of the former group was lower than that of the latter one, and the difference was not significant either ( = 3.7519, = 0.0527). The cases in 30―60-year-old age group were divided into five age sub-groups, and the HPV-positive rate of the 22―29-year-old age group was compared with the remaining groups, and it was found that the HPV-positive rate of the former group (13.40%) was lower than that of the 40―44-year-old age group (14.70%) but higher than that of the other four groups. Moreover, the difference in the HPV-positive rate between the 22―29-year-old age group and the 50―60-year-old age group (6.06%) was significant ( = 5.545, = 0.018), but the difference between the 22― 29-year-old age group and each of the other four groups was not significant (>0.05). In addition, the CIN and cervical cancer detection rate of the 22―29-year-old age group (0.34%) was lower than that of the remaining five groups, and the difference between the 22―29-year-old age group and the 35―39-year-old age group (2.26%), and between 22―29-year-old age group and 40―44-year-old age group (2.30%) was significant ( = 4.446, = 0.0035; = 4.525, = 0.0363, respectively), but the difference between the 22―29-year-old age group and each of other three groups was not significant (>0.05). Furthermore, 80.00% (28/35) cases of pathological diagnosis≥CIN I and 90.91% (10/11) lesions of pathological diagnosis≥CIN II occurred at 35―49 years of age. For many young women below the age of 30 who were infected with high-risk HPV were one-off infections, so it was not appropriate to recommend HPV detection as cervical precancerous lesions or cancer screening program for women less than 30 years old. The prevention and treatment of cervical cancer should be focused on those women more than 35 years of age.

关键词： cervical cancer     human papilloma virus     cervical intraepithelial neoplasia    

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Clinical significance of human papilloma virus infection in the cervical lesions

Shuang LI, Yu-Han MENG, Hu TING, Jian SHEN, Ding MA

《医学前沿（英文）》 2010年 第4卷 第3期   页码 264-270 doi: 10.1007/s11684-010-0094-6

摘要： Cervical lesions have been regarded as the common and frequently occurring diseases in China. Recently, the morbidity and youth tendency of cervical cancer have gradually increased. Cervical cancer, related with human papilloma virus (HPV) infection, has been one of the severest diseases threatening health and life of women, and is an infectious disease. The universality of HPV infection in the reproductive tract should not be ignored. The well-known risk factors of HPV infection in cervical lesions consist of high-risk sexual behaviors, immunosuppression, age, contraceptive methods, the concurrent infection of other sexually transmitted diseases, etc. The variation of cervical lesions induced by HPV infection is involved in the continuous pathological process, including the subclinical, latent, and persistent infection of high risk (HR)-HPV, chronic cervicitis with abnormal results of cytological examination, cervical intraepithelial neoplasia (CIN), and cervical cancer. The outcome of patients with HPV infection is influenced by many factors, such as HPV subtype dominance, persistent HPV infection, HPV loading dose, and multiple HPV infection. Controlling HR-HPV persistent infection should be an important strategy for reducing cervical lesions.

关键词： cervical lesion     high risk-human papilloma virus     persistent infection     loading dose     cervical intraepithelial neoplasia     cervical cancer    

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标题 作者 时间 类型 操作

single-course methotrexate alone or combined with dactinomycin versus multi-course methotrexate for low-risk gestationaltrophoblastic neoplasia: a multi-centric randomized clinical trial

期刊论文

Difference between 2 h and 3 h 75 g glucose tolerance test in the diagnosis of gestational diabetes mellitus

Xue-Lian GAO, Yu-Mei WEI, Hui-Xia YANG, Xian-Ming XU, Ling FAN, Jing HE, Ning LIU, San-Cun ZHAO, Ya-Li HU, Zi YANG, Yun-Ping ZHANG, Xing-Hui LIU, Xu CHEN, Jian-Ping ZHANG, Wen-Li GOU, Mei XIAO, Hai-Rong WU, Mei-Hua ZHANG

期刊论文

Epidemiological studies of women under age 30 infected with human papillomavirus

Zhihua LIU MD, Qing LI BM, Weihong LI BM,

期刊论文

Clinical significance of human papilloma virus infection in the cervical lesions

Shuang LI, Yu-Han MENG, Hu TING, Jian SHEN, Ding MA

期刊论文