Objective: Observe and correlate the funneling of upper cervical canal by ultrasound and likelihood of cervical incompetence and premature delivery in twin pregnancy. Materials and methods: Retrospective study in twin...Objective: Observe and correlate the funneling of upper cervical canal by ultrasound and likelihood of cervical incompetence and premature delivery in twin pregnancy. Materials and methods: Retrospective study in twin pregnancies deliveries in 1997, in king Faisal specialist hospital and research center, Riyadh, Saudi Arabia. A total of 67 twin pregnancies underwent routine ultrasound for fetal assessment, when the cervix closed, long;and short, funneling. The time of ultrasound was divided in three groups by gestational age: from 18 to 22 weeks;from 22 to 26 weeks and from 26 to 30 weeks. The gestational age at delivery was our outcome parameter and subdivided the patients in 4 groups, group 1: patients delivered before 24 weeks (n = 4);group 2: delivered between 24 and 34 weeks (n = 16);group 3: delivered between 34 weeks and 36 weeks and 6 days (n = 18);and group 4: delivered with gestational age equal or above 37 weeks (n = 29). The data was analyzed statistically using Pearson chi square method and p value below 0.05 was considered significant. Results: There was no significant difference among the 4 subgroups in maternal age, body mass index, parity, previous history of preterm delivery or presence of urinary/vaginal infection in actual pregnancy. There was stronger history of mid trimester abortion in patients delivered before 34 weeks of gestational age. Considering the cervical sonographic findings, the diagnosis of funneling between 18 - 22 weeks was higher among the group delivered before 34 weeks of gestational age (1 and 2) comparing to other groups (3 and 4) with p value equal to 0.016. The finding in ultrasound justifies the results of higher aggressive management in patients from groups 1 and 2 comparing with groups 3 and 4;admission to hospital (p = 0.007);emergency cerclage (p = 0.04), complete hospital bed rest (p = 0.002). Conclusion: Cervical assessment during routine ultrasound in twins pregnancy seems to be useful for prediction of preterm delivery and counseling the patient without risk factors regarding cervical cerclage. Because of restricted number of patients, especially group 1 (11 = 4), we suggest further study with bigger sample and prospective trial for valued conclusion.展开更多
Objective: Observe and correlate the cervical length by ultrasound and likelihood of cervical incompetence and premature delivery in multiple gestations. Materials and Methods: Retrospective study in multiple pregnanc...Objective: Observe and correlate the cervical length by ultrasound and likelihood of cervical incompetence and premature delivery in multiple gestations. Materials and Methods: Retrospective study in multiple pregnancy (twin, triplet, quadruplet) delivered between 2002-2003, in King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. A total of 68 multiple pregnancies underwent routine ultrasound for fetal assessment between 16 - 32 weeks when the cervix was observed. The sonographic measurements included cervix > 2.5 cm and <2.5 cm. The time of ultrasound was divided in five groups by gestational age from 18 - 20 weeks, 21 - 24 weeks, 25 - 26 weeks, 29 - 32 weeks and >32 weeks. The gestational age at delivery was our outcome parameter. The data was analyzed statistically using Fisher’s exact test and P-value below 0.05 was considered significant. Results: Endovaginal ultrasongoraphic cervical measurement in multiple pregnancies predicted increased preterm delivery risk regardless of maternal age, previous history of preterm deliveries or presence of vaginal infection. It was found that spontaneous preterm labor < 32 weeks is a relatively rate outcome with cervix > 25 mm;this majority reached > 32 weeks while the patient who had cervix < 25 mm, 1 in 25 of the women who underwent a cervical ultrasound assessment will have preterm labor. The finding in ultrasound justifies the results of higher aggressive management inpatient with cervix Conclusion: Cervical assessment during routine ultrasound in multiple gestations seems to be useful for prediction of preterm delivery and counseling the patient without risk factors regarding cervical cerclage. Because of restricted number of patients, we suggest further study with bigger sample and prospective trial for valued conclusions.展开更多
This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Sample...This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Samples with screening results showing atypical squamous cells of undetermined significance （ASC-US） or worse were referred for colposcopy, and some samples were tested for high-risk HPV types with the Hybrid Capture II system （HC II）. Data on LCT （n=61,193） and HC II （n=1056） results were analysed. Overall test positivity for LCT was 2.53% using an ASC-US threshold, 3.11% using a low-grade squamous intraepithelial lesion （LSIL） threshold, and 0.67% using a high-grade squamous intraepithelial lesion （HSIL） threshold. A total of 1839 women （84% of the 3893 patients with abnormal cytology） underwent colposcopy-directed biopsy. HPV was positive in 80.3% of women with cervical intraepithelial neoplasia 1 （CIN1）, 88.3% of those with CIN2, 79.2% of women with CIN3 and 50% （2 of 4） of women with invasive cancer. There was a significant increase in the detection of CIN2 or worse with adjunct HPV testing of women with ASC-US and LSIL However, there were detection of CIN2＋ cases no differences in the with adjunct HPV testing of women with HSlI.. The results indicate that HPV testing for HSlL triage should not be recommended in cervical cancer screening.展开更多
Objective:To observe the clinical effect of combined acupuncture and kinesiotherapy on upper cross syndrome(UCS) by a parallel randomized clinical trial.Methods:A total of 45 patients with UCS were recruited from the ...Objective:To observe the clinical effect of combined acupuncture and kinesiotherapy on upper cross syndrome(UCS) by a parallel randomized clinical trial.Methods:A total of 45 patients with UCS were recruited from the outpatients of AcupunctureMoxibustion,Tuina and Rehabilitation Department of the First Affiliated Hospital of Hunan University of Chinese Medicine,the students of Hunan University of Chinese Medicine and the patients from the nearby communities in accordance with the inclusion criteria.Using the random number table method,they were divided into a combined treatment group(acupuncture plus kinesiotherapy,23 cases) and a simple kinesiotherapy group(22 patients).Treatment for 4 weeks was one course,and two consecutive courses were required.The visual analog scale(VAS) score,the score of the assessment scale for cervical spondylosis,the value of surface electromyography(root mean square,RMS),and the cervical curvature value were used in the evaluation.The allocation scheme was concealed from the outcome assessors.Results:The data from 23 cases of the combined treatment group and 22 cases of the simple kinesiotherapy group were analyzed.Before treatment,the differences were not statistically significant in the general conditions,VAS score,assessment score of cervical spondylosis,cervical curvature value,and RMS in UCS patients between the two groups(all P> 0.05).After treatment,the VAS score was reduced compared with that before treatment in both groups(all P <0.05).In two courses of treatment,the VAS score decreased as compared with that in one course of treatment in both groups(both P <0.05),and the VAS score in the combined treatment group decreased more obviously after each course of treatment(both P <0.05).The RMS decreased compared with that before treatment in each group(both P <0.05),and the decrease in the combined treatment group was more obvious(P <0.05).After treatment of each course,the assessment score was all increased as compared with that before treatment in two groups(all P <0.05).In two courses of treatment,the assessment score was increased as compared with that in one course of treatment in both groups(both P <0.05),and the score in the combined treatment group was increased more obviously in the two courses of treatment(P <0.05).Regarding either the intra-group comparison or the inter-group comparison before and after treatment,the differences were not statistically significant(all P> 0.05),suggesting no obvious improvement of cervical curvature in the two courses of treatment in patients with UCS.However,cervical curvature tended to improve in the combined treatment group.The total effective rate was significantly different between the two groups(P <0.05),indicating that the total effective rate in the combined treatment group was better than that in the simple kinesiotherapy group.No any adverse reactions occurred.Conclusion:Combined treatment with acupuncture,kinesiotherapy,and kinesiotherapy alleviated pain,relieved the symptoms and physical signs,and improved the daily movement of the patients.However,the combined treatment of acupuncture and kinesiotherapy had a much better effect on UCS.展开更多
文摘Objective: Observe and correlate the funneling of upper cervical canal by ultrasound and likelihood of cervical incompetence and premature delivery in twin pregnancy. Materials and methods: Retrospective study in twin pregnancies deliveries in 1997, in king Faisal specialist hospital and research center, Riyadh, Saudi Arabia. A total of 67 twin pregnancies underwent routine ultrasound for fetal assessment, when the cervix closed, long;and short, funneling. The time of ultrasound was divided in three groups by gestational age: from 18 to 22 weeks;from 22 to 26 weeks and from 26 to 30 weeks. The gestational age at delivery was our outcome parameter and subdivided the patients in 4 groups, group 1: patients delivered before 24 weeks (n = 4);group 2: delivered between 24 and 34 weeks (n = 16);group 3: delivered between 34 weeks and 36 weeks and 6 days (n = 18);and group 4: delivered with gestational age equal or above 37 weeks (n = 29). The data was analyzed statistically using Pearson chi square method and p value below 0.05 was considered significant. Results: There was no significant difference among the 4 subgroups in maternal age, body mass index, parity, previous history of preterm delivery or presence of urinary/vaginal infection in actual pregnancy. There was stronger history of mid trimester abortion in patients delivered before 34 weeks of gestational age. Considering the cervical sonographic findings, the diagnosis of funneling between 18 - 22 weeks was higher among the group delivered before 34 weeks of gestational age (1 and 2) comparing to other groups (3 and 4) with p value equal to 0.016. The finding in ultrasound justifies the results of higher aggressive management in patients from groups 1 and 2 comparing with groups 3 and 4;admission to hospital (p = 0.007);emergency cerclage (p = 0.04), complete hospital bed rest (p = 0.002). Conclusion: Cervical assessment during routine ultrasound in twins pregnancy seems to be useful for prediction of preterm delivery and counseling the patient without risk factors regarding cervical cerclage. Because of restricted number of patients, especially group 1 (11 = 4), we suggest further study with bigger sample and prospective trial for valued conclusion.
文摘Objective: Observe and correlate the cervical length by ultrasound and likelihood of cervical incompetence and premature delivery in multiple gestations. Materials and Methods: Retrospective study in multiple pregnancy (twin, triplet, quadruplet) delivered between 2002-2003, in King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. A total of 68 multiple pregnancies underwent routine ultrasound for fetal assessment between 16 - 32 weeks when the cervix was observed. The sonographic measurements included cervix > 2.5 cm and <2.5 cm. The time of ultrasound was divided in five groups by gestational age from 18 - 20 weeks, 21 - 24 weeks, 25 - 26 weeks, 29 - 32 weeks and >32 weeks. The gestational age at delivery was our outcome parameter. The data was analyzed statistically using Fisher’s exact test and P-value below 0.05 was considered significant. Results: Endovaginal ultrasongoraphic cervical measurement in multiple pregnancies predicted increased preterm delivery risk regardless of maternal age, previous history of preterm deliveries or presence of vaginal infection. It was found that spontaneous preterm labor < 32 weeks is a relatively rate outcome with cervix > 25 mm;this majority reached > 32 weeks while the patient who had cervix < 25 mm, 1 in 25 of the women who underwent a cervical ultrasound assessment will have preterm labor. The finding in ultrasound justifies the results of higher aggressive management inpatient with cervix Conclusion: Cervical assessment during routine ultrasound in multiple gestations seems to be useful for prediction of preterm delivery and counseling the patient without risk factors regarding cervical cerclage. Because of restricted number of patients, we suggest further study with bigger sample and prospective trial for valued conclusions.
基金funded by Beijing Municipal Science & Technology Commission(No.Y0905001000091)
文摘This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Samples with screening results showing atypical squamous cells of undetermined significance （ASC-US） or worse were referred for colposcopy, and some samples were tested for high-risk HPV types with the Hybrid Capture II system （HC II）. Data on LCT （n=61,193） and HC II （n=1056） results were analysed. Overall test positivity for LCT was 2.53% using an ASC-US threshold, 3.11% using a low-grade squamous intraepithelial lesion （LSIL） threshold, and 0.67% using a high-grade squamous intraepithelial lesion （HSIL） threshold. A total of 1839 women （84% of the 3893 patients with abnormal cytology） underwent colposcopy-directed biopsy. HPV was positive in 80.3% of women with cervical intraepithelial neoplasia 1 （CIN1）, 88.3% of those with CIN2, 79.2% of women with CIN3 and 50% （2 of 4） of women with invasive cancer. There was a significant increase in the detection of CIN2 or worse with adjunct HPV testing of women with ASC-US and LSIL However, there were detection of CIN2＋ cases no differences in the with adjunct HPV testing of women with HSlI.. The results indicate that HPV testing for HSlL triage should not be recommended in cervical cancer screening.
基金Supported by Leading Talents Training Program of Hunan Province High-Level Health Talents 225 Project (Hunan Health-20N9-N9S)。
文摘Objective:To observe the clinical effect of combined acupuncture and kinesiotherapy on upper cross syndrome(UCS) by a parallel randomized clinical trial.Methods:A total of 45 patients with UCS were recruited from the outpatients of AcupunctureMoxibustion,Tuina and Rehabilitation Department of the First Affiliated Hospital of Hunan University of Chinese Medicine,the students of Hunan University of Chinese Medicine and the patients from the nearby communities in accordance with the inclusion criteria.Using the random number table method,they were divided into a combined treatment group(acupuncture plus kinesiotherapy,23 cases) and a simple kinesiotherapy group(22 patients).Treatment for 4 weeks was one course,and two consecutive courses were required.The visual analog scale(VAS) score,the score of the assessment scale for cervical spondylosis,the value of surface electromyography(root mean square,RMS),and the cervical curvature value were used in the evaluation.The allocation scheme was concealed from the outcome assessors.Results:The data from 23 cases of the combined treatment group and 22 cases of the simple kinesiotherapy group were analyzed.Before treatment,the differences were not statistically significant in the general conditions,VAS score,assessment score of cervical spondylosis,cervical curvature value,and RMS in UCS patients between the two groups(all P> 0.05).After treatment,the VAS score was reduced compared with that before treatment in both groups(all P <0.05).In two courses of treatment,the VAS score decreased as compared with that in one course of treatment in both groups(both P <0.05),and the VAS score in the combined treatment group decreased more obviously after each course of treatment(both P <0.05).The RMS decreased compared with that before treatment in each group(both P <0.05),and the decrease in the combined treatment group was more obvious(P <0.05).After treatment of each course,the assessment score was all increased as compared with that before treatment in two groups(all P <0.05).In two courses of treatment,the assessment score was increased as compared with that in one course of treatment in both groups(both P <0.05),and the score in the combined treatment group was increased more obviously in the two courses of treatment(P <0.05).Regarding either the intra-group comparison or the inter-group comparison before and after treatment,the differences were not statistically significant(all P> 0.05),suggesting no obvious improvement of cervical curvature in the two courses of treatment in patients with UCS.However,cervical curvature tended to improve in the combined treatment group.The total effective rate was significantly different between the two groups(P <0.05),indicating that the total effective rate in the combined treatment group was better than that in the simple kinesiotherapy group.No any adverse reactions occurred.Conclusion:Combined treatment with acupuncture,kinesiotherapy,and kinesiotherapy alleviated pain,relieved the symptoms and physical signs,and improved the daily movement of the patients.However,the combined treatment of acupuncture and kinesiotherapy had a much better effect on UCS.
