Objective To explore the feasibility and safety of tension-free vaginal tape-obturator for female stress urinary incontinence under the daytime surgical mode based on the concept of enhanced recovery after surgery. Methods The clinical data of female patients with stress urinary incontinence at the First Affiliated Hospital of Kunming Medical University between June 2019 and June 2023 were retrospectively analyzed. According to the perioperative management mode of patients, they were divided into daytime surgery group and routine surgery group. The basic, intraoperative, and postoperative conditions of two groups of patients were compared. Results Finally, 183 patients were included, including 91 in the routine surgery group and 92 in the daytime surgery group. All patients successfully completed the surgery. There was no statistically significant difference in age, preoperative comorbidities, surgeon in chief, or operation duration between the two groups of patients (P>0.05). The preoperative waiting time after hospitalization [(0.00±0.00) vs. (2.42±0.58) d], hospitalization expenses [(13815.10±2906.01) vs. (18095.21±3586.67) yuan], total surgical expenses [(3961.36±707.35) vs. (4440.19±1016.31) yuan], anesthesia expenses [(718.53±61.06) vs. (755.30±74.65) yuan], western medicine expenses [(818.07±259.30) vs. (1282.14±460.75) yuan], total hospitalization duration [(1.11±0.31) vs. (5.77±1.30) d], and postoperative hospitalization duration [(1.11±0.31) vs. (3.35±1.42) d] in the daytime surgery group were lower than those in the routine surgery group (P<0.05). There was no significant difference between the two groups in postoperative complications (respiratory complications, fever, nausea and vomiting, vaginal bleeding, urinary retention, peritonitis), satisfaction, postoperative pain or self perception of symptom improvement (P>0.05). Conclusion The daytime surgery for female stress urinary incontinence based on the concept of enhanced recovery after surgery is safe and feasible, which can shorten hospitalization duration and reduce hospitalization costs.
ObjectiveTo compare the clinical outcome of tension-free vaginal tape (TVT) and TVT-obturator (TVT-O) for female stress urinary incontinence (SUI).
MethodsSixty-one female SUI patients were included in our study, in which 33 received TVT procedure and 28 received TVT-O procedure. The patients were followed up for 1 to 62 months post-operatively, averaging at 22 months. Cure was defined as no leakage during the stress test and no residual urine showed by B ultrasound, improvement as less leakage during the stress test after operation, and inefficacy as leakage during the stress test and no difference was detected after operation.
ResultsAge and disease course were not significantly different between the two groups (P>0.05). All patients underwent TVT or TVT-O procedure successfully. Time of TVT ranged from 26 to 45 min averaging at (35.5±4.3) minutes, and it was significantly different from the time of TVT-O which ranged from 15 to 20 min averaging at (7.2±3.1) minutes (P<0.05). Bleeding during the surgery was not significantly different between the two groups (P>0.05). The rate of complications occurring during TVT-O procedure was significantly less and milder than that during the TVT procedure (P<0.05). The cure rate and improvement rate indicated no significant differences between the two groups (P>0.05).
ConclusionThe evidence available indicates that TVT and TVT-O procedure are both effective and safe for female SUI. Compared with TVT, TVT-O procedure has the advantages of being more convenient, shorter operation time, being less invasive, and fewer complications, and it may be more suitable for female SUI.
ObjectivesTo systematically review the epidemiology of high-risk human papillomavirus (HPV) infections in western Chinese females.MethodsPubMed, Web of Science, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect epidemiological studies on female genital high-risk HPV infection in western China from January 2000 to July 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, and then, meta-analysis was performed by using R software.ResultsA total of 35 studies involving 149 037 objects were included. The results of meta-analysis showed that: the total infection rate of high-risk HPV in the northwest was 12.21% (95%CI 10.0% to 16.72%), and that in the southwest was 17.48% (95%CI 13.55% to 21.4%). The infection rate of high-risk HPV among healthy females in the northwest was 10.03% (95%CI 10.0% to 11.67%), while that in the southwest was 14.94% (95%CI 11.51% to 18.38%). CINⅠ, CINⅡ-Ⅲ and cervical cancer patients in the northwest with high-risk HPV infection rate were 70.31% (95%CI 49.0% to 91.61%), 84.29% (95%CI 68.36% to 100.22%) and 89.35% (95%CI 74.15% to 104.55%), respectively. The infection rates of patients with corresponding lesions in the southwest were 59.06% (95%CI 45.87% to 72.25%), 83.79% (95%CI 76.62% to 90.96%), and 81.07% (95%CI 67.77% to 94.37%), respectively.ConclusionsCurrent evidence shows that the epidemiological pattern of female genital high-risk HPV infection in western China is basically consistent with overseas. The high-risk HPV subtypes are subtype 16, 18, 31, 52, 53 and 58. The HPV vaccine used in China has basically covered the prevalent high-risk HPV subtypes in Western China. The wide application of vaccine may reduce the incidence and mortality of cervical precancerous lesions and cervical cancer, which will ensure reproductive health females in Western China. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Objective To investigate the clinicopathological features, postoperative survival and prognostic influencing factors of male patients with hepatocellular carcinoma （HCC）. Methods The clinicopathological features and the follow-up data of 155 male HCC patients who received hepatectomy from Jan. 1995 to Dec. 2002 were retrospectively analyzed and the prognostic influencing factors were defined by uni- and multi-variate analysis. Results Compared with 24 female patients at the same period, males were about six-year older and both of their hepatitis B surface antigen (HBsAg) and liver cirrhosis positive rates were higher (P＜0.05)， but there were no significant differences of the other clinicopathological parameters between the male group and the female group. Multivariate analysis showed that Edmondson-Steiner grade and portal vein tumor thrombosis (PVTT) were two independent prognostic influencing factors of both the overall survival and the tumor-free postoperative survival of male patients with HCC, while satellite nodule and tumor size only influenced the overall survival. Conclusion The main clinicopathological features and the postoperative survival of male HCC patients were similar than those of female’s. Tumor differentiation and biological behaviors were major factors affecting postoperative survival of male patients with HCC.
Objective To systematically review the clinical presentations and gene types of oculo-facio-cardio-dental (OFCD) syndrome and to provide a theoretical basis for future diagnosis, prevention, and treatment of the disease. Methods The PubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang Data, and CNKI databases were electronically searched to collect studies on OFCD syndrome published from inception to March 1st, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. A systematic review was then performed. Results A total of 19 studies involving 83 patients with OFCD syndrome were included. The patients had an average age of 15.95±16.03 years, including 5 males and 78 females. The clinical presentations mainly included ocular disorders, facial abnormalities, cardiac disorders, dental abnormalities, physical anomalies, and dysfunctions of other body systems. BCOR gene mutations were detected in 71 patients with OFCD syndrome (overall detection rate: 86%, 95%CI 78% to 93%), of whom five were males (detection rate: 6%, 95%CI 1% to 11%) and 66 were females (detection rate: 80%, 95%CI 71% to 88%). Patients were mostly treated using multidisciplinary symptomatic treatment approaches based on clinical presentations and imaging findings. Conclusion In addition to the typical clinical presentations, BCOR gene testing results should also be taken into consideration for the differential diagnosis of OFCD syndrome. Although symptomatic therapies in clinical practice are relatively mature, they do not address the underlying cause of the disease, i.e., BCOR gene mutations. In future research, greater attention should be diverted to gene therapy.
ObjectiveTo find out the most appropriate way to fix scalp electrodes for long-range video electroencephalogram on female patients.
MethodsA total of 50 female patients with epilepsy who underment video electroencephalogram between May 2011 and May 2013 were divided into tonsure group, collodion group, and improvement group, with 40 patients in each group. Differences among three methods of fixation were observed and a questionnaire survey on satisfaction of patients and medical staff was conducted.
ResultsWe found that the modified-method cost less time, caused less pain during electrode removal, required fewer procedures for nurses and was more acceptable by patients.
ConclusionWe recommend the modified-method for female patients unless they are limited by some special conditions.
Objective To research clinic characteristics, therapies and 2-year progress of female patients with Non-ST-segment Elevation Acute Coronary Syndrome (NSTE-ACS). Methods This study was part of the internationalized Organization to Assess Strategies for Ischemic Syndromes (OASIS) registry. There was no intervention in the therapy. Patients admitted to hospital with NSTE-ACS (including unstable angina and non-Q wave myocardial infarction) were enrolled. The patients’ clinical characteristics, treatment procedure, major events in hospital and two-year progress were recorded by filling in Case Report Forms. Single-variate analyses were made between patients of difference genders. Results A total of 2 294 patients with NSTE-ACS were enrolled in China. The female patients were 37.7% (n=864), whose mean age was 65.1±6.7 years. Unstable angina dominant (90.7%) was noted on admission. The percentage of patients with abnormal ECG was 92.6%. The prior hypertension and diabetes were 64.1% and 23.4%, respectively, in female patients which were evidently higher than those of males (P≤0.001). The prior coronary heart disease, old myocardial infarction, smoking, and percutaneous coronary intervention (PCI) were 39.4%, 16.8%, 11.7%, and 2.3% respectively, in females, which were evidently lower than in males (P≤0.001). The prior history of coronary artery bypass graft (CABG) surgery was 0.5% in females, which was evidently lower than in males (P≤0.05). During hospitalization, the therapeutic rates of anti-platelets and β-adrenergic blockers were 92.8% and 64.8%, respectively, in female patients, which were observably lower than in males (P≤0.05). The therapeutic rates of nitrates, angiotensin-converting enzyme inhibitor (ACEI), calcium antagonists, lipid lowering agents were 96.9%, 60.0%, 59.1%, and 47.1%, respectively, in females, which were not significantly different from those of males. The medication rate in females fell off gradually after discharge, which was more evident than in males. In two-year follow up, the therapeutic rates of anti-platelets, β-adrenergic blockers, ACEI, and lipid lowering agents were 68.4%, 39.5%, 27.4%, and 19.4%, respectively, in female patients, which were markedly lower than those in males (P≤0.05). During hospitalization, the therapeutic rates of PCI and CABG were 10.5% and 2.7%, respectively. In two year follow-up, their therapeutic rates were 13.4% and 4.8%, respectively. The rate of females performing revascularization procedures was evidently lower than that of males (P≤0.001), either during hospitalization or in two-year follow up. In two years of follow up, mortality and incidence rates of new myocardial infarction, stroke, heart failure, hospitalization because of refractory angina were 7.4%, 4.7%, 6.8%, 15.4%, and 31.3%, respectively, in female patients. There were no significant differences between females and males (Pgt;0.05). Conclusion Compared with male patients, female patients with NSTE-ACS are less likely to adopt and / or attach importance to treatment. As to the reason why there are no significant differences in major events of NSTE-ACS between females and males under the current circumstance that females’ treatment is inferior to males’, gender of females is an important protective factor.
ObjectiveTo investigate the clinical significance of Q-angle measuring under different conditions in female recurrent patellar dislocation female patients.
MethodsBetween August 2012 and March 2013, 10 female patients (11 knees) with recurrent patellar dislocation were collected as trial group; 20 female patients (20 knees) with simple meniscus injury were collected as control group at the same time. Q-angle was measured in extension, 30° flexion, 30° flexion with manual correction, and surgical correction in the trial group, and only in extension and 30° flexion in the control group. Then the difference value of Q-angle between extension and 30° flexion (Q-angle in extension subtracts Q-angle in 30 flexion) were calculated. Independent sample t-test was used to analyze Q-angle degrees in extension, 30° flexion, and the changed degrees of 2 groups. The Q-angle between manual correction and surgical correction of the trial group was analyzed by paired t-test.
ResultsThe Q-angle in extension, Q-angle in 30° flexion, and difference value of Q-angle between extension and 30° flexion were (17.2±3.6), (14.3±3.0), and (2.9±1.9)° in the trial group and were (15.2±3.4), (14.4±3.5), and (0.8±1.7)° in the control group. No significant difference was found in Q-angle of extension or Q-angle of 30° flexion between 2 groups (P>0.05), but the difference value of Q-angle between extension and 30° flexion in the trial group was significantly larger than that in the control group (t=3.253, P=0.003). The Q-angle in 30° flexion with manual correction and surgical correction in the trial group was (19.8±3.4)° and (18.9±3.8)° respectively, showing no significant difference (t=2.193, P=0.053).
ConclusionWhen a female patient's Q-angle in 30° flexion knee changes obviously compared with Q-angle in extension position, recurrent patellar dislocation should be considered. For female patients with recurrent patellar dislocation, the preoperative Q-angle in 30° flexion with manual correction should be measured, which can help increasing the accuracy of evaluation whether rearrangement should be performed.
