Objective To systematically review the association between menstrual condition and the risk of breast cancer. Methods We searched The Cochrane Library (Issue 4, 2016), PubMed, EMbase, CNKI, WanFang Data, VIP and ScienceDirect databases from inception to June 1st 2016 to collect case-control studies about the association between menstrual condition and breast cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using Stata12.0 software. Results Eighty-three studies involving 48 811 breast cancer patients and 57 268 controls were finally included. The results of meta-analysis showed that breast cancer was associated with age at menarche≤13 years old (OR=1.17, 95%CI 1.12 to 1.24) and irregular menstruation (OR=1.98, 95%CI 1.62 to 2.41), but was not associated with history of dysmenorrhea, cycle time≥30 days and period of time>7 days. Further subgroup analysis showed that the sample size was one of the main source of heterogeneity for history of dysmenorrheal analysis, and breast cancer was associated with the history of dysmenorrhea after removing small-sampled studies (OR=1.47, 95%CI 1.36 to 1.59). The association between breast cancer and age at menarche≤13 years old, irregular menstruation was statistically significant in community control, but not in hospital control. The association between breast cancer and age at menarche≤13 years old, irregular menstruation were statistically significant both in Chinese and foreign population. Conclusion Early age at menarche, irregular menstruation and history of dysmenorrhea may be risk factors of breast cancer. Due to the limitation of quality and quanity of included studies, the above conclusions need more researches to verify.
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.
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.
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 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.
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 evaluate the sensitivity， specificity, and accuracy of magnetic resonance imaging （MRI） in characterizing adnexal masses. Methods The databases such as the Cochrane Library, PubMed， EMbase， CNKI， and WanFang Data were searched on computer from 1991 to 2011. The reviewers screened the trials according to inclusion and exclusion criteria strictly, extracted the data， and assessed the methodology quality. Meta-analysis were performed using the Metadisc 1.40 software. The acquired pooled sensitivity, specificity， and summary receiver operating characteristic curve （SROC） were used to describe the diagnostic value. The pooled likelihood ratios were calculated based on the pooled sensitivity and specificity. Results Ten case-control studies involving 649 women who were suspected to have pelvic masses were included and 729 masses were confirmed by the postoperative histopathology. The pooled statistical results of meta-analysis showed that：the sensitivity and specificity of MRI were 〔89%（84%-92%）， P=0.046 6〕 and 〔87% （83%-90%）， P=0.000 2〕 respectively, the positive and negative likelihood ratios of MRI were 6.25（P=0.008 5） and 0.14（P=0.029 1） respectively, and the area under the SROC curve （AUC） was 0.941. The sensitivity and specificity of ultrasound were 〔87%（82%-91%）， P=0.000 0〕 and 〔73%（69%-77%）, P=0.000 0〕 respectively, the positive and negative likelihood ratios of MRI were 3.07（P=0.000 0） and 0.18（P=0.000 1） respectively， and the AUC was 0.897. The speci?city and accuracy of MRI in characterizing female pelvic masses were higher than ultrasound obviously. Conclusion According these evidences， the MRI should be recommended to the women who are suspected to have pelvic masses as a preferred.
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.
