Prevalence of type-specific human papillomavirus and pap results in Chinese women: a multi-center, population-based cross-sectional study

Purpose

To estimate the burden of human papillomavirus (HPV) infection among sexually active women in China.

Methods

We conducted a multi-center, population-based study between May 2006 and April 2007. A total of 4,215 women aged 17–54 years were surveyed from five geographical sites: Beijing, Shanghai, Shanxi, Henan, and Xinjiang. Direct endocervical exfoliated cells were collected from consenting participants for Sure Path liquid-based cytology (BD) and HPV testing. HPV testing was performed with Hybrid Capture II (Qiagen) with high-risk and low-risk probes, and Linear Array (Roche) was utilized for HPV genotyping.

Results

Approximately 11 % of the study population had a cytological abnormality (ASCUS or worse). HPV prevalence in the entire study population was 14.3 % (age-standardized to the world standard female population 14.5 %). The most prevalent types found were HPV16 (2.9 %), HPV52 (1.7 %), HPV58 (1.5 %), HPV33 (1 %), and HPV18 (0.8 %). Patterns of HPV prevalence differed by age, geographic region, and cytology findings. However, HPV16 was predominant among all grades of cytological abnormalities for all areas.

Conclusions

Although HPV18 appeared to be less frequent among population-based samples of China, given the high prevalence of HPV 16 and 18 in high-grade squamous intraepithelial lesion (HSIL) or worse pap abnormalities, prophylactic HPV16/18 vaccines should substantially reduce the burden of cervical cancer in China.     

Assessment of quality of life for the patients with cervical cancer at different clinical stages

With improved overall survival of cervical cancer patients, the importance of the quality of life (QOL) is increasingly recognized. This study was conducted to compare the QOL of women with different stage cervical cancer before and after treatment to facilitate improved cervical cancer prevention and treatment. We used the generic Medical Outcomes Study Short Form-36 (MOS SF-36) to collect QOL information. Based on SF-36, we interviewed cervical cancer patients at West China Second Affiliated Hospital and Sichuan Cancer Hospital between May 2010 and January 2011. A total of 92 patients with precancerous lesions, 93 with early cancer, and 35 with advanced cancer responded to our survey. Average physical component summary (PCS) scores were significantly different between the three groups at every time point (P 0.05). Average mental component summary (MCS) scores were significantly different between the three groups after treatment (P 0.05). Average PCS and MCS scores increased gradually from the pretreatment to posttreatment period for patients with precancerous lesions. However, they reached the lowest at 1 month after treatment for patients with early and advanced cancers and rebounded between 1 and 6 months after treatment. Our results indicate that patients with precancerous lesions and early cervical cancer show better overall QOL than do those with advanced cervical cancer. Additionally, patients with early cancer recover more quickly than do those with advanced cancer in terms of both physical and mental functions. Thus, early detection and treatment initiatives may improve the QOL for patients with precancerous lesions and cervical cancer.     

Asymmetric dimethylarginine: clinical applications in pediatric medicine

Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase (NOS). Growing evidence indicates that ADMA plays an important role in the initiation and progression of a variety of adulthood diseases, especially in the cardiovascular and renal systems. However, the study of ADMA in pediatric diseases has just begun. This review provides an overview of potential clinical applications of ADMA in pediatric practice, with an emphasis on the following areas: the biochemistry and pathophysiology of ADMA; clinical ramifications of elevated ADMA levels in pediatric population; age-related normal reference ranges of ADMA; methodology for measuring ADMA; current and potential agents to reduce ADMA; and the problems that must be addressed before use of ADMA in pediatric medicine. ADMA will soon be available for use as a biomarker and therapeutic target in the pediatric population.     

The association between dietary intake and cervical intraepithelial neoplasia grade 2 or higher among women in a high-risk rural area of china

Objective  

To evaluate the relationship between dietary intake and risk of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) while controlling for human papillomavirus (HPV) infection.     

Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility

Background Echocardiography is the first-line modality for the investigation of neonatal congenital heart disease. Diagnostic cardiac catheterization, which has a small but recognized risk, is usually performed if echocardiography fails to provide a confident evaluation of the lesions. Objective To verify the technical and clinical feasibilities of replacing diagnostic cardiac catheterization with multidetector-row CT (MDCT) in neonatal complex congenital heart disease. Materials and methods Over a 1-year period we prospectively enrolled all neonates with complex congenital heart disease referred for diagnostic cardiac catheterization after initial assessment by echocardiography. MDCT was performed using a 40-detector-row CT scanner with dual syringe injection. A multidisciplinary congenital heart disease team evaluated the MDCT images and decided if further diagnostic cardiac catheterization was necessary. The accuracy of MDCT in detecting separate cardiovascular anomalies and bolus geometry of contrast enhancement were calculated. Results A total of 14 neonates were included in the study. No further diagnostic cardiac catheterization was needed in any neonate. The accuracy of MDCT in diagnosing separate cardiovascular anomalies was 98% (53/54) with only one atrial septal defect missed in a patient with coarctation syndrome. The average cardiovascular enhancement in evaluated chambers was 471 HU. No obvious beam-hardening artefact was observed. Conclusion The technical and clinical feasibility of MDCT in complex congenital heart disease in neonates is confirmed. After initial assessment with echocardiography, MDCT could probably replace diagnostic cardiac catheterization for further anatomical clarification in neonates.     

Visualization of neonatal coronary arteries on multidetector row CT: ECG-gated versus non-ECG-gated technique

Background Multidetector CT (MDCT) seems to be a promising tool for detection of neonatal coronary arteries, but whether the ECG-gated or non-ECG-gated technique should be used has not been established. Objective To compare the detection rate and image quality of neonatal coronary arteries on MDCT using ECG-gated and non-ECG-gated techniques. Materials and methods Twelve neonates with complex congenital heart disease were included. The CT scan was acquired using an ECG-gated technique, and the most quiescent phase of the RR interval was selected to represent the ECG-gated images. The raw data were then reconstructed without the ECG signal to obtain non-ECG-gated images. The detection rate and image quality of nine coronary artery segments in the two sets of images were then compared. A two-tailed paired t test was used with P values <0.05 considered as statistically significant. Results In all coronary segments the ECG-gated technique had a better detection rate and produced images of better quality. The difference between the two techniques ranged from 25% in the left main coronary artery to 100% in the distal right coronary artery. Conclusion For neonates referred for MDCT, if evaluation of coronary artery anatomy is important for the clinical management or surgical planning, the ECG-gated technique should be used because it can reliably detect the coronary arteries. Electronic supplementary material The online version of this article (doi: ) contains supplementary material, which is available to authorized users.     

Prospective study of tooth loss and incident esophageal and gastric cancers in China

Objective: To determine the association between tooth loss and the risk of developing esophageal squamous cell carcinoma, gastric cardia adenocarcinoma, or gastric non-cardia adenocarcinoma in a prospective study. Methods: Cox proportional hazards regression was used to examine these associations in a 28,868-person cohort followed prospectively for 5.25 years. The baseline questionnaire included questions regarding tooth loss, and individuals reporting lost teeth had their teeth counted by study personnel. The analytic cohort included 620 esophagus, 431 gastric cardia, and 102 gastric non-cardia cancer cases. Results: Tooth loss was associated with a significantly elevated risk of developing all three cancers. When examined as median splits, tooth loss was associated with a relative risk (RR) (95% confidence interval, CI) of 1.3 (1.1–1.6) in the esophagus, 1.3 (1.0–1.6) in the gastric cardia, and 1.8 (1.1–3.0) in the gastric non-cardia. Further analysis demonstrated that this increased risk was most strongly associated with the loss of the first few teeth and was primarily confined to the younger members of our cohort. Conclusions: In this cohort tooth loss increased the risk of developing upper gastrointestinal cancer. We hypothesize that this may be related to alterations in oral bacterial flora and subsequent increases in the in-vivo production of carcinogens such as nitrosamines.