Prediction of preeclampsia in twin pregnancies: a review / 中华围产医学杂志

Incidence of twin pregnancies increases significantly in recent years. Twin pregnancies are likely to have a higher risk of quicker progression and more severe preeclampsia (PE) than singletons, making the prediction and prevention of PE of twin pregnancies even more important. The prediction and screening for PE have evolved from guideline-based risk factor screening to simple models with maternal factors only, and then to complex models with a wider range of indicators. Besides, the modeling algorithms have expanded from logistic regression to complex algorithms such as competing risk models. Continuous improvements have been achieved in the prediction models. This paper presents a comprehensive overview of the applicability and the prospect of these models in this area in twin pregnancies and suggests that the prediction models should be improved by optimizing modeling strategies using localized indicators.

18F-FDG positron emission tomography for the assessment of histological response to neoadjuvant chemotherapy in osteosarcomas: a meta-analysis.

PURPOSE: The purpose of this meta-analysis was to evaluate the predicting value of fluorine-18-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET-CT) in the assessment of histological response to neoadjuvant chemotherapy in patients with osteosarcomas. METHODS: A detailed search was made in MEDLINE, EMBASE and the Web of Knowledge for relevant original articles published in English; methodological quality of the included studies were also assessed. Two reviewers extracted data independently. Sufficient data was presented to construct a 2 × 2 contingency table. Pooled sensitivity and specificity, positive and negative likelihood ratios were estimated. A summary receiver operating characteristic curve (SROC) was constructed with the Moses' constant of linear model. A χ(2) test was performed to test for heterogeneity. RESULTS: Eight studies comprising 178 patients met the inclusion criteria. The pooled sensitivity and specificity for standardized uptake values (SUV) after chemotherapy (SUV2) ≤ 2.5 were 0.734 (95% CI, 0.537-0.867) and 0.864 (95% CI, 0.510-0.975), for the ratio of standardized uptake values after (SUV2) to before (SUV1) chemotherapy SUV 2:1 ≤ 0.5 were 0.690 (95% CI, 0.497-0.833) and 0.653 (95% CI, 0.492-0.786), the positive and negative likelihood ratio (LR+/LR-) for SUV2 ≤ 2.5 were 5.397 (95% CI, 1.169-24.920) and 0.308 (95% CI, 0.165-0.577), for SUV 2:1 ≤ 0.5 were 1.989 (95% CI, 1.145-3.457) and 0.475 (95% CI, 0.247-0.915). There was no significant difference between-study heterogeneity for either LR + or LR- in any of these analyses. The area under the SROC curve for SUV2 ≤ 2.5 and SUV 2:1 ≤ 0.5 were 0.81 and 0.72, respectively. CONCLUSIONS: The present meta-analysis showed that 18F-FDG PET-CT scan, as measured by the SUV before and after treatment, SUV2 ≤ 2.5 and SUV 2:1 ≤ 0.5 are valuable for predicting the histological response to chemotherapy. SUV2 ≤ 2.5 have better predicting performance than SUV 2:1 ≤ 0.5.

A randomized controlled trial of efficacy and safety of PES14LF polyethersulfone dialyzer on hemodialysis patients / 中华肾脏病杂志

Objective To evaluate the efficacy and safety of PES14LF polyethersulfone highflux dialyzer on maintenance hemodialysis(MHD)patients. Methods A total of 72 MHD patients from two hospitals in Shanghai were enrolled in a randomized parallel controlled study.Conventional hemodialysis was performed for 4 h with PES14LF dialyzer in trial group and with German F6 dialyzer in control group.For each patient the study lasted one week.The clearances of urea,creatinine and phosphate were calculated.Adverse event and adverse reaction were recorded.Results There were no significant difierences of urea and creatinine clearance and reduction ratio between trial and control group.The phosphate clearance in trial group was significantly higher than that in control group[(144.57±27.83)ml/min vs(117.15±22.77)ml/min,P＜0.051.There was no significant difference of phosphate reduction ratio between trial and control group.The efficiency of urea clearance and urea reduction ratio achieved clinic effective target in two groups and no significant differences in above indexes between two groups were found. Conclusion PES14LF dialyzer is effective and safe for clinical application.

Multi-center study of motherwort injection to prevent postpartum hemorrhage after caesarian section / 中华妇产科杂志

Objective To evaluate the efficacy and safety of motherwort (herbs leonuri/leonurus heterophyllus sweet) injection for preventing postpartum hemorrhage after caesarian section. Methods The prospective study was designed as a randomized and single blind multi-center research matched with positive agent as controls from Apt 2007 to Aug 2007. 440 women underwent caesarian section (CS) indicated by obstetric factors were enrolled from 15 teaching hospitals in China and assigned into three groups: group of motherwort: 147 cases were administered by motherwort 40 rag uterine injection during CS and 20 mg intramuscular injection per 12 hours 3 times after CS; group of motherwort + oxytocin : 144 cases were administered by motherwort 40 mg and oxytocin 10 U uterine injection during CS and motherwort 20 mg intramuscular injection per 12 hours 3 times after CS and group of oxytocin: 149 cases were administered by oxytocin 10 U uterine injection and oxytocin 10 U + 5% glucose 500 nd intravenously injection during operation and oxytocin 10 U intramuscular injection per 12 hours 3 times after CS. The following clinical parameter were collected and analyzed: (1) The amount of blood loss during operation, at 2, 6, 12, 24, 48 hours after operation. (2) The total amount of blood loss in 24 hours after CS and the incidence of postpartum hemorrhage. (3) The change of level of hemoglobin (Hb) and counting of red blood cell ( RBC ) from prepartum to postpartum. (4) Adverse reaction. Results (1) The mean amount of blood loss during operation were (368±258) ml in group of motherwort, (255±114) mi in group of motherwort + oxytocinand (269±141 ) ml in group of oxytocin, which exhibited significant difference among three groups ( P<0.01 ). Meanwhile, no statistical different amount of blood loss among three groups were observed at 2,6,12, 24, 48 hours after CS. (2)The amount of blood loss of postpartum at 24 hours were (480±276)ml ingroup of motherwort, (361±179) ml in group of motherwort + oxytocin, (381±179) nd in group of oxytocin, which showed significant difference among 3 groups(P <0.01 ). (3) The incidence of postpartum hemorrhage were 32.0% (47/147) in group of motherwort, 11.1% (16/144) in group of motherwort + oxytocin, and 18.8% in (28/149) in group of oxytocin. When comparing the lowest rate of postpartum blood loss in group of motherwort + oxytocin and the highest rate in group of motherwort, it displayed statistical difference (P<0.01). (4) The decreased level of RBC and Hb were shown that RBC(0.3±0.5)×10<'12<‘/L and Hb(9±13)g/L in group of motherwort, RBC (0.2±0.4)×10<'12/L and Hb ( 6±10) g/Lin group of motherwort + oxytocin and RBC (0.2±0.4)×10<'12/L and Hb(7±30) g/L in group of oxytocinrespectively. However, the comparison of different value of RBC and lib in group of oxytocin and motherwort +oxytocin showed significant difference (P<0.05 ). (5) Two cases with allery reaction was observed.Conclusion It is safe and efficacious that combined use of motherwort injection and oxytocin was to preventpostpartum hemorrhage during or after caesarian section.

A randomized controlled trial for the efficacy and safety of REXEEDTM series highflux dialyzer / 中华肾脏病杂志

Objective To evaluate the efficacy and safety of REXEEDTM series highflux dialyzer. Methods A randomized cross-over study of 3×3 Latin square was designed based on the surface area of dialyzer membrane (1.5 m2 and 2.1 m2). Seventy-two stable maintenance hemodialysis (MHD) patients from Shanghai Renji Hospital and Ruijin Hospital were enrolled in this study for 3 consecutive weeks. REXEEDTM-15AC, 15UC, 21AC, 21UC dialyzers were used as trial group and APS-15U,BIO-HX100 dialyzers were used as control group. The clearances of urea, creatinine, phosphorus and β2-microglobulin were calculated. Adverse event and adverse reactions were recorded. Results There were significantly higher urea and creatinine clearance in 1SAC and 15UC dialyzers as compared to APS-15U dialyzer [(222.07±18.74) mi/min, (220.23±26.26) ml/min vs (199.56±14.21) ml/min; (176.73±16.41) ml/min, (175.22±25.94) ml/min vs (165.42±14.68) ml/min, all P<0.05]. There were significantly higher urea, creatinine and β2-microglobulin clearance in 21AC and 21UC dialyzer as compared to BIO-HX100 dialyzer [(230.59±15.24) ml/min, (233.96±7.06) ml/min vs (203.43±36.66) ml/min; (183.50±25.90) ml/min, (181.05±23.94) ml/min vs (166.25±29.82) ml/min; (111.77±53.42) ml/min, (125.54±51.99) ml/min vs (42.39±4.81) ml/min; all P<0.05]. There was no significant difference of phosphorus clearance between REXEEDTM series dialyzers and control dialyzers. The efficiency of urea clearance and urea reduction ratio could achieve clinical targets in REXEEDTM series. Conclusion REXEEDTM series highflux dialyzers are effective and safe for clinical application.

A randomized comparative study on mifepristone alone and in combination with tamoxifen for emergency contraception.

The purpose of the clinical study was to compare the efficacy and side effects of 10 mg of mifepristone alone (Group 1) and with 20 mg of tamoxifen (Group 2) for emergency contraception, especially as used within 72-120 h after coitus. Four-hundred female volunteers with one act of unprotected intercourse or contraception failure (200 cases in each group) were recruited and completed the study. There were 198 women treated < 72 h after coitus (100 in Group 1 and 98 in Group 2), whereas the remaining 202 patients were treated between 72-120 h (100 in Group 1 and 102 in Group 2). In total, four pregnancies occurred; one treated < 72 h in each group, two between 72-120 h in Group 1. Efficacy for prevention of unwanted pregnancy by Trussell method is 84% for Group 1, and 95% for Group 2, and which is not significantly different between the two groups and even subgroups. The side effects (15.5% for Group 1 and 14.5% for Group 2) and changes in menstruation were infrequent and mild in both groups. Further studies should be conducted to determine whether tamoxifen combined with mifepristone for emergency contraception is more effective as compared with mifepristone alone.