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Jing-he Lang

Publications and source records attributed to Jing-he Lang.

At least 37 records · Page 2Linked to original sources
PubMed2005

[Analysis of prognostic factors of malignant ovarian tumor after fertility-preserving treatment].

OBJECTIVE: To explore the prognostic factors of malignant ovarian tumor after fertility-preserving treatment. METHODS: 189 patients with malignant ovarian tumor who had undergone fertility-preserving management in the past 20 years were retrospectively analyzed. The correlative factors for survival, recurrence and reproductive status were evaluated. Among the patients, 136 cases suffered from ovarian germ cell tumor (OGCT), 31 cases suffered from ovarian sex cord-stromal tumor (OSCST), and 22 cases suffered from epithelial ovarian cancer (EOC). The median follow-up time of different groups was 50 months for OGCT, 46 months for OSCST, 45 months for EOC respectively. RESULTS: The 5-year survival rates for OGCT, OSCST and EOC groups were 94.0% (131/134), 77.1% (26/30) and 64.7% (16/21) respectively. The recurrent rates were 29.9% (40/134), 20.0% (6/30) and 47.6% (10/21) respectively. 46 babies were delivered during the follow-up period. Standard chemotherapy was the most important prognostic factor for OGCT. FIGO stage and standard chemotherapy were favourable factors for prognosis in OSCST group. The important prognostic factors included FIGO stage and standard comprehensive surgical staging for EOC. CONCLUSION: Fertility-preserving treatment should be considered for OGCT without limitation of FIGO stage, whereas it should be performed individually for OSCST and EOC. The treatment outcome for OGCT is the best, for EOC the worst.

Adolescent↗
PubMed2005

[A multicenter randomized clinical trial of weekly paclitaxel and carboplatin vs three weeks paclitaxel and carboplatin as first line chemotherapy in epithelial ovarian cancer].

OBJECTIVE: To compare the efficacy of combination regiments of taxol given weekly plus carboplatin and taxol given every three weeks plus carboplatin. To observe the toxicity of the two regiments. To observe the two-year survival rate in the two groups. METHODS: Total 125 eligible patients in 13 centers of CGOG were entered into the two arms of this randomized clinical trial, of whom 51 were entered into weekly taxol group and 74 entered into 3 weeks taxol group. RESULTS: 81.6% (102/125) of patients had satisfactory decreasing of CA125 level after optimal cytoreductive surgery and chemotherapy. 86.3% (44/51) of patients is in weekly group and 78.4% (58/74) of patients in three weeks group (P > 0.05). Relapse frequency is 29.7% in every three weeks group and 19.6% in weekly group (P > 0.05). Median interval to relapse is 15.7 months in every three weeks group and 13.6 months in weekly group (P > 0.05). One-year survival rate is 95.2% in every three weeks and 93.9% in weekly group (P > 0.05). Two-year survival rate is 78.7% in every three weeks and 85.3% in weekly group (P > 0.05). Grade III and IV myelosuooression is 45.9% in three weeks group and, 27.5% in weekly group (P < 0.05). CONCLUSION: (1) The two regiments had equal efficacy. (2) Myelosuppression was less frequency in the weekly group than in every three weeks group. (3) Weekly taxol therapy has mild toxicity and is more suitable for the old and feeble patients. Weekly taxol therapy can be conveniently administered in outpatients department.

Adult↗
PubMed2005

[Expression of vascular endothelial growth factor receptors in the ectopic and eutopic endometrium of women with endometriosis].

OBJECTIVE: To study the localization and expression of the vascular endothelial growth factor receptors (VEGFR) Fms-like tyrosine kinase (Flt-1) and kinase insert domain-containing receptor (KDR) in human ectopic and eutopic endometrium of patients with endometriosis. METHODS: Specimens of endometriosis patients, aged (38 +/- 8) years, including 37 specimens of entopic endometrium, 34 specimens of ovarian chocolate cyst, 34 specimens of ovarian chocolate cyst, 15 specimens of red peritoneal endometriosis lesions, and 4 abdominal wall endometriosis lesions were collected. Specimens of endometrium of 33 patients with other gynecological diseases, aged (36 +/- 8) years, were collected during operation and used as controls. Immunohistochemistry was used to detect the location and expression of Flt-1 and KDR protein in different tissues. Western blotting was used to detect the protein expression of Flt-1 and KDR protein in different tissues. The mRNA expressions of Flt-1 and KDR were detected by RT-PCR. RESULTS: Flt-1 and KDR were expressed in the endometrial glandular epithelium and stromal cells besides the endometrial blood vessels. The positive expression rate of Flt-1 and KDR in the ectopic endometrium of endometriosis patients were 94.3% and 91.4% respectively, both significantly higher than those in the ovarian endometrial cyst (74.3% and 77.1% respectively, both P < 0.05), and similar to those in the eutopic endometrium of the endometriosis patients (93.8% and 90.6% respectively, both P > 0.05). In the eutopic endometrium of the endometriosis patients, the Flt-1 mRNA expression level was 2.4 +/- 1.2 and the Flt-1 protein expression level was 31 +/- 17, and the KDR mRNA expression level was 3.0 +/- 1.4 and the KDR protein expression level was 36 +/- 24, all significantly higher than those in the ovarian endometrial cyst (1.5 +/- 0.9 and 1.8 +/- 1.0 for the Flt-1 and KDR mRNA expressions, and 17 +/- 6 and 20 +/- 11 for the Flt-1 and KDR protein expressions, all P < 0.05), and similar to those in the eutopic endometrium of the non-endometriosis patients (1.9 +/- 0.8 and 2.3 +/- 1.3 for the Flt-1 and KDR mRNA expressions, and 24 +/- 18 and 25 +/- 16 for the Flt-1 and KDR protein expressions, all P > 0.05) CONCLUSION: VEGF may play certain biological role in the development of endometriosis through VEGFR (Flt-1 and KDR). The expression of Flt-1 and KDR in the endometriotic lesion appears to be associated with neovascualization.

Adult↗
PubMed2005

[Clinical analysis of prognostic factors for stage III ovarian epithelial carcinoma].

OBJECTIVE: To evaluate the prognostic factors for stage III ovarian epithelial carcinoma so as to provide scientific basis for further reasonable therapy. METHODS: The clinical records of 369 patients with stage III ovarian epithelial carcinoma, aged 53 +/- 9 (22-77), were reviewed retrospectively. SPSS 10.0 was utilized to analyze the possible prognostic factors statistically. RESULTS: All patients received cytoreductive surgery, 289 cases (71.8%) of which achieved optimal cytoreduction. During the operation, 150 cases (41.8%) and 265 cases (71.8%) were found with intestinal and diaphragmatic involvement respectively. Pathologic results showed that serous type was the most common histological type (48.9%) and mucinous type was the least one (2.2%). The grades G1, G2, and G3 accounted for 1.7%, 42.7%, and 55.6% respectively. 290 cases with effective response to surgery underwent chemotherapy for 3-22 (10 +/- 4) courses. Recurrence was recorded in 190 cases (51.5%) and death was recorded in 152 cases (41.2%). Multivariate analysis revealed that intestinal involvement, diaphragmatic invasion, tumor residuals, and course number of chemotherapy were significantly correlated with prognosis (P < 0.01, < 0.05, < 0.01, and < 0.01 respectively). CONCLUSION: Cytoreduction for the tumor in peritoneal cavity and positive chemotherapy should be emphasized sufficiently and may be helpful for the prognosis of stage III ovarian epithelial carcinoma.

Adult↗
PubMed2005

[Clinical features and prognostic of double primary carcinoma of uterine corpus and the ovary].

OBJECTIVE: To investigate the clinical features, treatment and prognosis of patients with double primary carcinoma of uterine corpus and ovary. METHODS: The clinical features, operation findings, treatment and prognosis of 36 patients with double primary carcinoma of uterine corpus diagnosed and treated in the last 20 years, 25 with typical endometrial adenocarcinoma and endometrioid carcinoma of the ovary (group A) 11 with non-endometrioid carcinoma in uterine corpus and/or ovary (group B) were respectively analyzed. RESULTS: There was no significant difference in survival rate between the group A and group B. The 1, 3, and 5-year survival rates of these 36 patients were 89%, 83%, and 75% respectively, all equal to those of the patients with stage I ovarian cancer. The pelvic and abdominal involvement, histologic grade, positive abdominal washing and myometrial invasion were proven to be statistically significant indicators of the poor prognosis (all P < 0.05). Radiotherapy seemed to be useful for improving the survival. CONCLUSION: The prognosis of double primary carcinoma of uterine corpus and ovary is rather good. It is necessary to distinguish double primary carcinoma of uterine corpus and ovary from stage II ovarian cancer and stage III endometrial carcinoma.

Adult↗
PubMed2005

[Correlative factors analysis of recurrence of endometriosis after conservative surgery].

OBJECTIVE: To determine the correlative factors with recurrence of endometriosis after conservative surgery. METHODS: A cohort study was performed on 285 patients who had a minimum of 36 months of follow-up after conservative surgery for endometriosis. All patients underwent clinical interview, physical examination and ultrasonography. The factors measured included: age at surgery, age at onset of disease, gravidity, parity, tenderness nodule at cul-de-sac (yes/no), uterus mobility (movable/fixed), serum CA(125) level, type of operation (laparoscopy/laparotomy), history of operation for endometriosis (yes/no), side of endometrioma (left/right/bilateral), intraoperative revised classification American Fertility Society (r-AFS) scores, post-operative r-AFS scores, highest post-operative temperature, post-operative adjuvant therapy, post-operative gravidity and parity. The recurrent rate and its predictive factors were evaluated and the univariate, multivariate COX regression and Kaplan-Meier analyses were performed to determine the predictive factors for recurrence of endometriosis. RESULTS: The related factors and their odds ratio (OR) by univariate analysis were as follows: history of endometriosis surgery, 13.630 (P < 0.01); nodules with tenderness at cul-de-sac, 6.133 (P < 0.01); post-operative administration of clomiphene, 5.173 (P < 0.01); left endometrioma, 4.503 (P < 0.01); bilateral endometrioma, 3.709 (P < 0.01); post-operative r-AFS scores, 1.831 (P < 0.01); post-operative gravidity, 0.392 (P < 0.05); post-operative administration of progesterone for 6 months, 0.472 (P < 0.01); laparoscopic surgery, 0.567 (P < 0.05); pre-operative parity, 0.640 (P < 0.05); pre-operative gravidity, 0.759 (P < 0.05); age at onset of disease, 0.912 (P < 0.01) and age at surgery, 0.932 (P < 0.05). Meanwhile, the related factors and their odds ratio (OR) by multivariate COX analysis were as follows: history of endometriosis surgery, 8.219 (P < 0.01); bilateral endometrioma, 6.369 (P < 0.01); left endometrioma, 2.682 (P < 0.05); tenderness nodules at cul-de-sac, 2.154 (P < 0.05); post-operative administration of clomiphene, 1.860 (P < 0.05); post-operative r-AFS scores, 1.188 (P < 0.01); post-operative gravidity, 0.253 (P < 0.01); post-operative administration of progesterone for 6 months, 0.518 (P < 0.05); age at surgery, 0.937 (P < 0.01). CONCLUSIONS: The risk factors for recurrence of endometriosis include a history of endometriosis surgery, bilateral endometrioma, left endometrioma, tenderness nodules at cul-de-sac, post-operative administration of clomiphene, post-operative r-AFS scores,whereas the protective factors include the post-operative gravidity, post-operative adjuvant therapy and age at surgery.

Adult↗
PubMed2005

[Clinical and pathological analysis of intravenous leiomyomatosis].

OBJECTIVE: To investigate the clinical and biological characteristics of intravenous leiomyomatosis and the treatment methods, as well as their effect on prognosis. METHODS: The clinical and pathologic data of 7 patients with intravenous leiomyomatosis of the uterus admitted to our hospital from June 1992 to June 2003 were analyzed retrospectively. All the cases were followed up. RESULTS: All the patients complained of pelvic mass. Three of them had enlarged uterus which was over 12 gestational week, 2 of them had prolonged menstruation and hypermenorrhea, 1 of them presented with postmenopausal bleeding. B-ultrasound examination showed 4 leiomyomas, 1 sarcoma of uterus, and 3 ovarian tumors. No intravenous leiomyomatosis within uterus was diagnosed preoperatively. A resection of the mass and a total abdominal hysterectomy with bilateral salpingo-oophorectomy were performed in 4 cases. CONCLUSIONS: Intravenous leiomyomatosis has special and quasi-malignant biological behavior. The prognosis can be improved if the disease could be correctly diagnosed during the operation and treated with combined modality therapy and intensively followed up after operation.

Adult↗
PubMed2005

[Study on posterior intra-vaginal slingplasty for pelvic floor reconstruction].

OBJECTIVE: To study the efficacy and safety of posterior intra-vaginal slingplasty (IVS) in the re-construction surgery of pelvic floor. METHODS: Eleven patients with vault prolapse and severe prolapse of uterus undergoing posterior IVS were prospectively studied. RESULTS: Average operation time was 55 min. Average blood loss was 86 ml. Average hospitalization time was 5.6 d. No severe complications occurred. According to subjective assessment of the outcome, all patients were cured. CONCLUSION: Posterior IVS is a minimally invasive, effective and safety surgery for re-construction of pelvic floor.

Aged↗
PubMed2005

[Primary malignant melanoma of the cervix: report of four cases and review of the literature].

OBJECTIVE: To investigate the clinical and pathological characteristics of primary cervical malignant melanoma, the treatment, and prognosis. METHODS: The clinical and pathological data of four patients with primary malignant melanoma of the cervix admitted to our hospital from Sept. 1996 to Aug 2002 were analyzed retrospectively. Their follow-up records were also reviewed. Nerve tissue protein S-100 and monoclonal antibody to melanoma (HMB-45) were examined in all cases by immunohistochemical method. RESULTS: All the patients received radical hysterectomy. In addition, three of them received chemotherapy, and one received immunotherapy simultaneously. One patient died six months and another 41 months after the operation respectively. One patient survived for 3 years, and another over 6 years free of tumor. S-100 protein and HMB-45 were positive in all patients. CONCLUSIONS: The prognosis of primary malignant melanoma of cervix is relatively poor. S-100 protein and HMB-45 play important roles in the diagnosis of primary malignant melanoma of cervix. Radical hysterectomy, chemotherapy combined with dimethyl triazemo imidazole carboxamide (DTIC) and immunotherapy can improve the prognosis if the disease could be diagnosed in early stage.

Adult↗
PubMed2005

Laparoscopic surgery in patients with hypovolemic shock due to ectopic pregnancy.

OBJECTIVE: To evaluate the feasibility and safety of operative laparoscopy for ectopic pregnancy with hypovolemic shock. METHODS: Two hundred and fifteen women with ectopic pregnancy underwent operative laparoscopy. These patients were divided into two groups. The study group included 21 patients with shock and intraperitoneal hemorrhage more than 1000 mL, and control group included 194 patients, hemodynamically stable, with blood loss less than 1000 mL. Clinical data of perioperative periods in two groups were retrospectively analyzed. RESULTS: All patients were tubal pregnancies. The occurrence rate of tubal rupture was higher in study group than in control group (80.95% vs. 15.98%, P < 0.001). Intraabdominal blood loss was significantly higher in study group than in control group (1900 mL vs. 300 mL, P < 0.001), and autologous blood transfusions were given to 95.24% and 9.3% of patients in study and control group, respectively (P < 0.001). Laparoscopic salpingectomy was performed on 85.7 % and 50.5% of patients in study and control group (P < 0.001). The operative time was somewhat longer in study group than that in control group (60 minutes vs. 45 minutes), but with no significant difference. All patients had no perioperative complications. CONCLUSION: Operative laparoscopy in patients with hopovolemic shock can be safely and effectively performed by experienced laparoscopists with the aid of optimal anesthesia, advanced cardiovascular monitoring, and autologous blood transfusion.

Adult↗
PubMed2005

[Analysis of 21 cases of epithelial ovarian malignancies in women aged below 30 years].

OBJECTIVE: To study the presentation, histology type, stage of disease, treatment and outcome of epithelial ovarian malignancies in young women less than 30 years old. METHOD: A total of 21 cases of epithelial ovarian malignancies in young women less than 30 years old between Jan 1986 and Mar 2002 were analyzed retrospectively. RESULTS: The median age at the time of diagnosis was 24 years (range 16-29 years). All carcinomas occurred after menarche. The most common presenting symptoms were abdominal pain (50%), followed by tympanites (25%) and dysmenorrhea (19%), and the initial diagnosis was usually made based on physical examination, ultrasonography and serum CA(125). The mean maximal tumor diameter was 17.6 cm. Ten (67%) patients had stage I disease (5 Ia, 5 Ic), and 5 (33%) had stage III disease at the time of diagnosis; 43% were mucinous tumors, and 29% serous ones. Most tumors were well-differentiated ones classified as grade 1, 73%, others were grade 2, 13%, and grade 3, 13%. Optimal cytoreduction was achieved in 93% (14/15) of patients in primary treatment and 83% (5/6) in recurrence treatment. Eight patients were treated with conservative surgery, and 18 patients with chemotherapy, of which 7 patients had more than six courses of chemotherapy. The median follow-up was 50 months (range, 2-192 months). Six patients died in this series, 2 were alive with tumor, 11 alive free of tumor, and two were lost in follow-up. The 3-year and 5-year survival rate was 89%, and 76%, respectively. CONCLUSION: Young patients with epithelial ovarian carcinoma appear to have favorable stage and histologic grade and good survival.

Adolescent↗
PubMed2005

Postoperative evaluation of tension-free vaginal tape procedure.

OBJECTIVE: To study the outcome of tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in women with cystocele. METHODS: Forty-two patients with SUI confirmed by urodynamics underwent the TVT procedure under local anesthesia. A prolapse repair was done simultaneously. RESULTS: Mean TVT operation time was 26.29 minutes. Mean blood loss was 29.86 mL. Eighty-eight percent of the PATIENTS: were able to micturate spontaneously within 12 hours and residual urine was less than 100 mL. And 12% of the patients had to use indwelling catheter for 3-11 days. Average hospital stay was 2.91 days. Eighty-eight percent of patients were discharged within 2 days. All patients were followed up (an average of 10.26 months). According to subjective and objective assessment of the outcome, 39 patients (93%) were cured, another 3 patients (7%) were significantly improved and none was failed. There were no major complications such as bladder injury occurred. CONCLUSION: TVT procedure is a minimal invasive, effective, and safe surgery for treatment of SUI.

Adult↗
PubMed2005

[Increased levels of prostaglandin E2 and bcl-2 in peritoneal fluid and serum of patients with endometriosis].

OBJECTIVE: To detect the concentrations of prostaglandin E2 (PGE2) and bcl-2 in sera and peritoneal fluid of women with endometriosis. METHODS: The study group included 36 samples of peritoneal fluid and serum respectively from patients with endometriosis, and control group included 30 samples of peritoneal fluid and serum respectively from patients without endometriosis (either ovary cyst or uterine myoma). The peritoneal fluids were collected at the time of laparoscopic operation, and the sera were collected before surgery. Concentrations of PGE2 and bcl-2 were determined by enzyme linked immunosorbent assay (ELISA). RESULTS: The peritoneal fluid concentrations of PGE2 and bcl-2 in study group were significantly higher than that of control group, (1987 +/- 532) ng/L vs (386 +/- 215) ng/L, (177 +/- 53) U/L vs (86 +/- 21) U/L, (P < 0.05); and the PGE2 levels of severe endometriosis were significantly higher than that of mild endometriosis, (2221 +/- 1352) ng/L vs (1694 +/- 381) ng/L, (P < 0.01). The serum concentrations of PGE2 and bcl-2 in study group were significantly higher than that of control group, (3787 +/- 514) ng/L vs (129 +/- 97) ng/L, (96 +/- 44) U/L vs (53 +/- 40) U/L, (P < 0.01). Serum PGE2 concentrations of severe endometriosis were significantly higher than that of mild endometriosis, (964 +/- 290) ng/L vs (590 +/- 362) ng/L, (P < 0.01). CONCLUSIONS: The concentrations of PGE2 and bcl-2 in peritoneal fluid are increased in endometriosis. The concentrations of PGE2 and bcl-2 are associated with the extent of endometriosis lesions.

Adult↗
PubMed2005

[Study of bone mineral density in complete androgen insensitivity syndrome patients].

OBJECTIVE: To explore the characteristics and treatment of bone mineral density (BMD) change in complete androgen insensitivity syndrome (CAIS) of Chinese patients. METHODS: Fourteen cases of CAIS were studied retrospectively through analyzing and comparing BMD of pre- and post-orchidectomy with normal Chinese men and women. BMD at the lumbar spine and the femur were measured by dual energy X-ray absorptiometry (DXA). RESULTS: Ten cases of CAIS had pre-orchidectomy DXA, in which 6 cases had very significantly reduced L(2-4) BMD (0.92 +/- 0.08) g/cm(2) compared with normal men and women (P < 0.01). Five cases had significantly reduced femur neck BMD (0.89 +/- 0.12) g/cm(2) compared with normal male (P < 0.05). Seven cases had 12 post-orchidectomy DXA, in which all L(2-4) BMD (0.95 +/- 0.06) g/cm(2) were very significantly reduced compared with normal male and female (P < 0.01), femur neck BMD (0.91 +/- 0.08) g/cm(2) was also significantly reduced compared with normal male (P < 0.01) and normal female (P < 0.05). CONCLUSIONS: There are different degrees of osteopenia in patients of CAIS, especially in lumbar vertebra. This suggests that estrogen and androgen play important roles in the acquirement and maintenance of bone mass.

Adolescent↗
PubMed2005

[Comprehensive staging surgery in treatment of malignant ovarian germ cell tumor].

OBJECTIVE: To evaluate the impact of comprehensive staging surgery on relapse and survival of malignant ovarian germ cell tumor (MOGCT). METHODS: The clinical data of 127 MOGCT cases treated in Peking Union Medical College Hospital from June 1980 to June 2003 were analyzed retrospectively. All the data about comprehensive staging surgery during primary surgery were collected, and other factors related to prognosis were also collected at the same time. COX model was applied in multivariate analysis related to relapse and survival. RESULTS: Among 127 patients, 45 (35.4%) received comprehensive staging surgery. Seventy-one cases (55.9%) received satisfied cytoreduction with residual tumor < 2 cm, 11 cases (8.7%) with residual tumor > or = 2 cm, and another 45 cases (35.4%) were undetermined. Seventy-five cases (59.1%) received cisplatin, etoposide, and bleomycin (BEP) or cisplatin, vinblastine, and bleomycin (PVB) chemotherapy, 18 cases (14.2%) received vincristine, actinomycin D, cyclophosphamide (VAC) chemotherapy, and 34 cases (26.8%) received other regimens or no chemotherapy. During the follow up period, 7 of 45 patients relapsed in patients who received compressive staging surgery, while the latter was not a significant factor (P = 0.061). Chemotherapy regimen and residual tumor were the significant factors related to the relapse (P < 0.05). All the patients were followed up for 2-254 months. Chemotherapy regimen and residual tumor were also the significant factors related to survival (P < 0.05). Compressive staging surgery showed no significant effect on survival (P > 0.05). CONCLUSIONS: The critical treatment for MOGCT is satisfactory cytoreduction surgery plus standard chemotherapy. Comprehensive staging surgery shows no significant impact on the prognosis of MOGCT patients.

Adolescent↗