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Jing-he Lang

Publications and source records attributed to Jing-he Lang.

68 records · Page 4Linked to original sources
PubMed2003

[Benign ovarian tumor with ascites and high serum levels of CA125: report of 3 cases].

OBJECTIVE: To describe the clinical characteristics of benign ovarian tumor/mass which manifest as pelvic mass, ascites and high serum levels of CA(125). METHOD: Clinical data of 3 cases of such disease in Peking Union Medical College Hospital were analyzed and relevant literatures were reviewed. RESULTS: The patients all were misdiagnosed as ovarian carcinoma, and operations designed for malignant ovarian tumor were performed on all of them. There was no definite proof of malignant tumor, such as positive findings of pathology and/or cytology, in any patients before operation. Among these diseases, pelvic tuberculosis, ovarian endometrioid cyst and ovarian fibroma are the three most common ones, others are: fibrothecoma, thecoma, struma ovarii, adenofibroma, benign Brenner tumor, mature theratoma, ovarian edema and fibromatosis. CONCLUSIONS: Pelvic mass, ascites and high serum level of CA(125) can't always result of a diagnosis of ovarian carcinoma. Positive findings of pathology and/or cytology is the only definite proof of a diagnosis of ovarian malignant tumor. On the susceptible case, laparoscopy is a useful and reliable method.

Adult↗
PubMed2003

[Clinical analysis of lower uterine segment pregnancy with heavy hemorrhage in inducing abortion].

OBJECTIVE: To discuss the diagnosis and conservation managements for the lower uterine segment pregnancy complicating the first trimester inducing abortion cases. METHOD: Four cases of lower uterine segment pregnancy that had heavy hemorrhage and received bilateral uterine artery embolization (UAE) were analysed. RESULTS: Four patients with previous caesarean section had torrential hemorrhage when they received inducing abortion in the first trimester. Digital subtractive angiography (DSA) showed branches of uterine artery were bleeding, the site of the branches were equivalent to the lower segment of uterus. UAE could control heavy uterine bleeding satisfactory and save their uterus successfully. One of four patients asked hysterectomy after UAE, her pathological examination of the operative specimen confirmed "lower uterine segment pregnancy with placenta increta". CONCLUSION: Previous caesarean section is one risk factor of lower uterine segment pregnancy, UAE is one of the best satisfactory conservation managements; the main prevent methods are controlling caesarean section rate and paying attention to the contraception.

Abortion, Induced↗
PubMed2003

[Clinical study about diagnosis and management on 10 women with rectovaginal endometriosis].

OBJECTIVE: To study the diagnosis and therapy of the rectovaginal endometriosis. METHODS: Descriptive retrospective study, between 1992 and 2002, 10 women with rectovaginal endometriosis were treated at the Peking Union Medical College Hospital. RESULTS: The average age were 40 years old. Six patients presented with rectal irritative symptom. Three of them complained about deep dyspareunia. Eight patients complained about mild to moderate dysmenorrhea. The recto-vaginal septum should be carefully palpated. None of these patients had either clinical or objective evidence of ovarian endometriosis, nor was there evidence of any obstructive lesions of the intestine or ureters. The CA(125) levels had a sensitivity of 20%. Ultrasonography failed to find the rectovaginal endometriotic nodules. Diagnosis of the rectovaginal endometriosis was based on symptoms, vaginal and rectal examination. The Revised American Fertility Society (rAFS) stages can not evaluate the grade of the endometriosis. Four patients were given leuprolide acetate depot at 3.75 mg, 1 ampule every 28 days, and treatment had a planned duration of 3 mouths. Follow-up evaluations were set 3 mouths later. The patients showed an improvement with respect to pain during the 3 mouths treatment course but had early pain recurrence after drug suspension. The endometriotic lesions showed a slight but reduction in size during therapy but had returned to original volume within 3 mouths after cessation of the gonadotropin-releasing hormone analog (GnRH-a) treatment. Finally, all patients required further treatment with a surgical solution. Six patients succeeded to remove the nodules by laparotomy. Four patients were failed to remove the total lesions by laparoscope and transvaginal section. CONCLUSIONS: The vaginal and rectal examination should be performed if the patients complained about tectal irritative symptom or dyspareunia. The rAFS stages had no strong association with the severity of the rectovaginal endometriosis. GnRH-a should not be considered a real therapeutic alternative to surgical treatment for patients with symptom endometriosis of rectovaginal septum. Laparotomy is efficient for the treatment of the rectovaginal endometriosis.

Adult↗
PubMed2003

[Treatment of female stress urinary incontinence with tension-free vaginal tape procedure: a report of 34 cases].

OBJECTIVE: To assess the efficiency of tension-free vaginal tape (TVT) procedure in the treatment of female stress urinary incontinence (SUI). METHODS: Thirty-four cases with proven SUI and accompanied cystocele were undergone the TVT procedure and cystocele repair simultaneously. RESULTS: Thirty-three patients were operated under local anesthesia. Mean operation time was 26.9 minutes. Mean blood loss was 29.8 ml. Thirty patients (88%) were able to micturate spontaneously 12 hours after operation and their volumes of residual urine were all less than 100 ml. They were discharged on the next day. In the remaining 4 cases (12%) an in-dwelling catheter had to be used for 3 - 11 days. The overall hospital stay averaged was 2.9 days. Patients were followed up for 1 - 21 months (average 8.3 months). According to patients self-assessment, 94% of them feel cured, 6% improved. Postoperative complications was rarely seen. CONCLUSION: TVT procedure is a mini-invasive, effective and safe surgery in the treatment of female SUI.

Adult↗
PubMed2003

[Gynecological oncology in new millennium].

Twenty-one century is a digital era, an informative era. With the rapid progress of molecular biology, clinical pharmacology, radiotherapy, sciences of material and sciences of human being culture, advance changes with each passing day in gynecological oncology. Prevention and screening of gynecological oncology should be paid more attention to. Decision making should be considered by evidence-based medicine. Diagnosis and treatment of gynecological oncology will be standardized and humanized. New methods and techniques will be used more and more. Communications between the patients and gynecological oncologiests should play an important role in the improvement of gynecological oncology in the new era.

Adult↗
PubMed2003

[Sentinel lymph notes in female reproductive tract cancer].

To reduce extensive radical procedures and decrease morbidity in gynecologic malignancies, much effort is being focused on implementing less aggressive interventions. Two different approaches such as lymphatic mapping and lymphoscintigraphy are currently used to identify sentinel lymph nodes. In vulvar and cervical carcinomas, metastatic spread of disease commonly follows stepwise progressive drainage. Thus, sentinel lymph node identification may significantly reduce the number of patients undergoing unnecessary, extensive lymphadenectomy in the absence of metastatic disease. The addition of novel techniques, such as histopathologic ultrastaging, step sectioning, and immunohistochemistry staining, will help increase the accuracy and rate of detection of the disease. Any definitive statements can be made to the validity of sentinel lymphadenectomy until we got data with long-term follow-up.

Endometrial Neoplasms↗
PubMed2003

[Clinical features and treatment of cervical malignant tumor in young women].

OBJECTIVE: To evaluate clinical characteristics, prognosis, prognostic factors, and the ideal treatment of the young patients with cervical malignant tumor. METHODS: We analyzed retrospectively 52 cervical malignant tumor patients younger than 35 years (study group) and 45 cervical carcinoma patients older than 50 years (control group) who were admitted in Peking Union Medical College Hospital from 1985 to 2002. The data were analyzed statistically by SPSS10.0. The ovarian functions were evaluated by the questionnaire and the serum sex hormone assay. RESULTS: In study group, the median age was (31.0 +/- 0.6) years old. The most common clinical symptoms were contact bleeding and irregular bleeding; 55.8% of patients had more than one symptom. HPV positive rate was 20.5%, which was higher than control group significantly (P < 0.05). The percentage of advanced stage (stage II b-stage IV b) of disease in study group and control group were 30.8% and 22.2%, respectively, the difference was significant (P < 0.05). The most common histological type was squamous cell carcinoma (71.2%) in study group, while the percentage of non-squamous cell carcinoma (43.8%) in patients younger than 30 years was much higher than control group (P < 0.05). All the histological type was non-squamous cell carcinoma in the patients younger than 25 years. Histological grade showed that G1, G2, and G3 were 21.2%, 54.5%, and 24.2% respectively in study group. The percentage of bulky cervix (tumor diameter > 4 cm) in study group and control group was 27.9% and 2.7% respectively (P < 0.005). The overall 5-year survival rates were 75.7% in study group, lower than control group (P < 0.05). The COX hazards regression model showed histological type (P = 0.003) and bulky cervix (P = 0.001) were of significant prognostic values. CONCLUSIONS: There are more advanced stage carcinoma and non-squamous cell carcinoma patients with poor prognosis in study group. The treatment to younger patients should be concerned individually, as well as preservation of reproductive and female endocrine function should be considered.

Adenocarcinoma↗
PubMed2003

[Operative approaches, indications, and medical economics evaluation of 4180 cases of hysterectomy].

OBJECTIVE: To examine the operative approaches, major indications, and medical economic parameters of the hysterectomy. METHODS: Data on hysterectomy performed due to benign gynecological disorders in Peking Union Medical College Hospital (PUMCH) from 1996 to 2001 were reviewed. The cases were classified into three groups according to the operative approaches: total abdominal hysterectomy (TAH), vaginal hysterectomy (VH), and laparoscopic assisted vaginal hysterectomy (LAVH). The major indications, length of hospital stay, operative cost, and total medical cost were analyzed. RESULTS: Records of 4,180 women who had hysterectomies in PUMCH were examined. Operations included TAH (78.4%), LAVH (13.0%), and VH (8.6%). The use of LAVH increased from 2.4% in 1996 to 17.3% in 2001. The common indications for surgery included uterine leiomyoma (56.2%), adenomyosis (12.2%), benign ovarian tumor (9.2%), genital prolapse (7.7%), endometriosis (6.9%), atypical endometrial hyperplasia (3.0%), and cervical intraepithelial neoplasm (2.0%). The most common indications for TAH and LAVH were uterine leiomyomas and adenomyosis, whereas the most common indication for VH was genital prolapse, followed by uterine leiomyoma. The lengths of hospital stay in TAH, VH, and LAVH were (11.0 +/- 4.9) d, (10.9 +/- 3.9) d, and (8.9 +/- 3.7) d respectively. The total medical cost was (5,666.6 +/- 1,709.4) RMB Yuan for TAH, (5,027.6 +/- 1,067.0) RMB Yuan for VH, and (7,473.8 +/- 1,464.8) RMB Yuan for LAVH. CONCLUSIONS: The use of LAVH has been increasing. Although the direct medical cost for LAVH is higher than that for TAH, its indirect benefit appeares superior to TAH. The major indications for LAVH and TAH are similar, whereas the indications for VH are different from those for TAH and LAVH.

Costs and Cost Analysis↗
PubMed2003

[Effect of chemotherapy to ovary function in ovarian malignancy patients undergoing conservative surgery].

OBJECTIVE: To determine the effect of chemotherapy on ovarian endocrine function and menstruation. METHODS: Menstruation and serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol (E2) levels were observed when the patients with ovarian cancer undergoing one side ovarectomy were followed by chemotherapy. RESULTS: Abnormal menstruation occurred in 86.7% cases, including 80% amenorrhea and 6.7% oligomenstruate. Menstruation resumed around 2 months after chemotherapy. Serum LH, FSH levels rose and E2 level declined during amenorrhea. No significant change was observed in progesterone or testosterone levels. CONCLUSIONS: Ovary function impairment may occur in ovarian cancer patient treated by one side ovarectomy followed by chemotherapy. Serum LH, FSH, and E2 levels change and abnormal menstruation are two common manifestations. However, chemotherapy-related amenorrhea is reversible.

Adolescent↗
PubMed2003

[Study of morphological changes in levator ani muscle of patients with stress urinary incontinence].

OBJECTIVE: To observe the the histological changes of levator ani muscle in patients with stress urinary incontinence (SUI) or pelvic organ prolapse (POP) and to determine the alteration that contributed to pathogenesis. METHODS: Biopsy specimens of levator ani muscle were obtained from 15 patients with SUI, 19 patients with POP and 3 asymptomatic control with rectal cancer during operation. Levator ani muscle's structure was examined with routine histological techniques. At the same time, fiber distribution and diameters were also measured. RESULTS: The morphological features of levator ani muscle in SUI and POP group included the muscular fiber density decreased and separated by large amounts of dense connective tissue. The mean diameter of levator ani muscle in 4 SUI patients containing striated muscle fibers was (24 +/- 9) micro m, the mean diameter in 3 POP patients was (24 +/- 5) micro m, and the mean diameter in 3 control cases was (54 +/- 11) micro m. There was no diameter difference between SUI and POP group (P > 0.05), and the mean fiber diameters of SUI and POP patients were significantly smaller than that of the control group (P < 0.05). The proportion of type I fibers in SUI and POP patients had the tendency to increase (79.6%, 97.2% and 77.2%), with relative decrease of type II fibers. In control group the mean diameter of muscle fiber decreased significantly with age and menopausal time (P = 0.000). CONCLUSIONS: There was obvious fibrosis and the muscle fiber atrophy in SUI and POP group, which resulted in the weakness of pelvic floor. The prevalence of type I fibers might be disadvantage to forceful contraction during straining. Aging also contributed to neuromuscular degeneration and then associated with urinary incontinence in elderly women.

Aged↗
PubMed2003

[Recytoreductive surgery for recurrent epithelial ovarian cancer].

OBJECTIVE: To evaluate the role of recytoreductive surgery (RCRS) in recurrent epithelial ovarian cancer. METHODS: Fifty-five patients who underwent recytoreductive surgery at Peking Union Medical College Hospital between Nov. 1998 and Apr. 2002 were retrospectively reviewed. They were divided into four groups firstly by the identity of recurrent lesion: group A, single lesion; B, disseminated lesion; C, intestinal obstruction; D, palliative surgery. Then they were divided into 3 groups according to the sensitivity to chemotherapy. Group A, diseases relapsed more than 6 months after chemotherapy; group B, relapsed less than 6 months; group C, relapsed during chemotherapy. We review the cases with regard to its macroscopic residual disease, complications of operation, cases with complete remission and partial remission, postoperation survival time and disease-free interval. RESULTS: Recytoreductive surgery for patients with isolated recurrent tumor were optimal. For those diagnosed as local lesion preoperatively, 61% of these cases were found to have disseminated diseases postioeratively. Sixty-five percents of these cases received optimal RCRS, but their prognosis were not as well as those with real isolated leasion (response rate: 36% vs 67%). Cases with different sensitivity to chemotherapy had different prognosis (response rate: A, 50%; B, 26%; C, 28%). CONCLUSION: Recytoreductive surgery should be considered in patients with isolated recurrent ovarian cancer and patient with recurrence more than 6 months after chemotherapy.

Female↗
PubMed2003

[Role of positron emission tomography in diagnosis of recurrent ovarian cancer].

OBJECTIVE: To investigate the efficiency of positron emission tomography (PET) with (fluorine-18)-2-deoxyglucose ((18)FDG) in diagnosis of recurrent ovarian cancer. METHODS: (18)FDG-PET scanning and computerized tomography (CT) were performed on 31 patients 35 times, who were clinically free of disease after optimal cytoreductive surgery and first-line chemotherapy. Twenty-two patients were confirmed pathologically after second-look or re-debulking operation and the others were followed up by many methods (ultrasonography, CA(125) and pelvic examination combined), evaluating the role of PET and CT in the diagnosis of recurrent ovarian cancer. RESULTS: (1) PET demonstrated recurrent sites through increased (18)FDG uptake. In 35 times, PET showed 1 false-negative and 1 false-positive cases. (2) The sensitivity of (18)FDG-PET is 96.3%, and CT is 70.4%. There was significant difference between two groups (P < 0.05). CONCLUSION: PET is more sensitive in diagnosing recurrent ovarian cancer than CT, so it improve early diagnosis in recurrent ovarian cancer.

Adult↗