Abstract Background Polypoid endometriosis (PEM) is rare benign tumors with morphological features resembling malignant tumors. We aimed to analyze the clinicopathological features and outcomes of patients with PEM, and compare them to cases of endometriosis with malignant transformation. Methods In total 28 PEM and 44 cases of endometriosis with malignant transformation were retrospectively analyzed. Data from each of the patients was collected including clinicopathological features, treatment, and outcomes for evaluation. Results In the PEM group patients were aged 30 to 63 years (mean, 40.7 years). The most common clinical symptoms were pelvic mass, irregular vaginal bleeding, and lower abdominal pain. The primary sites were ovary, posterior vaginal fornix, rectum, uterosacral ligament, and abdominal incision. The PEM tumors had a median maximum diameter of 5.3 cm (IQR, 3.1–7.9). The follow-up data in the PEM group showed that 23/27 patients survived without residual disease, 3/27 patients survived with residual endometriosis, 1/27 patient survived with endometriosis-malignant low-grade endometrial stromal sarcoma (ESS). Compared with patients in the endometriosis with malignant transformation group, there were statistically significant differences in age, menopause, dysmenorrhea, adenomyosis, cancer antigen 125 (CA125) levels, and tumor size. Conclusions PEM is a benign lesion and has a risk of malignant transformation. Patients with PEM were younger with a smaller tumor size and a higher CA125 level when compared to patients with endometriosis with malignant transformation, which provides important information for the correct diagnosis of PEM.
Technical and vocational education and training (TVET) is essential worldwide due to its prominent role in preparing the skilled workforce to participate in economic development. This article reports on the TVET situation in Pakistan. First, it reports the historical developments of TVET in Pakistan. TVET has been given priority in policy documents since the independence of Pakistan, but real practical work has been done in the last two decades. National and provincial governments have formulated many new policies to improve TVET and created new governing authorities to regulate it. This results in increased TVET institutions and enrollments. However, this article also identified the significant challenges to TVET in Pakistan. Governance and infrastructure problems, gender inequality, and quality of teaching and learning are three critical challenges to developing TVET. National and provincial governments should partner with local industry and international organizations to build a better framework for TVET in Pakistan.
Two or more embryo transfers have been used to increase the success rate of live birth in traditional in vitro fertilization (IVF) strategy at the expense of increased risks of multiple pregnancy and adverse perinatal outcomes. The decision regarding the elective single embryo transfer or double embryo transfer remains inconclusive. The aim of this study was to investigate the risk factors for twin pregnancy in IVF.Participants who underwent their first fresh IVF cycle where two cleavage stage embryos were transferred in Women's Hospital of Zhejiang University between January 2010 and December 2018 were included in this retrospective cohort study. The primary outcome was twin delivery. Secondary outcomes included preterm birth and low birth weight RESULTS: Fifteen thousand four hundred fifty-nine women were available for final analysis, in which 1511 women resulted in twin delivery and 4788 women had singleton delivery. Female age over 35 was associated with reduced rates of twin pregnancy compared with female age at or less than 35 (9.5% vs 25.1%, aRR = 0.38 (0.27. 0.55)). Poor-type endometrium was associated with reduced rates of twin pregnancy (19.2% vs 27.5%, aRR = 0.75 (0.58. 0.96)). Two good-quality embryos for transfer was associated with significantly higher rates of twin pregnancy compared with one good-quality or none good-quality embryo (26% vs 12.8% vs 9.3%, aRR = 0.56 (0.45. 0.70), aRR = 0.44(0.26. 0.74)). Female age over 35 and none or one good-quality embryo for transfer were associated with reduced rate of low birth weight and preterm birth.Women with age over 35, poor-type endometrium, one good-quality embryo or none good-quality embryo were associated with reduced rate for twin pregnancy.
The article selects 12 financial indicators from the six aspects of listed companies' profitability, operating capacity, solvency, growth capacity, cash flow and capital structure to construct Probit model and Logit model to study the financial difficulties of listed companies in China. The results show that earnings per share, equity ratio, interest protection multiples and inventory turnover ratio have a significant early warning effect on the financial distress of listed companies in China. The Probit model has a prediction accuracy rate of 78.31% for whether the company will fall into financial difficulties, and the Logit model has a prediction accuracy rate of 92.18%. The Logit model's prediction ability is significantly better than the Probit model.
Background Stroke is a severe health problem, and magnetic resonance imaging (MRI) plays a significant role in stroke. Purpose To investigate the clinical value of MRI T2-mapping in carotid artery plaque. Material and Methods To locate the plaque in the carotid artery, 25 patients with carotid atherosclerosis were examined by 3.0-T MRI with three-dimensional (3D) time-of-flight and 3D fast spin-echo (FSE) T1-weighted scanning. The original images were obtained after T2-mapping (multi-spin-echo sequence) scanning. The T2 values of the plaque in the narrowest lumen were measured on T2 maps after postprocessing of the original images. Based on the symptoms, the patients were divided into two sub-groups; independent sample t-test was employed to compare the difference between the T2 values of the plaque in the two groups. We evaluated the optimal threshold and diagnostic efficacy of T2 values in predicting cerebrovascular symptoms by the receiver operating characteristic (ROC) curve. Results The T2 values of the carotid artery plaque in symptomatic and asymptomatic patients were 111.43 ± 46.54 ms and 59.25 ± 39.77 ms, respectively (t = −3.421, P < 0.01). ROC analysis showed that the T2 value of 65.38 ms was the optimal threshold to predict cerebrovascular symptoms. The specificity, sensitivity, and accuracy attained were 94.1% (16/17), 93.3% (14/15), and 93.8% (30/32), respectively. Conclusion We quantitatively assessed carotid plaque components by MRI T2-mapping technology. The T2 values of the carotid plaque were associated with cerebrovascular symptoms. The T2 values of the symptomatic plaque group were significantly higher than those of the asymptomatic group.
BACKGROUND To assess the non-adherence rate among pulmonary tuberculosis (TB) patients in Anhui Province, eastern China and to explore the influential factors, so as to identify targets for intervention. MATERIAL AND METHODS A total of 339 TB patients were recruited from TB dispensaries in 8 counties of Anhui Province, eastern China using a stratified sampling method. All study subjects were surveyed using a structured questionnaire. Differences between groups involving categorical data were analyzed using the chi-square test. RESULTS Overall, of the 339 patients, 33.63% missed medication. Divorced and widowed patients were more likely to miss medication compared with those who were married or unmarried (P<0.01). Regarding the knowledge related to topics such as transmission route, preventive measures, and suspicious symptoms, the awareness rate in the group with good medication compliance was higher than in the group with poor compliance (P<0.05). We found that compliance was not significantly associated with seeking medical treatment in professional institutions, the national free TB treatment policy, or discrimination (P>0.05). The rate of non-compliance under supervision (26.10%) was lower than that without supervision (64.18%) (P<0.001). CONCLUSIONS The anti-TB treatment non-adherence rate in TB patients is relatively high in Anhui Province, eastern China, and is associated with marital status, annual income, TB knowledge, and medical staff visits.
Patients with primary hyperparathyroidism (PHPT) are at risk for severe hypocalcemia (SH) following parathyroidectomy (PTX), but limited data exist on the predictors of SH. We aimed to identify risk factors for early postoperative SH after PTX in patients with PHPT and to evaluate the predictive value of clinical parameters.
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