Centers In Mainland China Research Articles

Statistical analysis of twenty years (1993 to 2012) of data from mainland China's first intervention center for children with autism spectrum disorder.

BackgroundAutism spectrum disorder (ASD) is characterized by persistent deficits in social communication and interaction, and restrictive and repetitive patterns of behavior, interests or activities. This study aimed to analyze trends in ASD diagnosis and intervention in 20 years of data from the Beijing Stars and Rain Education Institute for Autism (SR), the first autism intervention center in mainland China, and from a recent survey of members of the Heart Alliance, an industry association of autism intervention centers in China.MethodsWe analyzed the registration data at the SR from 1993 to 2012 for a total of 2,222 children who had a parent-reported diagnosis of ASD and 612 of ‘autistic tendencies’. Most of the children who were the primary focus of our analyses were age six and under. We also analyzed results of a survey we conducted in 2013 of 100 member centers of the Heart Alliance. Generalized Estimating Equations, multiple linear regression and the Mann-Whitney test were used for data analysis. Statistically significant findings are reported here.ResultsThe number of hospitals where SR children received their diagnosis increased from several in the early 1990s to 276 at present. The proportion of ‘autistic tendencies’ diagnosis increased 2.04-fold from 1998 to 2012 and was higher for children diagnosed at a younger age. The mean age at first diagnosis of ASD or ‘autistic tendencies’ decreased by 0.27 years every decade. A higher level of parental education was statistically significantly associated with an earlier diagnosis of the child. The mean parental age at childbirth increased by about 1.48 years per decade, and the mean maternal age was 1.40 and 2.10 years higher than that in the national population censuses of 2000 and 2010, respectively. At the time of the survey 3,957 children with ASD were being trained at the 100 autism intervention centers. Ninety-seven of these centers opened after the year 2000. Economically underdeveloped regions are still underserved.ConclusionsThis study revealed encouraging trends and remaining challenges in ASD diagnosis and intervention among children at the SR over the past 20 years and the 100 autism intervention centers in China at present.Electronic supplementary materialThe online version of this article (doi:10.1186/2040-2392-5-52) contains supplementary material, which is available to authorized users.

Efficacy and safety of aripiprazole in Chinese Han schizophrenia subjects: A randomized, double-blind, active parallel-controlled, multicenter clinical trial

ObjectiveAntipsychotics, such as aripiprazole and risperidone, are often used to treat individuals with schizophrenia. The efficacy as well as safety of aripiprazole in Western populations has been described. The objective of this study is to investigate the efficacy, safety, and tolerability of aripiprazole and risperidone in Chinese Han schizophrenia subjects in mainland China. MethodThe 6-week, double-blind, randomized, parallel study was conducted in 5 medical centers in mainland China from November 2007 to March 2011. A total of 279 subjects with a primary DSM-IV diagnosis of schizophrenia were randomly assigned (with a randomization ratio of 1:1) to aripiprazole (n=139) or risperidone (n=140). Efficacy measurements included the Positive and Negative Syndrome Scale (PANSS) total, positive, negative and general psychopathology subscale scores, and Clinical Global Impressions-Severity of Illness (CGI-S), and Improvement scale scores. Extrapyramidal symptoms (EPS), weight gain, serum prolactin level, QTc interval, and self-reported adverse events were also assessed as measures of safety and tolerability. ResultsBoth the aripiprazole and risperidone groups showed statistically significant improvement of PANSS total, positive, negative, general psychopathology subscale scores, and CGI-S scores from baseline to the endpoint (all p<0.01). Significant improvement was noted in the first week for both treatment groups. There were no significant differences in efficacy measurements between the two treatment groups. Mean change of PANSS total scores from baseline to the endpoint was −26.8±18.1 for aripiprazole and −30.0±17.7 for risperidone, (p=0.1475). The responder rate was 71% (n=99) and 76% (n=107) for aripiprazole and risperidone, respectively, (p=0.323). The incidences of EPS were similar in the aripiprazole (25%, n=35) and risperidone groups (24%, n=34), respectively (p=0.757). No clinically meaningful effects on QTc interval, QRS duration, or PR interval were observed in either treatment groups. However, the incidence of clinically significant weight gain (p=0.0118) and hyperprolactinemia (p<0.001) in the aripiprazole group was significantly lower than in the risperidone group. ConclusionThe study demonstrated that aripiprazole, as well as risperidone, had rapid and persistent efficacy for psychotic symptoms from the first week of therapy. There may be poor efficacy for aripiprazole compared with risperidone for overall improvement, but there were no significant differences in this study. Aripiprazole showed good tolerability with less weight gain and hyperprolactinemia compared with risperidone. The overall efficacy and safety of aripiprazole in Chinese Han schizophrenia subjects were similar to that reported in Western populations.

Insulin pen injection technique survey in patients with type 2 diabetes in mainland China in 2010

Objective:The efficacy of injection therapy in diabetes depends on correct injection technique. To provide patients with guidance in this area and help patients inject themselves correctly, we must understand how they currently inject; therefore, the purpose of this study was to assess the current situation of insulin injection technique in patients with diabetes in mainland China.Design and methods:From October 2010 to November 2010, a cross-sectional survey of 380 diabetes patients from 20 centers in mainland China was conducted regarding their daily insulin pen injection practice.Results:Overall, 35.26% of patients had lipohypertrophy; 58.68% of patients had bleeding and bruising, and abdominal lipohypertrophy at injection sites. Bleeding and bruising were more frequent. We found a significant relationship between the frequency of a single needle reuse and lipohypertrophy (r = 0.426, P = 0.000). In addition, there was a significant relationship between the frequency of daily insulin injection and lipohypertrophy (r = 0.146, P = 0.004), between rolling the pen while pulling out the needle after injection and lipohypertrophy (χ2 = 7.355, P = 0.007). Bleeding and bruising at injection sites were found to be related to HbA1c levels (r = 0.151, P = 0.003).Limitations:A few limitations linked with this survey should be noted. Because of the limited budget, the ultrasound was not used to evaluate lipodystrophy and the photographs of lipodystrophy were not taken. On the other hand, specific size of lipodystrophy and the cost of insulin wastage were not evaluated. Furthermore, the population of this survey is limited, and it was only done in general hospitals and not in community hospitals, therefore, a larger study sample is advisable.Conclusions:The insulin injection skill of patients with diabetes in mainland China was poor, and the incidence of lipohypertrophy, bleeding, and needle reuse was high. Frequency of daily insulin injection and needle reuse may relate to the incidence of lipohypertrophy and bleeding. The bleeding and bruising at the injection sites may be associated with suboptimal absorption of injected insulin. Improved education in optimal insulin injection technique, including reducing needle reuse and correct rotation of injection sites should be emphasized.

Genetic diversity of Bartonella quintana in macaques suggests zoonotic origin of trench fever

Bartonella quintana is a bacterium that causes a broad spectrum of diseases in humans including trench fever. Humans were previously considered to be the primary, if not the only, reservoir hosts for B.quintana. To identify the animal reservoir and extend our understanding of the ecological and evolutionary history of B.quintana, we examined blood samples from macaques and performed multilocus sequence typing (MLST) analysis. We demonstrated the prevalence of B.quintana infection was common in macaques from main primate centres in mainland China. Overall, 18.0% (59/328) of rhesus macaques and 12.7% (39/308) of cynomolgus macaques were found to be infected with B.quintana by blood culture and/or polymerase chain reaction. The infection was more frequently identified in juvenile and young monkeys compared with adult animals. In contrast with the relatively low level of sequence divergence of B.quintana reported in humans, our investigation revealed much higher genetic diversity in nonhuman primates. We identified 44 new nucleotide variable sites and 14 novel sequence types (STs) among the B.quintana isolates by MLST analysis. Some STs were found only in cynomolgus macaques, while some others were detected only in rhesus macaques, suggesting evidence of host-cospeciation, which were further confirmed by phylogenetic analysis and Splits decomposition analysis. Our findings suggest that trench fever may primarily be a zoonotic disease with macaques as the natural hosts.

Factors influencing diagnosis and treatment of osteoporosis after a fragility fracture among postmenopausal women in Asian countries: a retrospective study

BackgroundA vast amount of literature describes the incidence of fracture as a risk for recurrent osteoporotic fractures in western and Asian countries. Osteoporosis evaluation and treatment after a low-trauma fracture, however, has not been well characterized in postmenopausal women in Asia. The purpose of this study was to characterize patient and health system characteristics associated with the diagnosis and management of osteoporosis among postmenopausal women hospitalized with a fragility fracture in Asia.MethodsPatient surveys and medical charts of postmenopausal women (N=1,122) discharged after a fragility hip fracture from treatment centers in mainland China, Hong Kong, Singapore, South Korea, Malaysia, Taiwan, and Thailand between July 1, 2006 and June 30, 2007 were reviewed for bone mineral density (BMD) measurement, osteoporosis diagnosis, and osteoporosis treatment.ResultsThe mean (SD) age was 72.9 (11.5) years. A BMD measurement was reported by 28.2% of patients, 51.5% were informed that they had osteoporosis, and 33.0% received prescription medications for osteoporosis in the 6 months after discharge. Using multivariate logistic regression analyses, prior history of fracture decreased the odds of a BMD measurement (OR 0.63, 95% CI 0.45-0.88). Having a BMD measurement increased the odds of osteoporosis diagnosis (OR 10.1, 95% CI 6.36-16.0), as did having health insurance (OR 4.95, 95% CI 1.51-16.21 for private insurance with partial self-payment relative to 100% self-payment). A history of fracture was not independently associated with an osteoporosis diagnosis (OR 0.80, 95% CI 0.56-1.15). Younger age reduced the odds of receiving medication for osteoporosis (OR 0.59, 95% CI 0.36-0.96 relative to age ≥65), while having a BMD measurement increased the odds (OR 1.79, 95% CI 1.23-2.61).ConclusionsOsteoporosis diagnosis and treatment in Asian countries were driven by BMD measurement but not by fracture history. Future efforts should emphasize education of general practitioners and patients about the importance of fracture.

The morbidity and survival of 196 consecutive cases undergoing liver transplantation in a single center in Mainland China: Ten-year experience

Right lobar living donor living transplantation (LDLT) has been controversial because of widely differing reports of recipient morbidity. Herein, we present our nearly 10-year experience and identify factors that potentially could be modified to improve recipient outcome. The Clavien 5-tier grading system was applied retrospectively in 196 consecutive adult right lobar recipients. We determined the incidence of potentially life- threatening (Grade III), actually life-threatening (Grade IV), and lethal (Grade V) complications during the first post-transplant year. The most serious and seminal complication was considered if simultaneous or multiple complications appeared. One-year recipient/graft survival was 82%/82%. Within the first year, 68 (34.69%) of the 196 recipients had Grade III (n=31), Grade IV (n=7), or Grade V (n=30) complications. The complications were 19.90% graft-related and 15.82% non-graft-related. Complications during the first half year did not decline with increased team experience over time and adversely affected recipients' long-term survival, albeit not significantly. According to univariate analysis, high Child-Pugh scores before transplantation (P=0.016), prolonged ICU-stay (P=0.003) and hospitalization time (P=0.032) after transplantation were found to be risk factors for the appearance of ≥ Clavien III complications, while duct-to-duct biliary reconstruction (P=0.02) had a beneficial role in reducing serious complications after LDLTs. In conclusion, serious complications during the first post-transplant year shortened recipient survival and prolonged primary hospitalization duration and postoperative ICU-stay, which is more frequent in recipients with higher Child-Pugh scores and in those with hepaticojejunostomy.

The geography of equity listing and financial centre competition in mainland China and Hong Kong

This study examines the changing competitiveness of financial centres in mainland China and Hong Kong based on the geography of equity listing of mainland Chinese firms. Pre-listing firm characteristics are used to explore firms’ motives for listing on a particular exchange and whether these motives have changed over time. The results show that Hong Kong’s prominence as an international financial centre is attracting the largest and, recently, also the best performing mainland Chinese state-owned enterprises to go public. Less differentiation exists between the competitiveness of Shanghai and Shenzhen, although the renewed strategy of the Shenzhen stock exchange to attract smaller firms appears to be successful.

International outcome inventory for hearing aids (IOI-HA): Results from the Chinese version

Objective: The purpose of this study is to present normative data on the Chinese version of the international outcome inventory for hearing aids (IOI-HA) and examine the effective-ness of the hearing aid service. Design: Cross-sectional study. The IOI-HA was administered in a paper and pencil format. Study sample: The IOI-HA and self-designed questionnaire were mailed to 1502 experienced hearing-aid users who received their hearing aids from 14 hearing service centers in mainland China. In all, 1049 completed responses were included in the final analysis, and descriptive statistics were reported. Results: The mean scores of each item of the IOI-HA ranged from 3.55 to 4.16. The IOI-HA scores showed a skewed distribution, with the maximum frequency for a score of 4 or 5. The total IOI-HA scores ranged from 9 to 35, and the mean total score was 26.3. The results compared favorably with the previous reports, and slightly higher than the published norms, indicating a high level of self-reported outcomes. Conclusiones: The IOI-HA could be used as an effective tool to measure the general effectiveness of the hearing aid outcomes in China. The implementation of the IOI-HA is time-efficient, imposing little burden on the clinician and patient.SumarioObjetivo: El propósito de este estudio es presentar datos normativos de la versión en chino del Inventario Internacional de Resultados con Auxiliares Auditivos (IOI-HA) y examinar la efectividad del servicio de auxiliares auditivos. Diseño: Estudio transversal. El IOI-HA fue administrado en formato de papel y lápiz. Muestra Del Estudio: El IOI-HA y un cuestionario auto-diseñado fueron enviados por correo a 1502 usuarios con experiencia de auxiliares auditivos, quien habían recibido sus auxiliares auditivos de 14 centros de servicio auditivo en China continental. Globalmente, 1049 respuestas completas fueron incluidas en el análisis final, y se reportaron estadísticas descriptivas. Resultados: Los puntajes medios de cada ítem del IOI-HA fluctuaron de 3.55 a 4.16. Los puntajes del IOI-HA mostrados una distribución sesgada, con la mayor frecuencia para un puntaje de 4 o 5. Los puntajes totales del IOI-HA variaron de 9 a 35, el puntaje medio total fue de 26.3. Los resultados se compararon favorablemente con los reportes previos, y levemente más altos que las normas publicadas, indicando un alto nivel de resultados auto-reportados. Conclusiones: El IOI-HA puede servir como una herramienta efectiva para medir la efectividad general de los resultados en la adaptación de auxiliares auditivos en China. La implementación del IOI-HA es tiempo-efectivo, imponiendo una carga pequeña sobre el clínico y el paciente.

The transcription factor Pitx3 is a risk modifier for Parkinson’s disease in a Chinese Han population

The transcription factor Pitx3 plays a crucial role in the development and survival of midbrain dopaminergic (mDA) neurons, especially the mDA neurons in the substantia nigra pars compacta. The degeneration of these neurons is the pathological hallmark in Parkinson's disease (PD). Several polymorphisms of the Pitx3 gene have been linked with sporadic and early-onset forms of PD, but different studies have given conflicting or inconsistent findings. Amongst the polymorphisms studied, the single-nucleotide polymorphism (SNP) rs3758549, located in the promoter region of Pitx3 gene, is one of the most well-studied but also one of the most controversial. In order to explore the nature of this association in greater detail and in a new ethnic group, we carried out a case-control study of the SNP rs3758549. A total of 316 patients with sporadic PD and 305 healthy controls, from two centers in mainland China, were analyzed in our study. The genotypes at rs3758549 were determined by PCR-restriction fragment length polymorphism analysis. And we also analyzed the association between genotype and phenotype. Our data showed a significant association between the rs3758549 polymorphism and PD (P = 0.012, OR = 1.50, 95%CI: 1.15-1.96). Furthermore, allele T of SNP rs3758549 was significantly more frequent in early-onset PD than in healthy controls (P < 0.001). Our findings indicate that the SNP rs3758549 (C >T substitution) in the Pitx3 gene is a potential risk for sporadic PD, especially early-onset PD in Chinese Han population.

SNP rs7684318 of the α-synuclein gene is associated with Parkinson's disease in the Han Chinese population

Mutations in the α-synuclein (SNCA) gene have been shown to be responsible for a rare familial form of Parkinson's disease (PD). Furthermore, polymorphic variants in multiple regions of the gene have been associated with susceptibility to idiopathic PD in different populations. Previous studies in Japanese have found a strong association between idiopathic PD and the single-nucleotide polymorphism (SNP) rs7684318, which is located within an intron of the SNCA gene. Our aim was to verify these findings and to further explore the nature of the association in a subset of Han Chinese PD patients. A case–control study of the SNP rs7684318, comprising 332 PD patients and 300 healthy controls, was carried out in Han Chinese populations from two centers in mainland China. The rs7684318 polymorphism was determined by PCR-restriction fragment length polymorphism (PCR-RFLP) analysis. The SNP rs7684318 of the SNCA gene showed a strong association with PD ( P < 0.01). Among our PD patients, mean age at disease onset and gender did not differ significantly between rs7684318 carriers and non-carriers. Our findings suggested that the SNP rs7684318 (T>C) transition of the SNCA gene contributes to PD susceptibility in Chinese Han population, which is consistent with the earlier study form Japan.

Supply and demand in transplant tourism: Disclosure duties of the transplant physician and our global transplant community

Faced with a poor prognosis without transplantation, desperate patients with end-stage liver disease often reach for any means to prolong their lives. These patients, who resort to transplant tourism, are an especially vulnerable population who may be unaware of the substantial risks associated with organ transplantation practices in many areas of the world. I read with great interest the recently published article by Fan et al.1 documenting the dramatically higher hepatocellular cancer recurrence rates and markedly reduced posttransplant survival rates of recipients who traveled to mainland China for liver transplantation in comparison with those who stayed in Hong Kong. This is valuable evidence of the recipient outcomes of liver transplantation in mainland China and should be proactively shared with patients who are considering transplant tourism. Fan et al.1 reported a recipient survival rate after liver transplantation at their center (Queen Mary Hospital, Hong Kong) that compares favorably with the rates at leading centers worldwide. The authors' efforts to accurately quantitate outcomes at other centers in mainland China are commendable. Recipient selection and donor characteristics are likely influential drivers of the reported outcomes. In their article, organ donors are described as “probably more akin to uncontrolled non–heart-beating donors” for the mainland China cohort. Although the authors are circumspect regarding whether the donors were actually executed prisoners, it seems likely that this was the donor population.2 Although leading destination countries for transplant tourism include China, India, the Philippines, and Pakistan, transplant tourism to mainland China has been isolated as particularly controversial.3-6 Organ procurement from executed prisoners in China has been reported by nongovernmental investigative reports and in the medical literature.2-4 These reports indicate that as many as 95% of organ donors in China are prisoners. Indeed, Dr. Jiefu Huang, Vice Minister of Health in China, reported that “apart from a small portion of traffic victims, most of the cadaveric organs come from executed prisoners.”2 Both live and deceased donor organ procurement from prisoners violates US and international professional guidelines and international standards ratified by the World Medical Association in its statement on human organ donation and transplantation.7-9 These international ethical guidelines exist to ensure that the donation of organs is voluntary, both in life and after death. Because not all countries adhere to these ethical guidelines, when traveling to another country for organ transplant surgery, patients risk using an organ obtained in an unsafe or unethical manner.10, 11 Full disclosure, in scientific reports and at the bedside, is an imperative for our transplant community.5, 12, 13 Laudable efforts aimed at broadening the use of live donor organ donation and donation after brain death in China have the potential to mitigate China's dependence on executed prisoners as the dominant donor pool.14 Transplant physicians are obliged to inform patients considering transplant tourism about both the personal risks of inferior transplant outcomes and the potential for contributing to the demand for practices that may violate human rights.10 Yet, action by international regulatory and credentialing bodies, such as the Joint Commission International, may be required to ensure patient safety and the adherence to internationally accepted ethical standards in organ transplantation.10, 12 Scott W. Biggins M.D., M.A.S.*, * Gastroenterology Health Outcomes, Policy and Economics Program, Division of Gastroenterology and Hepatology, University of California, San Francisco, San Francisco, CA.

Extracurricular Involvement in Community Youth Centers: A Study of School-aged Adolescents, Parents and Center Staff in Mainland China

ABSTRACT This study examines adolescents' involvement in extracurricular activities provided by community youth centers in Mainland China and their perceptions of the benefits of this type of extracurricular involvement. Based on principal data obtained from a survey of 1,544 adolescents aged between 9 and 14, together with supplementary data collected from surveys of 1,116 parents of these adolescents and 632 staff members of community youth centers in five cities in Mainland China—Beijing, Guangzhou, Kunming, Lanzhou and Wuhan—the present study finds a great disconnection between the service condition of community youth centers and what adolescents expect and perform in the centers. Moreover, our findings on extracurricular involvement among adolescents in various academic grades show a tendency for adolescents to become progressively more pessimistic. Specifically, extracurricular involvement and perceptions of most of the benefits of such involvement are less strong among adolescents in higher grades than they are among adolescents in lower grades. In addition, despite a similar pattern regarding perceived benefits of extracurricular involvement between adolescents and parents, the ratings of parents on all benefit items were much lower than those given by their children. The research and practical implications of the current findings for promoting extracurricular involvement in community youth centers among Chinese adolescents are discussed.

Success rate and complications of ERCP performed during hands-on training courses: a multicenter study in China

Hands-on endoscopy workshops are popular and valuable sources for the continuing medical education of endoscopists. Concerns, however, exist regarding clinical outcomes of procedures performed during hands-on training of ERCP. We compared the success rates and complications between patients in the hands-on training courses and matched control patients. A retrospective, multicenter study. Seven endoscopy centers in mainland China. All patients who underwent ERCP during hands-on training courses at GI endoscopy conferences in China between January 2002 and December 2006 were included. Clinical and endoscopic characteristics, including age, sex, indication, therapeutic intervention, success rate, and complication, were collected. Differences in ERCP outcomes between domestic and foreign mentors were also compared. Conference, patient, and endoscopist-related variables were analyzed for potential risk factors associated with post-ERCP complications. Nine conferences with hands-on ERCP training, including 124 patients, were held at 7 endoscopy centers. There were no significant differences in the sex ratio, age, indication, and therapeutic intervention between patients for hands-on training (n = 124) and controls (n = 124). The success rates and overall complication rates were similar between the 2 groups (91.9% vs 92.7%, respectively, P = .811; 12.9% vs 9.7%, respectively, P = .422). Domestic mentors encountered more post-ERCP complications than foreign mentors (18.0% vs 0%, respectively, P = .001). Univariate analyses showed that a large-scale conference (P = .004), first-time mentorship (P = .015), and small case volume for the mentor (P = .015) were significantly associated with post-ERCP complications. Nominal significance in univariate testing was removed when analyzed in a comprehensive multivariate setting. A nonrandomized retrospective trial with only 7 centers (9 conferences). The success rate and overall complication rate were similar between patients in the hands-on training and those who had routine ERCP procedures. A large-scale conference, first-time mentorship, and small case volume for the mentor may be associated with post-ERCP complications.

Epidermal Growth Factor Receptor Mutations and Their Correlation with Gefitinib Therapy in Patients with Non-small Cell Lung Cancer: A Meta-Analysis Based on Updated Individual Patient Data from Six Medical Centers in Mainland China

Convincing data on epidermal growth factor receptor (EGFR) mutations in Chinese patients with non-small-cell lung cancer (NSCLC) remain limited. We investigated the relevance of demographic characteristics and EGFR mutations, correlations between the efficacy of gefitinib and EGFR mutations in NSCLC, and to identify individuals who would likely benefit from gefitinib. We conducted a meta-analysis based on updated individual patient data from six medical centers in mainland China. Outcome measures included the EGFR mutation status, demographic characteristics, response, and survival. Among 506 patients with NSCLC who received EGFR mutation analysis, the EGFR mutation rate was 30.04%. Patients with adenocarcinoma had a higher mutation rate than those with non-adenocarcinoma (44.1% vs 9.2%; p < 0.00001). The EGFR mutation rate for smokers was 15.1%, lower than that for non-smokers (45.5%) (p < 0.00001). Male patients had a lower mutation rate than female patients (23.1% vs 42.9%; p < 0.0001). Multivariate analysis showed that "adenocarcinoma" and "non-smoker" were independent predictors of EGFR mutations. In a subgroup of 57 patients with complete treatment data, the response rate to gefitinib in the EGFR mutant group was 60.7%, significantly higher than that in the wild-type EGFR group (17.2%) (odds ratio, 5.78; 95% CI, 1.95-17.13; p = 0.002). "EGFR mutation", "adenocarcinoma," and "non-smoker" were independent predictors of response. Overall survival in the EGFR mutant group and the wild-type group did not differ significantly (hazard ratio, 0.60; 95% CI, 0.32-1.12; p = 0.110). "Adenocarcinoma status" was an independent prognostic factor for survival. In mainland China, "adenocarcinoma" and "non-smoker" are independent predictors for EGFR mutations. Response to gefitinib favors patients with EGFR mutations. The clinical selected populations for gefitinib are non-smokers with adenocarcinoma.

Unicornuate uterus with rudimentary horn

OBJECTIVES: To identify the effects of unicornuate uterus with rudimentary horn on reproductive function and analyze the diagnosis and treatment of the condition. METHODS: The study was based in the gynecological unit of a city based Medical Center in Mainland China. Twenty-two cases of this anomaly were selected from a group of 130 cases of uterine abnormalities and were retrospectively analyzed. RESULTS: This kind of anomaly can cause hematometra and endometriosis leading to acute abdominal pain, infertility, rupture of pregnant rudimentary horn and obstetrical complications with pregnant semi-uterus. CONCLUSIONS: Rudimentary horn should be removed if detected.