Assessing the Effectiveness of a Cervical Cancer Screening Program in a Hospital-based Study

This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Samples with screening results showing atypical squamous cells of undetermined significance （ASC-US） or worse were referred for colposcopy, and some samples were tested for high-risk HPV types with the Hybrid Capture II system （HC II）. Data on LCT （n=61,193） and HC II （n=1056） results were analysed. Overall test positivity for LCT was 2.53% using an ASC-US threshold, 3.11% using a low-grade squamous intraepithelial lesion （LSIL） threshold, and 0.67% using a high-grade squamous intraepithelial lesion （HSIL） threshold. A total of 1839 women （84% of the 3893 patients with abnormal cytology） underwent colposcopy-directed biopsy. HPV was positive in 80.3% of women with cervical intraepithelial neoplasia 1 （CIN1）, 88.3% of those with CIN2, 79.2% of women with CIN3 and 50% （2 of 4） of women with invasive cancer. There was a significant increase in the detection of CIN2 or worse with adjunct HPV testing of women with ASC-US and LSIL However, there were detection of CIN2＋ cases no differences in the with adjunct HPV testing of women with HSlI.. The results indicate that HPV testing for HSlL triage should not be recommended in cervical cancer screening.

Effect of dexamethasone on intelligence and hearing in preterm infants: a meta-analysis

OBJECTIVE： A meta-analysis of published randomized controlled trials investigating the long- term effect of dexamethasone on the nervous system of preterm infants. DATA SOURCES： Online literature retrieval was conducted using The Cochrane Library （from January 1993 to June 2013）, EMBASE （from January 1980 to June 2013）, MEDLINE （from Janu- ary 1963 to June 2013）, OVID （from January 1993 to June 2013）, Springer （from January 1994 to June 2013） and Chinese Academic Journal Full-text Database （from January 1994 to June 2013）. Key words were preterm infants and dexamethasone in English and Chinese. STUDY SELECTION： Selected studies were randomized controlled trials assessing the effect of intravenous dexamethasone in preterm infants. The quality of the included papers was evaluated and those without the development of the nervous system and animal experiments were exclud- ed. Quality assessment was performed through bias risk evaluation in accordance with Cochrane Handbook 5.1.0 software in the Cochrane Collaboration. The homogeneous studies were analyzed and compared using Revman 5.2.6 software, and then effect model was selected and analyzed. Those papers failed to be included in the meta-analysis were subjected to descriptive analysis. MAIN OUTCOME MEASURES： Nervous system injury in preterm infants. RESULTS： Ten randomized controlled trials were screened, involving 1,038 subjects. Among them 512 cases received dexamethasone treatment while 526 cases served as placebo control group and blank control group. Meta-analysis results showed that the incidence of cerebral palsy, visual im- pairment and hearing loss in preterm infants after dexamethasone treatment within 7 days after birth was similar to that in the control group （RR = 1.47, 95%CI： 0.97-2.21; RR = 1.46, 95%CI： 0.97-2.20; RR = 0.80, 95%CI： 0.54-1.18; P 〉 0.05）, but intelligence quotient was significantly de- creased compared with the control group （MD = -3.55, 95%CI： -6.59 to -0.51; P = 0.02）. Prete rm infants treated with dexamethasone 7 days after birth demonstrated an incidence of cerebral palsy and visual impairment, and changes in intelligence quotient similar to those in the control group （RR = 1.26, 95%CI： 0.89-1.79; RR = 1.37, 95%CI： 0.73-2.59; RR = 0.53, 95%CI： 0.32-0.89; RR = 1.66, 95%CI： -4.7 to 8.01; P 〉 0.05）. However, the incidence of hearing loss was significantly increased compared with that in the control group （RR = 0.53, 95%CI： 0.32-0.89; P = 0.02）. CONCLUSION： Dexamethasone may affect the intelligence of preterm infants in the early stages after birth, but may lead to hearing impairment at later stages after birth. More reliable conclusions should be made through large-size, multi-center, well-designed randomized controlled trials.

AN OVERALL STUDY OF CONVERGENCE CONDITIONS FOR ALGORITHMS IN NONLINEAR PROGRAMMING

Since the point-to-set maps were introduced by Zangwill in the study of conceptual algorithms, various sufficient conditions for the algorithms to be of global convergence have been established.In this paper, the relations among all these conditions are illustrated by a unified approach;still more, unlike the sufficient conditions previously given in the literature,a new necessary condition is put forward at the end of the paper, so that it implies more applications.