BackgroundThe standard treatment for cervical adenocarcinoma in situ (AIS) is hysterectomy, which is a more aggressive treatment than that used for squamous intraepithelial lesions. Several previous studies have primarily demonstrated that the loop electrosurgical excision procedure (LEEP) is as safe and effective as cold knife cone (CKC) biopsy when AIS is unexpectedly found in a loop excision. This study evaluated the safety of LEEP as the initial treatment for patients with AIS who were strictly selected and evaluated before and after loop resection.MethodsThe oncological and reproductive outcomes of a series of AIS patients who underwent LEEP as the initial treatment between February 2006 and December 2016 were retrospectively evaluated.ResultsA total of 44 women were eligible for analysis. The mean age at diagnosis was 36.1 years, and 14 patients were nulliparous. Multiple lesions were identified in 4 (9.1%) patients. Either hysterectomy (6 patients) or repeat cone biopsies (3 patients) were performed in 8 of the 10 patients who presented positive or not evaluable surgical resection margins (SMs) on the initial LEEP specimens. Residual disease was detected in two patients. All patients were closely followed for a mean of 36.9 months via human papillomavirus testing, PAP smears, colposcopy, and endocervical curettage when necessary. No recurrences were detected. Of the 16 patients who desired to become pregnant, 8 (50%) successfully conceived, and the full-term live birth rate was 83.3% among this subgroup.ConclusionsLEEP with negative SMs was a safe and feasible fertility-sparing surgical procedure for patients with AIS, and the obstetric outcome was satisfactory. However, long-term follow-up is mandatory.

Summary In this paper, we consider the optimal control problem for delayed stochastic differential equations driven by fractional Brownian motions. Some necessary Pontryagin's type conditions are derived by considering the adjoint equations satisfying an anticipated backward stochastic differential equation driven by both fractional Brownian motions and the standard Brownian motions. Some new results on stochastic analysis about the control systems driven by fractional Brownian motions are presented. As an application, a linear quadratic problem is deduced, and a numerical example is shown to prove the effectiveness of our method. Copyright © 2014 John Wiley & Sons, Ltd.

In this paper, we obtain a maximum principle for controlled fractional Fokker-Planck equations. We prove the well-posedness of a stochastic differential equation driven by an α-stable process. We give some estimates of the solutions by fractional calculus. A linear-quadratic example is given at the end of the paper.