Clinical Value Analysis of Serum TK1, SCC-Ag, and MUC-1 in the Diagnosis and Prognosis Evaluation of Cervical Cancer.

Objective: This study aims to analyze the diagnostic and prognostic value of serum thymidine kinase (TK1), squamous cell carcinoma antigen (SCC-Ag), and mucin-1 (MUC-1) in cervical cancer. Methods: This retrospective study included 85 cervical cancer patients as the experimental group treated at our hospital's obstetrics and gynecology department from January 2016 to January 2019. The benign group also consisted of 85 patients with benign lesions treated during the same period, and the comparison group comprised 85 patients with healthy physical examinations at the same time. Results: Serum levels of TK1, SCC-Ag, and MUC-1 were significantly higher in the experimental group than in the benign group and higher in the benign group than in the comparison group (P < .05). Additionally, serum TK1, SCC-Ag, and MUC-1 were higher in the lymph node metastasis group, infiltration depth > 1/2 group, tumor diameter ≥ 4 cm group, and stage III-IV group compared to the non-lymph node metastasis group, infiltration depth ≤ 1/2 group, tumor diameter <4 cm group, and stage I-II group (P < .05). No significant differences in serum TK1, SCC-Ag, and MUC-1 among different pathological types and age groups (P > .05). Moreover, serum TK1, SCC-Ag, and MUC-1 levels were higher in the deceased group compared to the survivor group (P < .05). These markers were negatively correlated with survival time (r value = -0.524, -0.428, -0.516), indicating that as the severity of cervical cancer increased, serum TK1, SCC-Ag, and MUC-1 concentrations also increased. The levels of these markers were significantly higher in deceased patients compared to survivors. Conclusions: Serum levels of TK1, SCC-Ag, and MUC-1 show promise as biomarkers for cervical cancer diagnosis and prognosis. TK1 and SCC-Ag are elevated, while MUC-1 is decreased in cervical cancer patients. Further research is warranted to confirm these findings and explore additional biomarkers.

Honokiol alleviates radiation-induced premature ovarian failure via enhancing Nrf2.

BACKGROUND: The ovary is highly sensitive to radiation, and patients receiving radiotherapy are at significant risk of premature ovarian failure (POF). This study aimed to explore the radioprotective effect of honokiol (HKL) on ionizing radiation (IR)-induced POF. METHODS: Female C57BL/6 mice were administered intraperitoneally with vehicle or HKL once daily for 7 days. On day 7, the mice in the IR and HKL+IR groups were exposed to 3.2 Gy whole-body radiation for one hour after the intraperitoneal injection and sacrificed 12 or 72 h after radiation exposure. The gonadosomatic index (GSI) was calculated. Blood samples were collected for enzyme-linked immunosorbent assay (ELISA). Ovaries were harvested for histological examination, immunohistochemistry, immunofluorescence, TUNEL, western blot, and qPCR. The fertility assessment was evaluated by calculating live offspring number. RESULTS: The optimum dose of HKL against radiation was 10 mg/kg via intraperitoneal injection. POF was induced 72 h after irradiation with significantly downregulated proliferating cell nuclear antigen (PCNA). The numbers of primordial and preantral follicles decreased significantly after irradiation (p < .001), whereas the number of atretic follicles increased (p < .001). The serum levels of estradiol (E2 ) and anti-Müllerian hormone (AMH) decreased to 50% of the control group after irradiation (p < .05). Moreover, the GSI after irradiation was 27% lower than in the control group (p < .05). The number of offspring in the IR group dropped by 50% compared with the control group (p < .05). HKL pretreatment protected the animals' fertility, GSI, PCNA, serum levels of E2 and AMH, and the number of primordial and preantral follicles. Significant upregulation of apoptosis-related proteins such as Pho-P53, Bax, Cyto C, C-caspase-3, C-PARP, and pyroptosis-related proteins such as Pho-NF-κB p65, NLRP3, caspase-1, IL-1ß, and IL-18 was observed after irradiation, while the expression of Bcl-2 decreased. HKL pretreatment prevented these changes. After irradiation, malondialdehyde (MDA), Nrf2, and HO-1 were upregulated. HKL treatment activated the expression of Nrf2 and HO-1 and promoted the nucleus translocation of Nrf2. Furthermore, HKL did not affect ovarian reserves under physiological conditions. CONCLUSIONS: HKL ameliorated IR-induced POF by inhibiting apoptosis and pyroptosis by enhancing Nrf2 expression and translocation.

Efficacy and safety of oral gonadotropin-releasing hormone antagonists in moderate-to-severe endometriosis-associated pain: a systematic review and network meta-analysis.

PURPOSE: The aim of this NMA is to comprehensively analyze evidence of oral GnRH antagonist in the treatment of moderate-to-severe endometriosis-associated pain. METHODS: Literature searching was performed to select eligible studies published prior to April 2022 in PubMed, Cochrane, Embase and Web of Science. Randomized controlled trials involving patients who suffered from moderate-to-severe endometriosis-associated pain and treated with oral nonpeptide GnRH antagonists or placebo were included. RESULTS: Elagolix 400 mg and ASP1707 15 mg were most efficient in reducing pelvic pain, dysmenorrhea and dyspareunia. Relugolix 40 mg was best in reducing the analgesics use. The rates of any TEAEs and TEAEs-related discontinuation were highest in relugolix 40 mg and elagolix 250 mg, respectively, while rates of hot flush and headache were highest in relugolix 40 mg and elagolix 150 mg. Significantly decreased spinal BMD was observed in elagolix 250 mg. CONCLUSION: Oral GnRH antagonists were effective in endometriosis-associated pain in 12w, and most of the efficiency and safety outcomes were expressed in a dose-dependent manner, but linzagolix 75 mg was an exception.

Maternal and neonatal characteristics associated with clinical outcomes of TOLAC from 2012-20 in the USA: Evidence from a retrospective cohort study.

Background: The risks of a few maternal and/or neonatal morbidities are higher with the trial of labour after caesarean (TOLAC) owing to unplanned caesarean delivery. Thus, it is imperative to consider the trade-off between the risk of side effects and the potential benefits before TOLAC utilisation and whether TOLAC should be provided to women with specific characteristics related to previous caesarean delivery. We aimed to investigate maternal and neonatal characteristics associated with TOLAC utilisation, compare maternal and/or neonatal morbidities in TOLAC women with women who chose planned caesarean deliveries, and assess specific characteristics related to maternal and/or neonatal morbidities in women with TOLAC utilisation. Methods: In this retrospective cohort study, we used nationwide, linked birth and infant death data in the United States between 2012 and 2020, which covers all 50 states in the US. Poisson regression models using generalised estimating equations yielded adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs) of TOLAC utilisation and unsuccessful TOLAC by maternal and neonatal characteristics. Logistic regression models using generalised estimating equations yielded adjusted odds ratios (aORs) with 95% CIs of maternal and neonatal morbidities. Statistical analysis was performed from February 2022 to July 2022. Findings: The sample included 4,898,441 women with mean (SD) maternal age years (5.4 years; range 13-50). Several specific maternal and neonatal characteristics were significantly associated with unsuccessful TOLAC, although women with TOLAC utilisation were associated with significantly lower risks of maternal unplanned hysterectomy (aOR, 0.60; 95% CI, 0.60-0.61), admission to intensive care (aOR, 0.84; 95% CI, 0.84-0.85), and neonatal seizures (aOR, 0.80; 95% CI, 0.74-0.84). In women who attempted TOLAC, advanced maternal age, higher maternal body mass index, more than 2 previous caesarean deliveries, having maternal co-morbidities and fetal malpresentation increased the likelihood of maternal and neonatal morbidities. Interpretation: When utilising TOLAC, specific maternal and neonatal characteristics in pregnant women should be considered in conjunction with the potential benefits of TOLAC in preventing maternal and neonatal morbidities. Funding: This study is funded by the Clinical Medicine Plus X - Young Scholars Project, Peking University, the Fundamental Research Funds for the Central Universities (No: PKU2022LCXQ008).

The effects of vasopressin injection technique on ovarian reserve in laparoscopic cystectomy of bilateral ovarian endometrioma: a retrospective cohort study.

OBJECTIVE: To evaluate the effects of vasopressin injection technique (VIT) on ovarian reserve in laparoscopic cystectomy of bilateral ovarian endometrioma. MATERIAL AND METHODS: A total of 122 patients with bilateral ovarian endometrioma undergoing laparoscopic cystectomy were assigned to control or the VIT group. Coagulation-event count and blood loss were recorded. Levels of serum anti-Müllerian hormone (AMH) were assessed at 1 day pre-operation, 1 month, 3 months, and 6 months post-operation. The follicles in the tissue sections were counted, and the maximum thickness of cyst wall was measured. RESULTS: Coagulation-event count and blood loss in the VIT group were statistically less than those in control group (P<0.05). In both groups, AMH levels at pre-operation were the highest among different time-points (P<0.05); a remarkable decrease of AMH level was observed at 1 month post-operation, and the values were the lowest among different time-points (P<0.05). At 3 months post-operation, AMH levels gradually increased to approximately 60% of those at pre-operation (P<0.05); at 6 months post-operation, AMH levels were significantly higher than those at 3 months post-operation in VIT group (P<0.05). AMH levels in VIT group were significantly higher than those in control group at each time-point post-operation (P<0.05). The cyst walls in control group were statistically thicker than those in VIT group (P<0.05). Consistent with results of cyst wall thickness, numbers of total follicle loss, primordial and primary follicles in VIT group were less than those of control group (P<0.05). CONCLUSION: VIT effectively protected ovarian reserve in laparoscopic cystectomy of bilateral ovarian endometrioma.

Clinical analysis of uterine arterial interventional chemoembolization combined with radiotherapy in mid-advanced cervical cancer.

PURPOSE: To compare the efficacy and safety of uterine arterial interventional chemoembolization (UAIC) combined with radiotherapy and intravenous chemotherapy combined with radiotherapy in the treatment of mid-advanced cervical cancer. METHODS: The clinical data of 128 patients with mid-advanced cervical cancer were retrospectively analyzed. According to different treatment methods, the patients were divided into two groups. Docetaxel+nedaplatin UAIC combined with intensity-modulated radiotherapy was performed in UAIC group (n=64), while docetaxel+nedaplatin intravenous chemotherapy combined with intensity-modulated radiotherapy (IMRT) was performed in the control group (n=64). The short-term clinical efficacy and incidence of adverse reactions were compared between the two groups. The tumor recurrence and survival status were recorded during follow-up, and the progression-free survival (PFS) and overall survival (OS) were compared between the two groups. RESULTS: The short-term clinical response rate was 70.3% (45/64) and 48.4% (31/64), respectively, in the UAIC and the control group. In the functional scales of European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire-Core 30 (EORTC-QLQ-C30), the scores of physical function, role function, cognitive function, emotional function and social function were higher in the UAIC group than in the control group, but only the emotional function score had a statistically significant difference. In the symptom scales, the scores of sleep disturbance, nausea and vomiting, pain and fatigue were obviously lower in the UAIC group than those in the control group. The general health score was 79.46±11.28 points and 78.17±13.49 points, respectively, in the UAIC and the control group. Follow-up results revealed that the 3-year OS was 70.3% (45/64) and 73.4% (47/64), and the 3-year PFS was 64.1% (41/64) and 65.6% (42/64), respectively, in the UAIC and the control group. Log-rank test showed that OS and PFS had no statistically significant differences between the two groups. CONCLUSIONS: UAIC combined with radiotherapy has better short-term clinical efficacy than intravenous chemotherapy combined with radiotherapy in the treatment of mid-advanced cervical cancer, with fewer adverse reactions and higher quality of life, but it had no significant effect on the long-term survival and tumor progression.

Response to first-line treatment predicts progression-free survival benefit of small-cell lung cancer patients treated with anlotinib.

BACKGROUND: Anlotinib significantly extended progression-free survival (PFS) and overall survival (OS) in small-cell lung cancer (SCLC) as third or later line treatment. METHODS: In this study, we retrospectively analyzed the efficacy and safety of anlotinib in the clinical practice and aimed to identify risk factors for predicting the clinical benefit of anlotinib in SCLC patients. 29 SCLC patients treated with anlotinib monotherapy or combination therapy as second or later line treatment were included. PFS, OS, objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were analyzed. RESULTS: In whole patients, the median PFS was 2.1 months (95% confidence interval (CI): 1.1-3.2 months); The ORR and DCR were 10.3% and 48.3%, respectively; The median OS was 7.2 months (95%CI: 3.2-11.2 months). Cox regression analysis demonstrated that response to first-line treatment was the independent risk factor for PFS. The ORR (20.0% vs. 0%) and DCR (53.3% vs. 42.9%) were promoted in patients treated with anlotinib combination therapy comparing to anlotinib monotherapy. The most common AEs were hoarseness, fatigue, decreased appetite, oral mucositis, and anemia. No treatment-related AEs graded 3 or more. CONCLUSION: Anlotinib is an effective option for SCLC patients with tolerable toxicity as second or later line treatment. Patients sensitive to first-line treatment had longer PFS when treated with anlotinib. Anloitnib combined with other therapy increased the efficacy without adding toxicity.

Comparison between radiofrequency ablation combined with mifepristone and radiofrequency ablation for large uterine fibroids.

OBJECTIVE: To evaluate the clinical outcomes of transvaginal ultrasound-guided (US-guided) radiofrequency ablation (RFA) combined with mifepristone for the treatment of large uterine fibroids. METHODS: Between June 2016 and December 2018, a total of 30 patients with symptomatic uterine fibroids (≥5cm) who underwent transvaginal US-guided RFA combined with mifepristone were included in this retrospective study. A matching cohort of 30 patients underwent transvaginal US-guided RFA without mifepristone as controls. The technical efficacy, complications and mid-term treatment effectiveness were assessed and compared with the controls. RESULTS: The mean volume of uterine fibroid was 168.3 ± 40.1 cm3. The mean ablation time was 23.5 ± 11.3 min in the combined treatment group, which was demonstrably less than that of the RFA group, which was 45.7 ± 6.8 min. The mean number of punctures was 2.2 ± 0.6 in the combined treatment group, which was significantly less than that of the RFA group. No major complications occurred. The mean percentages of regression of fibroid at 3 and 12 months after the course of the combined treatment were 73.3% and 90.1%, respectively, which were significantly more than those of the RFA group. Quality of life and symptom scores improved in both groups but to a greater extent in the combined treatment group. CONCLUSIONS: US-guided RFA combined with mifepristone might be a simple, safe and effective alternative for the treatment of large uterine fibroids.

Ultrasound-guided transvaginal radiofrequency ablation combined with levonorgestrel-releasing intrauterine system for symptomatic uterine adenomyosis treatment.

OBJECTIVE: To evaluate the clinical outcomes of transvaginal ultrasound-guided radiofrequency ablation (RFA) combined with a levonorgestrel-releasing intrauterine system (LNG-IUS) for the treatment of symptomatic uterine adenomyosis. METHODS: Patients with symptomatic uterine adenomyosis treated with ultrasound-guided RFA in combined with an LNG-IUS from January 2013 to January 2016 and followed up for 3 years after treatment were selected. Assessment endpoints included the uterine volume reduction rate, dysmenorrheal score, symptom severity score and adverse events. RESULTS: Among the 72 patients, 64 completed the 3-year follow-up evaluations after treatment. No LNG-IUS expulsion was reported. Dysmenorrhea and symptom severity scores statistically significantly declined after the combined treatment of RFA and LNG-IUS was administered. The uterine volume significantly decreased, and the average reduction rate was 55%. CONCLUSION: Ultrasound-guided RFA combined with an LNG-IUS might be a simple, safe and effective alternative for the treatment of symptomatic adenomyosis.

Retroperitoneal ectopic pregnancy: A case report and literature review.

Retroperitoneal ectopic pregnancy (REP) is a rare type of pregnancy with retroperitoneal implantation of the embryo. Herein, we report a case of a 29-year-old female with REP admitted in our department. Moreover, we review the literatures published previously reporting REP with the aim to improve the understanding of diagnosis and treatment of REP.

Inhibitory and protective effect of obovatol against uterine fibroid (leiomyoma) cells.

Uterine fibroids (UF) or leiomyomas can be presented in post-menopausal women. The present study was aimed to examine the inhibitory and protective (anti-proliferative and apoptotic) effect of the obovatol (OB) in human leiomyoma cells (HuLM). The cell proliferative activity was determined by MTT assay and inflammatory markers were measured. Followed by evaluating DNA fragmentation and apoptotic markers using the ELISA kit method. Also, the apoptosis regulatory proteins expressions were determined using the immunoblot technique. Treatment with increasing concentration of OB (25-200 µM) significantly lowered the cell proliferation rate as well as considerably reduced the values of various pro-inflammatory cytokines like IL-1ß, TNF-α, IL-6. Whereas, the levels of DNA fragmentation and apoptotic marker like caspase-3 and 9 were considerably elevated after co-culturing HuLM cells with OB. In addition, apoptosis regulatory proteins like Bcl2 and Bax were substantially down and up-regulated respectively, by OB in a dose-dependent fashion. The above data clearly showcase that OB possesses potent anti-proliferative (inhibitory) as well as apoptotic activity and may be recommended as a chemotherapeutic agent against UF and related conditions. However, further studies are required before recommended for treating UF subjects.

Ultrasound-guided transcervical radiofrequency ablation for symptomatic uterine adenomyosis.

OBJECTIVE: To retrospectively evaluate the midterm outcomes of transvaginal ultrasound-guided radiofrequency ablation (RFA) for the treatment of symptomatic uterine adenomyosis. METHODS: 87 patients with symptomatic uterine adenomyosis, who met the inclusion criteria, were enrolled in our study from January 2013 to October 2015. All of the patients underwent transvaginal ultrasound-guided RFA and were followed up for 12 months. Assessment end points included uterus volume reduction rate, lesion regression rate, dysmenorrhoeal score, symptom severity score (SSS) and adverse events. RESULTS: In all 87 patients, 81 patients fulfilled the follow-up evaluations post-ablation. The mean uterine volume reduction rate was 35.8% at 1 month, 40.8% at 6 months and 41.2% at 12 months post-ablation. Dysmenorrhoea and SSS statistically significantly declined. Reintervention rate was 18.5%. Two patients developed intrauterine adhesion after ablation. No serious complications including penetration or burn injuries of the nearby organs were observed. CONCLUSION: Ultrasound-guided RFA might be a safe and effective minimally invasive alternative in the treatment of symptomatic adenomyosis. Advances in knowledge: This is the first study to evaluate the efficacy and safety of ultrasound-guided RFA for the treatment of adenomyosis to our knowledge. This is also the first study to provide various changes of intrauterine cavity after this treatment.

Proteomics study reveals that the dysregulation of focal adhesion and ribosome contribute to early pregnancy loss.

PURPOSE: Early pregnancy loss (EPL) affects 50-70% pregnant women in first trimester. The precise molecular mechanisms underlying EPL are far from being fully understood. Therefore, we aim to identify the molecular signaling pathways relating to EPL. EXPERIMENTAL DESIGN: We performed proteomics and bioinformatics analysis of the placental villi in women who have undergone EPL and in normal pregnant women. The proteomics data were validated by Western blot analysis. RESULTS: We identified a total of 5952 proteins in placental villi, of which 588 proteins were differentially expressed in the EPL women. Bioinformatics analysis revealed that these differentially expressed proteins participated in a variety of signaling pathways, including the focal adhesion pathway and ribosome pathway. Moreover, results of the Western blot confirmed that Desmin, Lamin A/C, MMP-9, and histone H4 were upregulated in EPL and the Lamin C/ Lamin A ratio decreased obviously in EPL. These proteins could be associated with the pathophysiology of EPL. The data have been deposited to the ProteomeXchange with identifier PXD002391. CONCLUSION AND CLINICAL RELEVANCE: Our study demonstrated that the focal adhesion pathway and ribosome pathway are involved in EPL, and these findings might contribute to unveil the pathophysiology of EPL.

Association between matrix metalloproteinase-2 and matrix metalloproteinase-9 polymorphisms and endometriosis: A systematic review and meta-analysis.

Matrix metalloproteinase-2 (MMP-2)-735C/T and MMP-9-1562C/T polymorphisms have been indicated in the predisposition to endometriosis. However, due to the small sample sizes of previous studies, the results remain inconclusive. The present meta-analysis was conducted to detect the association between the two genetic polymorphisms and the risk of endometriosis by pooling all the available data. Electronic databases, including PubMed, Embase, Web of Science and CNKI, were searched comprehensively for studies examining a link between MMP-2 and MMP-9 polymorphisms and endometriosis. The strength of the association was assessed based on the pooled odds ratio with a 95% confidence interval, which was calculated using either the fixed- or random-effect model. Following the inclusion criteria, 6 case-control studies were included. The total number of participants was 2,486 (558 cases and 797 controls concerning the MMP-9-1562C/T polymorphism, and 525 cases and 606 controls concerning the MMP-2-735C/T polymorphism). No significant association was identified between the MMP-2-735C/T or MMP-9-1562C/T polymorphism and endometriosis. In further stratified analysis, no significant association was identified between the MMP-9-1562C/T polymorphism and endometriosis. The present meta-analysis revealed no association between the MMP-2-735C/T and MMP-9-1562C/T polymorphisms and the risk of developing endometriosis. Considering the limitations of the meta-analysis, well-designed studies with larger sample sizes are required.

[Investigation into the serum uric acid level of the residents in Henglan town of Zhongshan city].

OBJECTIVE: To investigate the relationship between cardiac Cerebrovascular disease and serum uric acid(SUA) in the coastal inhabitant, and try to provide base for prevention of the local metabolic disease and cardiac Cerebrovascular disease. METHOD: We got 3111 local people who had participated in the annual physical examination in the perch hospital for the research on the level of SUA and the relative risk factor. According to SUA level we divided the cases into two groups. One is hyperuricemia group and the other is control group. RESULTS: (1)The average SUA level was (380.2-/+62.58) micromol/L in the males, while (290.82-/+60.32) micromlo/L in the female. The sick rate of hyperuricaemia rate, was 21.8% for male, and the 17.6% of female. This disease affected more men than women. It has significant difference (P<0.01); (2)The SUA level of the showed a positive correlation with the indexes of the total cholesterol, the triglyceride, the blood pressure and the body weight index. The SUA level in overweight/obesity people was obviously higher than that of the normal weight people. CONCLUSIONS: (1)The sick rate of hyperuricaemia is high in Zhongshan coastal area, which due to many related factors. As far as, few people know it, so we should adopt the synthesis measure to prevent and control it to reduce the sick rate; (2)the rise of The SUA level possibly becomes one of the independent dangerous and predictive factor for the heart cerebral von disease.

[Effect of carbon dioxide pneumoperitoneum during laparoscopic surgery on morphology of peritoneum].

OBJECTIVE: To investigate the influence of carbon dioxide (CO2) pneumoperitoneum during laparoscopic surgery on morphology of peritoneum. METHODS: Forty patients with myoma of uterus or simple ovarian cyst excluding peritonitis were randomly divided into 2 equal groups to undergo laparoscopic surgery with CO2 pneumoperitoneum or laparotomy respectively. Specimens of parietal peritoneum were obtained at different time points, 0, 30, 90, and 120 min after the beginning of observation, i.e. e, insufflation or opening of the peritoneal cavity, to undergo transmission electron microscopy and scanning electron microscopy to observe the morphological changes of mesothelial cells. RESULTS: In the laparotomy group, up to the time point of 60 min, there was no marked change of mesothelial cells. Intercellular cleft were occasionally found since 90 min and became significant 120 min after. However, in the CO2 pneumoperitoneum group bulging up of mesothelial cells was evident immediately at the time of filling of CO2, intercellular spaces could be found 30 min later, 60 min later intercellular cleft deep to the underlying basement membrane could be seen and the basement membrane lost its continuity and became uncovered, and 120 min later such changes became more significant and a small amount of lymphocytes and macrophages were found in the intercellular clefts. CONCLUSION: Carbon dioxide pneumoperitoneum during laparoscopic surgery causes significant morphological changes in the peritoneum duration of insufflation dependently.