LncRNA MALAT1 Knockdown Alleviates Fibrogenic Response in Human Endometrial Stromal Cells Via the miR-22-3p/TGFßR1/Smad2/3 Pathway.

Intrauterine adhesion (IUA) resulting from irreversible fibrotic repair of endometrium is the main cause of secondary infertility in women, and current therapeutic approaches to IUA are limited. Increasing evidence has suggested the important role of competitive endogenous RNA (ceRNA) in IUA pathologies. This study aimed to investigate the long noncoding RNA (lncRNA) metastasis associated lung adenocarcinoma transcript 1 (MALAT1)-associated ceRNA in IUA development. We harvested endometrial tissues from patients with or without IUA and extracted endometrial stromal cells (ESCs) from normal endometrial tissues. Transforming growth factor ß1 (TGF-ß1) was used to induce fibrosis in ESCs. The expression of transforming growth factor ß receptor 1 (TGFßR1), α-smooth muscle actin, phosphorylated suppressor of mother against decapentaplegic (p-Smad)2/3, collagen type I alpha 1, MALAT1, and microRNA (miR)-22-3p in endometrial tissues and ESCs was measured by reverse transcription quantitative polymerase chain reaction (RT-qPCR) or western blotting. Pearson's correlation analysis was conducted to assess the correlation between miR-22-3p expression or TGFßR1 and MALAT1 expression in endometrial tissues. The expression of TGFßR1 in ESCs was also evaluated by immunofluorescence staining. The location of MALAT1 was examined by fluorescence in situ hybridization. Luciferase reporter assays were performed to verify the binding relationship between MALAT1 or TGFßR1 and miR-22-3p. Cell viability was assessed via cell counting kit-8 assays. Our findings revealed that lncRNA MALAT1 and TGFßR1 were upregulated while miR-22-3p was downregulated in IUA endometrial tissues or TGF-ß1-stimulated ESCs, and lncRNA MALAT1 expression was negatively correlated with miR-22-3p expression while being positively correlated with TGFßR1 expression in IUA endometrial tissues. Additionally, lncRNA MALAT1 was mainly located in the cytoplasm of ESCs and directly targeted miR-22-3p to regulate TGFßR1 expression. Moreover, knockdown of lncRNA MALAT1 exerted anti-fibrotic effects on ESCs by targeting miR-22-3p, and miR-22-3p overexpression inhibited the fibrosis of ESCs by binding to TGFßR1 3'untranslated region. Collectively, lncRNA MALAT1 promotes endometrial fibrosis by sponging miR-22-3p to regulate TGFßR1 and Smad2/3, and inhibition of MALAT1 may represent a promising therapeutic option for suppressing endometrial fibrosis.

A review of the effects of estrogen and epithelial-mesenchymal transformation on intrauterine adhesion and endometriosis.

Uterus transplantation has become an option for women suffering from some form of infertility. Current review discusses key physiological functions of the endometrium requiring the transition of tissue cells between the mesenchyme and epithelial cell phenotype, a process known as epithelial-mesenchymal transition (EMT). Estrogen and EMT play a key role in the pathogenesis and treatment of intrauterine adhesion and endometriosis. There is also a close regulatory relationship between estrogen and EMT, and investigation of this relationship is of great significance for the treatment of endometrial disorders. The present review discusses the effects of estrogen on endometrial dysfunction, with a focus on the relationship between estrogen and EMT in endometrial disorders, taking into consideration the mechanisms by which receptors that regulate their functions and proteins that regulate their local biological functions interact with the factors involved in EMT. In addition, the review summarizes emerging drugs targeting receptors or proteins and provides information on the direction of new therapies for endometrial disorders.

Clinical study on multi-focused laser in the treatment of vulvar lichen sclerosus.

Objective: To investigate the clinical effect of Multi-focused (MF) laser in the treatment of vulvar lichen sclerosus (VLS). Methods: In this single-center, randomized controlled trial, we compared the effect of fractionated MF laser with other treatments on patients with biopsy-proven VLS. Patients with VLS were enrolled in this study and randomly divided into three groups. Patients in the experimental group were treated with a CO2 laser, control group 1 was treated with radiofrequency, and control group 2 was treated topically with glucocorticoids and soaking with Chinese patent medicine. The pruritus degree, skin elasticity, skin color, lesion scope, and total score were compared before treatment, at one month after treatment, and three months after treatment. Results: One month after treatment, the pruritus degree, skin elasticity, skin color, lesion scope, and total score decreased in the experimental group, and the differences were statistically significant (P < 0.05). In control group 1, the differences in pruritus degree, skin color, and total score were statistically significant (P < 0.05), but the differences in skin elasticity and lesion scope were not statistically significant (P > 0.05). In control group 2, the differences in pruritus degree and total score were statistically significant (P < 0.05), but the differences in skin elasticity, skin color, and lesion scope were not statistically significant (P > 0.05). At one month after the end of treatment, the differences in pruritus degree, skin elasticity, skin color, lesion scope, and total score among the three groups were not statistically significant. At three months after the end of treatment, the differences in the scores of the five indicators were statistically significant. Conclusion: For the three treatment methods for VLS, topical corticosteroids + traditional Chinese medicine can quickly relieve itching symptoms in patients, but it cannot significantly improve skin elasticity, skin color, and lesion scope, and VLS easily relapses after treatment. Radiofrequency can improve itching symptoms and skin color but has poor effects on the change of skin elasticity and lesion scope. Multi-focused laser treatment can alleviate the degree of pruritus, improve skin color and elasticity, and narrow the lesion scope, and VLS will not relapse within three months after treatment.

Analysis of the Clinical Efficacy of Conservative Treatment for an Unruptured Cornual Pregnancy.

Context: Early diagnosis and early treatment of cornual pregnancy are very important. Conservative treatment before rupture can greatly reduce the patient's trauma. It's very important to choose a treatment method for cornual pregnancy with a high level of effectiveness, few adverse reactions, and no effects on fertility. Objective: The study intended to compare the clinical efficacy of different treatments for unruptured cornual pregnancy to find a safe, effective, minimally invasive treatment for unruptured cornual pregnancy that has few side effects and doesn't affect fertility. Design: The research team retrospectively collected the clinical data of patients to analyze the benefits of treatments for cornual pregnancy. Setting: The study took place in the Department of Obstetrics and Gynecology at the Wuhan Third Hospital in Wuhan, Hubei Province, China. Participants: Participants were 61 patients with an unruptured cornual pregnancy who had been admitted to the hospital between September 2002 and May 2012. Intervention: Participants were divided into four groups according to the treatment they received: (1) 20 patients who had been orally administered mifepristone combined with misoprostol and received uterine curettage were included in the drug abortion + curettage group (D group); (2) 16 patients who had received ultrasound-guided uterine aspiration were included in the uterine aspiration group (U group); (3) 15 patients who had received methotrexate (MTX) chemotherapy were included in the chemotherapy group (C group); and (4) 10 patients who had received ultrasound-guided hysteroscope operation were included in the hysteroscope operation group (H group). Outcome Measures: Adverse reactions and the decrease in participants' blood ß-HCG were recorded in detail. The participants were followed up for two months. Results: Of the 61 participants, 12 underwent surgery after failed conservative treatment, one in the D group, four in the U group, three in the C group, and four in the H group. No significant difference existed in the baseline data among the four groups. The decline rates of ß-HCG at seven days after treatment and the treatment success rates of participants in the D group were significantly higher than those in the U group, the C group, and the H group (all P < .05). The time at which the ß-HCG turned negative and the average hospital stays weren't significantly different among the four groups. Conclusions: The current study found that oral administration of mifepristone, combined with misoprostol, plus uterine curettage was superior to the other three methods in treatment of unruptured cornual pregnancy. The drug abortion + curettage treatment was found to be a safe, effective, minimally invasive treatment for unruptured cornual pregnancy, which has few side effects and doesn't affect fertility.

Improving anaerobic sewage sludge digestion by implementation of a hyper-thermophilic prehydrolysis step.

The present study focuses on a two-step process for treatment and stabilisation of primary sludge. The process consists of a hyper-thermophilic hydrolysis step operated at 70 degrees C and a hydraulic retention time (HRT) of 2 days followed by a thermophilic (55 degrees C) anaerobic digestion step at a HRT of 13 days. A one-step anaerobic digester operated at 55 degrees C and 15 days HRT was used as a reference process. The two-step process was characterized by a 12% higher organic suspended solids removal efficiency and better pathogen reduction effect than the conventional one-step digestion. The microbial community of the digester fed with pre-treated sludge was characterised by a higher activity compared to that of the digester treating raw sludge. Moreover, the pre-treatment of the primary sludge resulted up to 48% increase of the methane potential (20.09 and 13.56 mmol CH(4)g(-)VS(-1) with and without pre-treatment, respectively) and up to 115% increase of the methane production rate. Finally it was shown that the extra energy requirements for the operation of a pre-treatment step would be covered by the energy produced from the extra methane production and in addition there would be a significant energy surplus of 2.17 kJ d(-1) for the system tested.