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BACKGROUND: Asthenozoospermia is a major factor contributing to male infertility. The mitochondrial sheath (MS), an important organelle in the midpiece of spermatozoa, is crucial to sperm motility. ARMC12 is a mitochondrial peripheral membrane protein. Deletion of Armc12 impairs the arrangement of MS and causes infertility in mice. However, the role of ARMC12 in human asthenozoospermia remains unknown. OBJECTIVE: To study the genetic defects in patients with asthenozoospermia. METHODS: A total of 125 patients with asthenozoospermia and 120 men with proven fertility were recruited. Whole-exome sequencing and Sanger sequencing were performed for genetic analysis. Papanicolaou staining, HE staining, immunofluorescent staining, transmission electron microscopy and field emission scanning electron microscopy were employed to observe the morphological and structural defects of the spermatozoa and testes. Armc12-knockout mice were generated using the CRISPR-Cas9 system. Intracytoplasmic sperm injection was used to treat the patients. RESULTS: Biallelic ARMC12 mutations were identified in three patients, including homozygous mutations in two siblings from a consanguineous family and compound heterozygous mutations in one sporadic patient. ARMC12 is mainly expressed in the midpiece of elongated and late spermatids in the human testis. The patients' spermatozoa displayed multiple midpiece defects, including absent MS and central pair, scattered or forked axoneme and incomplete plasma membrane. Spermatozoa from Armc12-/- mice showed parallel defects in the midpiece. Moreover, two patients were treated with intracytoplasmic sperm injection and achieved good outcomes. CONCLUSION: Our findings prove for the first time that defects in ARMC12 cause asthenozoospermia and multiple midpiece defects in humans.
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Proteínas do Domínio Armadillo , Astenozoospermia , Infertilidade Masculina , Animais , Humanos , Masculino , Camundongos , Astenozoospermia/genética , Infertilidade Masculina/genética , Camundongos Knockout , Mutação , Sêmen , Motilidade dos Espermatozoides/genética , Espermatozoides , Testículo , Proteínas do Domínio Armadillo/genéticaRESUMO
OBJECTIVES: Nodular sclerosing adenoses (NSAs) and malignant tumors (MTs) may coexist and are often classified into the same Breast Imaging Reporting and Data System (BI-RADS) category. We aimed to build and validate an ultrasound-based nomogram to distinguish MT from NSA for building a precise sequence of biopsies. MATERIALS AND METHODS: The training cohort included 156 patients (156 masses) with NSA or MT at one study institution. We used best subset regression to determine the predictors for building a nomogram from ultrasonic characteristics and patients' age. Model performance and clinical utility were evaluated using Brier score, concordance (C)-index, calibration curve, and decision curve analysis. The independent validation cohort consisted of 162 patients (162 masses) from a separate institution. RESULTS: Through best subset regression, we selected 6 predictors to develop nomogram: age, calcification, echogenic rim, vascularity distribution, tumor size, and thickness of breast parenchyma. Brier score and C-index of the nomogram in the training cohort were 0.068 and 0.967 (95% confidence interval [CI]: 0.941-0.993), respectively. In addition, calibration curve demonstrated good agreement between prediction and pathological result. In the validation cohort, the nomogram still obtained a favorable C-index score of 0.951 (95% CI: 0.919-0.983) and fine calibration. Decision curve analysis showed that the model was clinically useful. CONCLUSIONS: If multiple NSA and MT masses are present in the same patient and are classified into the same BI-RADS category, our nomogram can be used as a supplement to the BI-RADS category for accurate biopsy of the mass most likely to be MT.
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Doença da Mama Fibrocística , Neoplasias , Biópsia , Feminino , Humanos , Nomogramas , UltrassonografiaRESUMO
Uterus transplantation (UTx) is an emerging surgical treatment for patients with absolute uterine factor infertility. However, the initial low surgical success of human UTx from the teams worldwide has revealed the difficulty of the surgery and called for preparatory team training in large animals. Also, the team who carried out the human UTx without previous systematic research in large animals or deceased donors encountered transplant failures, which was controversial and even deprived them of further trials. Various UTx studies in large animals, including dogs, pigs, sheep and macaques have been performed in China from different teams, compared to other countries around the world. However, among over 70 UTx that have been carried out worldwide, only three were carried out in China, with one live baby achieved. In this paper, we explore the possible challenges for human UTx in China. We conclude that it is critical to learn the lessons from the international team and adopt the international ethic views regarding UTx on humans. Also, it would be positive for the Chinese groups to establishing an academic society for UTx with regular meetings, which will raise public awareness of UTx, and guide the proper development of human UTx in China.
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Infertilidade Feminina/cirurgia , Útero/transplante , China , Feminino , HumanosRESUMO
Aerobic glycolysis is an important metabolic rewiring in cancer cells to promote glucose uptake and lactate production, and targeting aerobic glycolysis becomes a promising therapeutic approach for cancer. Here we reported that a small polyphenol resveratrol exhibited profound anti-tumor efficacy on human ovarian cancer. Resveratrol markedly inhibited the proliferation, migration, and invasion of A2780 and SKOV3 ovarian cancer cells, while impaired glycolysis, and induced apoptosis in these cells. Exposure to resveratrol increased the expression and activation of AMPK and Caspase 3, and decreased the expression and activation of AMPK downstream kinase mTOR. Moreover, AMPK inhibitor Compound C significantly abolished the effects of resveratrol on the activation of AMPK and Caspase 3 and the inhibition of mTOR. In addition, in vivo data indicated that resveratrol suppressed ovarian cancer growth and liver metastasis in xenograft mouse model. In conclusion, our findings provide new insight into the mechanism underlying anticancer efficacy of resveratrol and help the utilization of resveratrol as a novel agent for the treatment of ovarian cancer.
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Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Glicólise/efeitos dos fármacos , Neoplasias Hepáticas/secundário , Neoplasias Ovarianas/patologia , Resveratrol/farmacologia , Quinases Proteína-Quinases Ativadas por AMP , Animais , Antineoplásicos Fitogênicos/farmacologia , Movimento Celular , Feminino , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/metabolismo , Proteínas Quinases/genética , Proteínas Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Serina-Treonina Quinases TOR/genética , Serina-Treonina Quinases TOR/metabolismo , Células Tumorais Cultivadas , Ensaios Antitumorais Modelo de XenoenxertoRESUMO
OBJECTIVE: To explore the role of miR-200a in chemosensitivity regulation of ovarian cancer. METHODS: Firstly miR-200a was up-regulated in ovarian cancer cell lines (SKOV-3 and ES-2) by lentiviral vector. Then the effects of miR-200a on cytotoxicity of paclitaxel and cisplatin were investigated by methyl thiazolyl tetrazolium (MTT). Furthermore miR-200a regulation of chemoresistance associated with ATP-binding cassette (ABC) family genes expression was detected by quantitative real-time polymerase chain reaction (PCR) and Western blot. Finally the interaction between miR-200a and ABCG2 mRNA 3'untranslated region (3'-UTR) was verified by dual-luciferase reporter assay. RESULTS: An over-expression of miR-200a were successfully achieved in SKOV-3 and ES-2 cells. MiR-200a enhanced the chemosensitivity of SKOV-3 and ES-2 to paclitaxel, but not to cisplatin. Chemoresistance associated ABC family (ABCB3, ABCC1, ABCC2, ABCC3, ABCG2) were down-regulated by miR-200a at several levels. However, the direct interaction between miR-200a and the 3'-UTR of ABCG2 mRNA was not found. CONCLUSION: An over-expression of miR-200a may increase chemosensitivity to paclitaxel in ovarian cancer cells through negatively regulated chemoresistance associated ABC family. However, no direct action on 3'-UTR of ABCG2 was not found after its down-regulation by miR-200a.
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MicroRNAs/genética , Neoplasias Ovarianas/tratamento farmacológico , Regiões 3' não Traduzidas , Linhagem Celular Tumoral , Cisplatino , Regulação para Baixo , Feminino , Humanos , Proteína 2 Associada à Farmacorresistência Múltipla , Paclitaxel , RNA Mensageiro , Transdução de Sinais , Regulação para CimaRESUMO
OBJECTIVE: To evaluate the surgical feasibility of uterine autologous transplantation in female cynomolgus monkeys and explore the effect of microsurgical technique. METHODS: From May 2011 to March 2014, 6 female cynomolgus monkeys, aged 7 to 12 years, were randomly divided into 2 surgical groups. In group A, gross surgeries were performed with naked eyes. In group B, uterine re-transplantation was performed under 10-time-magnifying microscopy. Anatomical data and operative durations were recorded and analyzed. Viable uterine tissue and vascular patency were observed on trans-abdominal ultrasonography and second-look laparotomy after 3 months. RESULTS: The average uterus retrieval time, average vascular anastomotic time, average perfusion time and average total operative time of group B were 88.7, 147.3 and 320.0 min versus 123.7, 180.7 and 393.7 min in group A. The average perfusion durations were 35.0 and 27.3 min. And there was no inter-group difference. A total of 12 successful vascular procedures (including 6 internal iliac arteries and 6 uterine-ovary veins) of vascular anastomosis were recorded in group B versus 4 cases (including 1 artery and 3 veins) in group A (vein, P > 0.05; artery, P < 0.05). In group A, there was only 1 successful operation but uterus turned necrotic after 4 weeks. In group B, the surgical success rate was 100%. However one animal died due to intestinal obstruction. And in another 2 animals, viable uterine tissue and vascular patency were observed on trans-abdominal ultrasonography and second-look laparotomy. Two survivors resumed cyclicity at days 17 and 50 respectively as a sign of re-established uterine function. CONCLUSION: This study has demonstrated the feasibility of uterus transplantation by vascular anastomosis in cynomolgus monkeys. And assistance of microsurgical technique can significantly improve the success rate of arterial anastomosis during uterus transplantation.
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Útero , Animais , Aorta Abdominal , Artérias , Feminino , Artéria Ilíaca , Macaca fascicularis , Ovário , Perfusão , Transplante Autólogo , Procedimentos Cirúrgicos Vasculares , VeiasRESUMO
OBJECTIVE: To describe and compare video endoscopic inguinal lymphadenectomy via hypogastric and limb approach (VEIL-H vs VEIL-L) in patients with invasive vulvar cancer. METHODS: From March 2011 to August 2013, 7 women with early-stage vulvar cancer were selected for this integrated procedure with a combination of VEIL-H and VEIL-L in bilateral groins.VEIL-L was performed on limb with old surgical scar in ipsilateral hypogastric area of 3 patients and VEIL-H in contralateral limb. Both novel procedures were performed with triple trocars respectively. The boundaries of inguinal lymph node dissection were the same template of open inguinal lymphadenectomy. Preoperative data, surgical techniques and follow-up outcomes were compared.Standard statistical tests were used. RESULTS: The combination of VEIL-H and VEIL-L was successfully completed in 7 patients without conversion into open surgery. The great saphenous vein was spared in 13 limbs.No difference existed in mean operative duration, average blood loss volume and median total regional lymph nodes removed in two groups. All nodes were confirmed tumor-free. Mean drain duration was (4.7 ± 1.4) days in the VEIL-H group and (2.7 ± 0.9) days in VEIL-L group respectively (P < 0.01). Mean drain volume was (123 ± 55) ml in VEIL-H group and (62 ± 32) ml respectively (P < 0.05). Mean postoperative hospital stay was (8.6 ± 2.2) days.No major intraoperative complications occurred. However, hypercarbia in one patient 1 was completely reversible with hyperventilation.Unilateral great saphenous vein was injured in another one.Regarding postoperative complications, one patient suffered lymphocele in VEIL-H side and another had lymphorrhea through drain orifice in VEIL-L side. During a follow-up period of (19 ± 7) months, there was no disease recurrence so far. CONCLUSION: The combination of VEIL-H and VEIL-L has the reproducibility and therapeutic potentials in the treatment for patients with vulvar cancer. Both minimal invasive techniques are viable. Although short-term results are encouraging, larger series with a longer follow-up are required to fully evaluate the therapeutic efficacy of VEIL-H and VEIL-L.
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Excisão de Linfonodo/métodos , Linfonodos/cirurgia , Neoplasias Vulvares/cirurgia , Adulto , Idoso , Endoscopia , Feminino , Humanos , Canal Inguinal , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
During the process of labor, the intrapartum transperineal ultrasound examination serves as a valuable tool, allowing direct observation of the relative positional relationship between the pubic symphysis and fetal head (PSFH). Accurate assessment of fetal head descent and the prediction of the most suitable mode of delivery heavily rely on this relationship. However, achieving an objective and quantitative interpretation of the ultrasound images necessitates precise PSFH segmentation (PSFHS), a task that is both time-consuming and demanding. Integrating the potential of artificial intelligence (AI) in the field of medical ultrasound image segmentation, the development and evaluation of AI-based models rely significantly on access to comprehensive and meticulously annotated datasets. Unfortunately, publicly accessible datasets tailored for PSFHS are notably scarce. Bridging this critical gap, we introduce a PSFHS dataset comprising 1358 images, meticulously annotated at the pixel level. The annotation process adhered to standardized protocols and involved collaboration among medical experts. Remarkably, this dataset stands as the most expansive and comprehensive resource for PSFHS to date.
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Inteligência Artificial , Cabeça , Sínfise Pubiana , Ultrassonografia Pré-Natal , Humanos , Sínfise Pubiana/diagnóstico por imagem , Feminino , Gravidez , Cabeça/diagnóstico por imagem , Feto/diagnóstico por imagemRESUMO
The segmentation of the fetal head (FH) and pubic symphysis (PS) from intrapartum ultrasound images plays a pivotal role in monitoring labor progression and informing crucial clinical decisions. Achieving real-time segmentation with high accuracy on systems with limited hardware capabilities presents significant challenges. To address these challenges, we propose the real-time segmentation network (RTSeg-Net), a groundbreaking lightweight deep learning model that incorporates innovative distribution shifting convolutional blocks, tokenized multilayer perceptron blocks, and efficient feature fusion blocks. Designed for optimal computational efficiency, RTSeg-Net minimizes resource demand while significantly enhancing segmentation performance. Our comprehensive evaluation on two distinct intrapartum ultrasound image datasets reveals that RTSeg-Net achieves segmentation accuracy on par with more complex state-of-the-art networks, utilizing merely 1.86 M parameters-just 6 % of their hyperparameters-and operating seven times faster, achieving a remarkable rate of 31.13 frames per second on a Jetson Nano, a device known for its limited computing capacity. These achievements underscore RTSeg-Net's potential to provide accurate, real-time segmentation on low-power devices, broadening the scope for its application across various stages of labor. By facilitating real-time, accurate ultrasound image analysis on portable, low-cost devices, RTSeg-Net promises to revolutionize intrapartum monitoring, making sophisticated diagnostic tools accessible to a wider range of healthcare settings.
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Cabeça , Sínfise Pubiana , Ultrassonografia Pré-Natal , Humanos , Feminino , Gravidez , Cabeça/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Sínfise Pubiana/diagnóstico por imagem , Aprendizado Profundo , Feto/diagnóstico por imagemRESUMO
OBJECTIVE: To evaluate the prognostic factors and survival outcomes of patients with surgically treated high-grade neuroendocrine carcinoma of the cervix (NECC). METHODS: This multicenter, retrospective study involved 98 cervical cancer patients with stage IA2-IIA2 and IIIC1/2p high-grade NECC. We divided the patients into two groups based on histology: the pure and mixed groups. All clinicopathologic variables were retrospectively evaluated. Cox regression and Kaplan-Meier methods were used for analysis. RESULTS: In our study, 60 patients were in the pure group and 38 patients were in the mixed group. Cox multivariate analysis showed that mixed histology was a protective factor impacting overall survival (OS) (P = 0.026) and progression free survival (PFS) (P = 0.018) in surgically treated high-grade NECC. Conversely, survival outcomes were negatively impacted by ovarian preservation (OS: HR, 20.84; 95% CI: 5.02-86.57, P < 0.001), age >45 years (OS: HR, 4.50; 95% CI: 1.0-18.83, P = 0.039), tumor size >4 cm (OS: HR, 6.23; 95% CI: 2.34-16.61, P < 0.001), parity >3 (OS: HR, 4.50; 95% CI: 1.02-19.91, P = 0.048), and perineural invasion (OS: HR, 5.21; 95% CI: 1.20-22.53, P = 0.027). Kaplan-Meier survival curves revealed notable differences in histologic type (OS: P = 0.045; PFS: P = 0.024), chemotherapy (OS: P = 0.0056; PFS: P = 0.0041), ovarian preservation (OS: P = 0.00031; PFS: P = 0.0023), uterine invasion (OS: P < 0.0001; PFS: P < 0.0001), and depth of stromal invasion (OS: P = 0.043; PFS: P = 0.022). CONCLUSION: Patients with mixed histologic types who undergo surgery for high-grade NECC have a better prognosis. Meanwhile, ovarian preservation, tumor size >4 cm, parity >3, age >45 years and perineural invasion were poor prognostic predictors. Therefore, patients with high-risk factors should be considered in clinical practice.
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OBJECTIVE: To evaluate the feasibility and safety of applying video endoscopic inguinal lymphadenectomy via hypogastric subcutaneous approach (VEIL-H) in the treatment of vulvar carcinoma. METHODS: From September 2009 to December 2012, 15 patients with vulvar carcinoma underwent VEIL-H plus radical vulvectomy at many participating hospitals. RESULTS: All were treated surgically. Two of them underwent laparoscopic pelvic lymphadenectomy (LPL) upon the positive results of parotid operations with frozen section. The mean operative duration of VEIL-H (bilateral groin) were (80.8 ± 2.9) minutes. The mean total volume of blood loss in VEIL was (5.5 ± 0.4) ml, the mean drainage duration (6 ± 2) days and the average postoperative hospitalization (11 ± 4) days. The mean follow-up period was 13.0 months. One patient suffered local recurrence at Month 2 postoperation. CONCLUSION: VEIL-H is both feasible and safe in inguinal lymphadenectomy.
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Virilha , Laparoscopia , Excisão de Linfonodo/métodos , Neoplasias Vulvares/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The generalization ability of the fetal head segmentation method is reduced due to the data obtained by different machines, settings, and operations. To keep the generalization ability, we proposed a Fourier domain adaptation (FDA) method based on amplitude and phase to achieve better multi-source ultrasound data segmentation performance. Given the source/target image, the Fourier domain information was first obtained using fast Fourier transform. Secondly, the target information was mapped to the source Fourier domain through the phase adjustment parameter α and the amplitude adjustment parameter ß. Thirdly, the target image and the preprocessed source image obtained through the inverse discrete Fourier transform were used as the input of the segmentation network. Finally, the dice loss was computed to adjust α and ß. In the existing transform methods, the proposed method achieved the best performance. The adaptive-FDA method provides a solution for the automatic preprocessing of multi-source data. Experimental results show that it quantitatively improves the segmentation results and model generalization performance.
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Cabeça , Ultrassonografia Pré-Natal , Feminino , Gravidez , Humanos , Ultrassonografia , Cabeça/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodosRESUMO
Background: To develop the preoperative prediction of ovarian lesions using regression-based statistics analyses and machine learning methods based on multiple serological biomarkers in China. Methods: 1137 patients with ovarian lesions in Zhujiang Hospital and 518 patients in others hospital in China were randomly assigned to training, test and external validation cohorts. Five machine learning classifiers, including Random Forest (RF), Extreme Gradient Boosting (XGB), Support Vector Classifier (SVC), K-nearest Neighbor (KN), Multi-Layer Perceptron (MLP) and the Lasso-Logistics prediction model (LLRM) were used to derive diagnostic information from 23 predictors. Results: The RF model had a high diagnostic value (AUC = 0.968) in predicting benign and malignant ovarian disease. Age and MLR were also potential diagnostic indicators for predicting ovarian disease except tumor indicators. The RF model well distinguished borderline ovarian tumors (AUC = 0.742). The RFM had a high predictive power to identify ovarian serous adenocarcinoma (AUC = 0.943) and ovarian endometriosis cysts (AUC = 0.914). Conclusions: The RF models can effectively predict adnexal lesions, promising to be adjuncts to the preoperative prediction of ovarian cancer.
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[This corrects the article DOI: 10.1016/j.dib.2022.107904.].
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Background: Accurate assessment of fetal descent by monitoring the fetal head (FH) station remains a clinical challenge in guiding obstetric management. Angle of progression (AoP) has been suggested to be a reliable and reproducible parameter for the assessment of FH descent. Methods: A novel framework, including image segmentation, target fitting and AoP calculation, is proposed for evaluating fetal descent. For image segmentation, this study presents a novel double branch segmentation network (DBSN), which consists of two parts: an encoding part receives image input, and a decoding part composed of deformable convolutional blocks and ordinary convolutional blocks. The decoding part includes the lower and upper branches, and the feature map of the lower branch is used as the input of the upper branch to assist the upper branch in decoding after being constrained by the attention gate (AG). Given an original transperineal ultrasound (TPU) image, areas of the pubic symphysis (PS) and FH are firstly segmented using the proposed DBSN, the ellipse contours of segmented regions are secondly fitted with the least square method, and three endpoints are finally determined for calculating AoP. Results: Our private dataset with 313 transperineal ultrasound (TPU) images was used for model evaluation with 5-fold cross-validation. The proposed method achieves the highest Dice coefficient (93.4%), the smallest Average Surface Distance (6.268 pixels) and the lowest AoP difference (5.993°) by comparing four state-of-the-art methods. Similar results (Dice coefficient: 91.7%, Average Surface Distance: 7.729 pixels: AoP difference: 5.110°) were obtained on a public dataset with >3,700 TPU images for evaluating its generalization performance. Conclusion: The proposed framework may be used for the automatic measurement of AoP with high accuracy and generalization performance. However, its clinical availability needs to be further evaluated.
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The angle of progression (AoP) for assessing fetal head (FH) descent during labor is measured from the standard plane of transperineal ultrasound images as the angle between a line through the long axis of pubic symphysis (PS) and a second line from the right end of PS tangentially to the contour of the FH. This paper presents a multitask network with a shared feature encoder and three task-special decoders for standard plane recognition (Task1), image segmentation (Task2) of PS and FH, and endpoint detection (Task3) of PS. Based on the segmented FH and two endpoints of PS from standard plane images, we determined the right FH tangent point that passes through the right endpoint of PS and then computed the AoP using the above three points. In this paper, the efficient channel attention unit is introduced into the shared feature encoder for improving the robustness of layer region encoding, while an attention fusion module is used to promote cross-branch interaction between the encoder for Task2 and that for Task3, and a shape-constrained loss function is designed for enhancing the robustness to noise based on the convex shape-prior. We use Pearson's correlation coefficient and the Bland-Altman graph to assess the degree of agreement. The dataset includes 1964 images, where 919 images are nonstandard planes, and the other 1045 images are standard planes including PS and FH. We achieve a classification accuracy of 92.26%, and for the AoP calculation, an absolute mean (STD) value of the difference in AoP (∆AoP) is 3.898° (3.192°), the Pearson's correlation coefficient between manual and automated AoP was 0.964 and the Bland-Altman plot demonstrates they were statistically significant (P < 0.05). In conclusion, our approach can achieve a fully automatic measurement of AoP with good efficiency and may help labor progress in the future.
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Apresentação no Trabalho de Parto , Ultrassonografia Pré-Natal , Feminino , Feto/diagnóstico por imagem , Humanos , Redes Neurais de Computação , Gravidez , Reprodutibilidade dos Testes , Ultrassonografia Pré-Natal/métodosRESUMO
The use of transperineal ultrasound techniques for the assessment of fetal head descent and progression is an adjunct to clinical examination. Automatic identification of parameters based on ultrasound images will greatly reduce the subjectivity and non-repeatability of the clinician's judgment. However, the lack of a pubic symphysis-fetal head dataset hinders the development of algorithms. Here, we present an intrapartum transperineal ultrasound dataset of the Intelligent Fetal Monitoring Lab of Jinan University (named the JNU-IFM dataset), in which intrapartum transperineal ultrasound videos of 78 were recorded from 51 patients. These data were obtained with the Youkey D8 wireless 2D ultrasound probe with its corresponding supporting software by Wuhan Youkey Bio-Medical Electronics Co., Ltd., Wuhan, China. In these videos, 6224 high-quality images with four categories were selected to form the JNU- IFM dataset. These images were labelled using the Pair software and then validated by two experienced radiologists. We hope that this data set can be used in the segmentation of the pubic symphysis-fetal head.
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Metabolic dysregulation in the tumor microenvironment has significant impact on immune infiltration and immune responses. However, interaction between immunity and metabolism in the ovarian microenvironment requires further exploration. We constructed an immunometabolism gene set and ovarian cancer cohort from The Cancer Genome Atlas (TCGA) and classified these into three immunometabolism subtypes. We explored the relationships between immune infiltration and metabolic reprogramming. Additionally, we built risk score and nomogram as prognostic signatures. Three distinctive immunometabolism subtypes were identified with therapeutic and prognostic implications. Subtype 1, the "immune suppressive-glycan metabolism subtype," featured high levels of immunosuppressive cell infiltration and glycan metabolism activation; Subtype 2, the "immune inflamed-amino acid metabolism subtype," showed abundant adaptive immune cell infiltration and amino acid metabolism activation; Subtype 3, the "immune desert-endocrine subtype," was characterized by low immune cell infiltration and upregulation of hormone biosynthesis. Furthermore, we found that epinephrine biosynthesis displayed a significantly negative correlation with MHC molecules, which may result in defective antigen presentation. We proposed immunometabolism subtypes with prognostic implications and provided new perspectives for the ovarian cancer microenvironment.
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BACKGROUND: In the process of decreasing the morbidity of wound-related complications after vulvectomy and IL for treating vulvar malignancy, we performed a novel surgical procedure-single-incision radical vulvectomy (SIRV). Here, we share our initial experience and report its safety and feasibility. METHODS: Patients with advanced local vulvar tumors were sequentially enrolled in this prospective cohort study to undergo SIRV. While performing SIRV, routine radical vulvectomies were performed first. Subsequently, the flaps of the bridge area between the vulvectomy incisions and femoral triangles were separated and the lymph nodes underneath were removed. Anterior working spaces (AWS) before the femoral triangle were then made. The saphenous vein was carefully identified and retained, while the superficial and deep inguinal lymph nodes were removed from the medial to the lateral sides. After careful hemostasis, the wounds were sutured. Patient demographics, clinical data, pathologic data, operation time, node count, and complications were recorded. RESULTS: Ten patients underwent SIRV for vulvar cancer. Average hospital stay was 11.70±3.16 (range, 9-13) days. The average number of harvested lymph nodes was 7.59±3.62 (range, 3-15) and 15.14±3.63 (range, 11-20) for per side or both sides of the groin. Blood loss was ≤35 mL. Three patients developed inguinal lymphoceles and underwent needle aspirations. Two patients had impaired wound healing and achieved healing after dressing change. No other postoperative complications were noted during follow-up. CONCLUSIONS: Compared with conventional open inguinal lymphadenectomy (COIL) and video endoscopic inguinal lymphadenectomy (VEIL), SIRV is a more minimally invasive procedure. Our short-term observations showed that SIRV is safe and feasible and has good future application prospects for vulvar cancer. However, definitive conclusions cannot be made. Therefore, long-term oncologic outcomes and large-scale clinical trials are warranted.
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Chiral nematic cellulose nanocrystal (CNC) structural colored materials are the focus of extensive research in recent years on account of their unique helical structure and excellent optical properties. However, the general weak mechanical properties and poor water-resistance of CNC limit its utility. Here, we fabricated highly flexible, water-resistant chiral nematic CNC/Poly(ethylene glycol) diacrylate(PEGDA) composite films, which was realized by co-assembling CNC and PEGDA precursor then via UV curing to construct a three-dimensional crosslinking network. Due to the water stimulus-responsive feature of the CNC and PEGDA, the CNC/PEGDA (8/2) composite film could be used as a water-content detector, photonic paper. In addition, it could produce different crosslinking degrees by coating the PEGMA solution or not, which could be applied to an anti-counterfeit label. The composite film with excellent stability of cycles is expected to be a promising candidate in optical sensors, display, and security fields.