Exploring transvaginal sonographic characteristics of the levator ani muscle in women with postpartum pelvic floor myofascial pain.

BACKGROUND: Pelvic floor myofascial pain is one of the pelvic floor dysfunction diseases disturbing women after delivery. There is a lack of objective standardization for the diagnosis of pelvic floor myofascial pain due to the various symptoms and the dependence on the palpating evaluation. Ultrasound imaging has the advantages of safety, simplicity, economy and high resolution, which makes it an ideal tool for the assistant diagnosis of pelvic floor myofascial pain and evaluation after treatment. METHODS: This is a retrospective case-control study including women accepting evaluation of pelvic floor function at 6 weeks to 1 year postpartum. They were divided into pelvic floor myofascial pain group and normal control group. A BCL 10-5 biplane transducer was applied to observed their puborectalis. The length, minimum width, area, deficiency, deficiency length, deficiency width, deficiency area, rate of deficiency area, local thickening,angle between the tendinous arch of levator ani muscle and puborectalis of corresponding puborectalis in different groups were observed and measured. RESULTS: A total of 220 postpartum women participated in the study, with 77 in the pelvic floor myofascial pain group and 143 in the normal control group. The Intraclass correlation coefficient value was over 0.750, and Kappa ranged from 0.600 to 0.800. puborectalis deficiency (adjusted odds ratio = 11.625, 95% confidence interval = 4.557-29.658) and focal thickening (adjusted odds ratio = 16.891, 95% confidence interval = 1.819-156.805) were significantly associated with higher odds of having postpartum pelvic floor myofascial pain. Grayscale or the angle between the arch tendineus levator ani and puborectalis measurements on the pain side tended to be smaller than on the non-pain side in patients with unilateral puborectalis or iliococcygeus pain (P < 0.05). CONCLUSIONS: This study demonstrated that transvaginal ultrasound was a potentially efficient technique for evaluating postpartum pelvic floor myofascial pain due to its ability to assess various sonographic characteristics of the levator ani muscles.

Contrast-enhanced US to Improve Diagnostic Performance of O-RADS US Risk Stratification System for Malignancy.

Background The Ovarian-Adnexal Reporting and Data System (O-RADS) has limited specificity for malignancy. Contrast-enhanced US can help distinguish malignant from benign lesions, but its added value to O-RADS has not yet been assessed. Purpose To establish a diagnostic model combining O-RADS and contrast-enhanced US and to validate whether O-RADS plus contrast-enhanced US has a better diagnostic performance than O-RADS alone. Materials and Methods This prospective study included participants from May 2018 to March 2021 who underwent contrast-enhanced US before surgery and had lesions categorized as O-RADS 3, 4, or 5 by US, with a histopathologic reference standard. From April 2021 to July 2022, participants with pathologically confirmed ovarian-adnexal lesions were recruited for the validation group. In the pilot group, the initial enhancement time and enhancement intensity in comparison with the uterine myometrium, contrast agent distribution pattern, and dynamic changes in enhancement of lesions were assessed. Contrast-enhanced US features were used to calculate contrast-enhanced US scores for benign (score ≤2) and malignant (score ≥4) lesions. Lesions were then re-rated according to O-RADS category plus contrast-enhanced US scores. Receiver operating characteristic curves were constructed and compared using the DeLong method. The combined system was validated in an independent group. Results The pilot group included 76 women (mean age, 44 years ± 13 [SD]), and the validation group included 46 women (mean age, 42 years ± 14). Differences in initial enhancement time (P < .001), enhancement intensity (P < .001), and dynamic changes in enhancement (P < .001) between benign and malignant lesions were observed in the pilot group. Contrast-enhanced US scores were calculated using these features. The O-RADS risk stratification was upgraded one level for contrast-enhanced US scores of 4 or more and downgraded one level for contrast-enhanced US scores of 2 or less. In the validation group, the diagnostic performance of O-RADS plus contrast-enhanced US score was higher (area under the receiver operating characteristic curve [AUC] = 0.93) than O-RADS (AUC = 0.71, P < .001). Conclusion Contrast-enhanced US improved the diagnostic performance for malignancy of the O-RADS categories 3-5. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Grant in this issue.

SHP2 participates in decidualization by activating ERK to maintain normal nuclear localization of progesterone receptor.

In brief: The establishment and maintenance of embryo implantation and pregnancy require decidualization of endometrial stromal cells. This paper reveals that SHP2 ensures the correct subcellular localization of progesterone receptor, thereby safeguarding the process of decidualization. Abstract: Decidualization is the process of conversion of endometrial stromal cells into decidual stromal cells, which is caused by progesterone production that begins during the luteal phase of the menstrual cycle and then increases throughout pregnancy dedicated to support embryonic development. Decidualization deficiency is closely associated with various pregnancy complications, such as recurrent miscarriage (RM). Here, we reported that Src-homology-2-containing phospho-tyrosine phosphatase (SHP2), a key regulator in the signal transduction process downstream of various receptors, plays an indispensable role in decidualization. SHP2 expression was upregulated during decidualization. SHP2 inhibitor RMC-4550 and shRNA-mediated SHP2 reduction resulted in a decreased level of phosphorylation of ERK and aberrant cytoplasmic localization of progesterone receptor (PR), coinciding with reduced expression of IGFBP1 and various other target genes of decidualization. Solely inhibiting ERK activity recapitulated these observations. Administration of RMC-4550 led to decidualization deficiency and embryo absorption in mice. Moreover, reduced expression of SHP2 was detected in the decidua of RM patients. Our results revealed that SHP2 is key to PR's nuclear localization, thereby indispensable for decidualization and that reduced expression of SHP2 might be engaged in the pathogenesis of RM.

The relationship of severity in diastasis recti abdominis and pelvic floor dysfunction: a retrospective cohort study.

BACKGROUND: Diastasis of rectus abdominis (DRA) refers to a separation of the rectus abdominis from the linea alba. This study aimed to investigate the association with the severity of DRA for developing pelvic floor dysfunction among women during the first year postpartum. METHODS: This is a retrospective cohort study which collected data from 229 postpartum women. DRA was defined as a separation of ≥ 20 mm at any point 4.5 cm above, at and 4.5 cm below the umbilicus. The data for analysis includes pelvic organ prolapse quantification (POP-Q), medical history of urinary incontinence (UI), the strength of rectus abdominis muscle and pelvic floor muscle. The differences in women with and without DRA were compared with independent samples t-test and Chi-square test. RESULTS: Prevalence of DRA was 82.6% during the first postpartum year. Cesarean section and multiple parturitions are recognized as risk factors for DRA due to the odds ratio in our study were 3.48 (95% CI 1.42-8.56), 3.20 (95% CI 1.59-6.45) respectively. There was no difference in the occurrence of UI and pelvic organ prolapse (POP) comparing women with and without DRA, even changing the cut-off values (inter-rectus distance = 20 mm, 30 mm, 40 mm, 50 mm) for determining DRA. The women with weak rectus abdominis muscle and pelvic floor muscle have no statistical difference in two group. CONCLUSION: The relationship of the diastasis recti abdominis and pelvic floor dysfunction has no connection, even with the severity of inter-rectus distance increasing.

Sub-nanometer, Ultrafine α-Fe2 O3 Sheets Realized by Controlled Crystallization Kinetics for Stable, High-Performance Energy Storage.

The development of energy devices based on iron oxides/hydroxides is largely hindered by their poor conductivity and large volume changes, especially with regard to specific capacitance and cycle stability. Herein, superior capacitance (1575 F g-1 at 1.25 A g-1 ) and high rate performance (955 F g-1 at 25 A g-1 ) were realized by synthesizing sub-nanometer, ultrafine α-Fe2 O3 sheets loaded on graphene (SU-Fe2 O3 -rGO). An assembled asymmetric supercapacitor showed outstanding cycle stability (106 % retention after 30 000 cycles). This excellent performance arises from the unique structural characteristics of the α-Fe2 O3 sheets, which not only enrich electrochemically reactive sites, but also largely eliminate the volume changes after long-term charge/discharge cycling. The synthesis of SU-Fe2 O3 -rGO critically depends on control of the crystallization kinetics during growth. A controlled heterogeneous nucleation mechanism results in the formation of atomically thin α-Fe2 O3 sheets on graphene rather than large particles in solvent, as clarified by theoretical calculations. This strategy paves a new way to synthesizing atomically thin transition metal oxide sheets and low-cost, eco-friendly iron-based energy storage.

Coating-free, air-stable silver nanowires for high-performance transparent conductive film.

Silver nanowire (Ag NW) based films are considered as a promising alternative for traditional indium tin oxide but still suffer from some limitations, including insufficient conductivity, transparency and environmental instability. We here report a novel etching synthesis strategy to improve the performance of Ag NW films. Different from the traditional methods to synthesize high aspect ratios of NWs or employ electrically conductive coatings, we find it effective to reduce the high-reactivity defects of NWs for optimizing the comprehensive performance of Ag NW films. In this strategy etching can suppress the generation of high-reactivity defects and meanwhile the etching growth of NWs can be accomplished in an uneven ligand distribution environment. The resulting Ag NWs are uniformly straight with a sharp-edged structure. The transparent conductive film obtained exhibits simultaneous improvements in electrical conductivity, transparency and air stability. Even after exposure in air for 200 days and no protective coatings, the film can still meet the highest requirement of practical applications, with a figure of merit 361 (i.e., FoM > 350). These results not only demonstrate the importance of defect control in the synthesis of Ag NWs, but also pave a way for further optimizing the performance of Ag NW-based films.

A study on cognitive impairment and gray matter volume abnormalities in silent cerebral infarction patients.

INTRODUCTION: The relationship between silent cerebral infarction (SCI) and the integrity of cognitive function is unknown. We intended to investigate whether cognitive impairment is associated with gray matter volume (GMV) in the SCI patients. METHODS: Sixty-two patients with SCI and 62 age- and gender-matched healthy controls (HC) were evaluated with P300 test, Montreal Cognitive Assessment (MoCA) test, Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HDRS). Whole brain high-resolution T1-weighted images were processed with SPM12b software and analyzed by voxel-based morphometry (VBM). Correlation analysis was performed between the GMV and the scores of MoCA Scale, P300 latency, P300 amplitude, HAMA, HDRS, age, and educational level. RESULTS: The brains of the SCI patients have a significant reduction in GMV in the left superior and inferior frontal gyrus, left superior temporal gyrus, right middle temporal gyrus, and bilateral hippocampus gyrus (p < 0.01, FDR correction). No significant increase of GMV was detected. The GMV of their frontal and temporal lobes is positively correlated with the score of MoCA scale and P300 amplitude (r ≥ 0.62, p < 0.01). The GMV of frontal, temporal, and hippocampus is negatively correlated with P300 latency (r ≤ -0.71, p < 0.05). No significant correlation between the GMV of abnormal brain regions and another two clinical characteristics was found. CONCLUSION: SCI patients have impaired cognitive function and reduced GMV compared to the HC subjects. The neuropathological basis of such cognitive deficits in SCI patients might be a reduced GMV.

Overexpression of RFC3 is correlated with ovarian tumor development and poor prognosis.

Replication factor C3 (RFC3) is an oncogene that can potentially predict prognosis in a variety of human cancers. RFC3 expression in ovarian carcinoma has not yet been determined. In this study, we evaluated the messenger RNA (mRNA) and protein expression levels of RFC3 in normal ovarian and ovarian carcinoma tissues using reverse transcription-polymerase chain reaction (RT-PCR), immunohistochemistry, and Western blots (WB). Results showed that higher RFC3 mRNA and protein levels were detected in ovarian carcinoma tissues by RT-PCR and WB. High RFC3 expression was defined as positive staining in >70 % of each tumor cell. High RFC3 expression was detected in 28.1, 17.6, 11.1, and 5.0 % of invasive carcinomas, borderline tumors, cystadenomas, and in normal ovary cells, respectively. Overexpression of RFC3 was associated with later pN status (p = 0.001), pM status (p = 0.001), and advanced International Federation of Gynecology and Obstetrics (FIGO) stage (p = 0.012) in ovarian carcinomas. Univariate survival analyses showed that RFC3 overexpression was also associated with shortened patient survival (mean 7.7 months in tumors with RFC3 overexpression vs 92.9 months in tumors with normal RFC3 levels; p < 0.001). In multivariate analyses, RFC3 protein levels were a significant prognostic factor for ovarian carcinoma (p < 0.001). In conclusion, our findings suggest that RFC3 protein is an important and independent biomarker with prognostic implications for patients with ovarian carcinoma.

[Design and appliation of a kind of bone age automatic analysis and assessment device].

OBJECTIVE: The device of a bone age film of analysis and process was designed, can calculate the expected patient's height and identify growth level and development. METHODS: Select the DR bone age of 100 children of 6-13 years old, used semi Lagrange algorithm of target region of interest on bone age piece (ROI) for image analysis, compared with 2 pediatric endocrinologists (A, B) who used TW3 artificial to judge bone age (two methods were detected 2 times), and report the results. RESULTS: Bone age assessment process, forecast error of bone age reduced to 0.12 years. CONCLUSIONS: This device can quickly calculate the expected patient's height and identify his growth level, improve the speed and accuracy of bone age assessment, especially in the poor medical conditions in rural and remote areas.

Relationship Between Gestational Diabetes Mellitus and Postpartum Diastasis Recti Abdominis in Women in the First Year Postdelivery.

OBJECTIVE: Postpartum diastasis recti abdominis (DRA) influences women's appearance and health. Gestational diabetes mellitus (GDM) can affect the structure of the rectus abdominis muscles. However, the relationship between GDM and postpartum DRA is unknown. The objective of this study was to investigate the relationship between GDM and postpartum DRA. METHODS: This retrospective cohort study included 241 women in the first year postdelivery. Women with GDM were matched with those without GDM using propensity score matching. They underwent an oral glucose tolerance test during pregnancy and a random blood glucose test before delivery. At follow-up, DRA was diagnosed by palpation, and interrectus distance was measured using ultrasound to evaluate the severity of DRA. The strength of the rectus abdominis was evaluated using the manual muscle testing method. RESULTS: Among the 241 participants, 174 (72.2%) had postpartum DRA, and 46 women with GDM were matched with 46 women without GDM on the basis of propensity scores. Women with GDM had higher odds of experiencing postpartum DRA (adjusted odds ratio = 4.792; 95% CI = 1.672 to 13.736) and larger interrectus distance values at the upper part of the rectus abdominis than those without GDM. There was a weak and positive correlation between the fasting oral glucose tolerance test level and the interrectus distance values (0.267 ≤ r ≤ 0.367). CONCLUSION: GDM was associated with postpartum DRA in women in the first year of delivery. Women with GDM had larger interrectus distance values at the upper part of the rectus abdominis than those without GDM. The fasting oral glucose tolerance test level showed a positive and weak correlation with the severity of postpartum DRA. IMPACT: Women with GDM have higher odds of experiencing postpartum DRA than those without GDM. The upper part of the rectus abdominis deserves increased focus during and after rehabilitation. Controlling the fasting oral glucose tolerance test level may help reduce the severity of postpartum DRA.

Human umbilical cord mesenchymal stem cells derived extracellular vesicles alleviate salpingitis by promoting M1-to-M2 transformation.

Background: With an increasing number of patients experiencing infertility due to chronic salpingitis after Chlamydia trachomatis (CT) infection, there is an unmet need for tissue repair or regeneration therapies. Treatment with human umbilical cord mesenchymal stem cell-derived extracellular vesicles (hucMSC-EV) provides an attractive cell-free therapeutic approach. Methods: In this study, we investigated the alleviating effect of hucMSC-EV on tubal inflammatory infertility caused by CT using in vivo animal experiments. Furthermore, we examined the effect of hucMSC-EV on inducing macrophage polarization to explore the molecular mechanism. Results: Our results showed that tubal inflammatory infertility caused by Chlamydia infection was significantly alleviated in the hucMSC-EV treatment group compared with the control group. Further mechanistic experiments showed that the application of hucMSC-EV induced macrophage polarization from the M1 to the M2 type via the NF-κB signaling pathway, improved the local inflammatory microenvironment of fallopian tubes and inhibited tube inflammation. Conclusion: We conclude that this approach represents a promising cell-free avenue to ameliorate infertility due to chronic salpingitis.

Upregulation of FAM83F by c-Myc promotes cervical cancer growth and aerobic glycolysis via Wnt/ß-catenin signaling activation.

Cervical cancer (CC) seriously affects women's health. Therefore, elucidation of the exact mechanisms and identification of novel therapeutic targets are urgently needed. In this study, we identified FAM83F, which was highly expressed in CC cells and tissues, as a potential target. Our clinical data revealed that FAM83F protein expression was markedly elevated in CC tissues and was positively correlated with poor prognosis. Moreover, we observed that FAM83F knockdown significantly inhibited cell proliferation, induced apoptosis, and suppressed glycolysis in CC cells, while its overexpression displayed opposite effects. Mechanistically, FAM83F regulated CC cell growth and glycolysis by the modulation of Wnt/ß-catenin pathway. The enhancing effects of FAM83F overexpression on CC cell proliferation and glycolysis could be impaired by the Wnt/ß-catenin inhibitor XAV939. Moreover, we found that c-Myc bound to the FAM83F promoter and activated the transcription of FAM83F. Notably, knockdown of FAM83F impaired the enhancement of cell proliferation and glycolysis induced by ectopic c-Myc. Consistent with in vitro findings, results from a xenograft mouse model confirmed the promoting role of FAM83F. In summary, our study demonstrated that FAM83F promoted CC growth and glycolysis through regulating the Wnt/ß-catenin pathway, suggesting that FAM83F may be a potential molecular target for CC treatment. Schematic summary of c-Myc-activated FAM83F transcription to promote cervical cancer growth and glycolysis by targeting the Wnt/ß-catenin signal pathway.

Hysteroscopic treatment of postcesarean scar defect.

STUDY OBJECTIVE: To estimate the usefulness of hysteroscopy in the diagnosis and treatment of postcesarean scar defect. DESIGN: Retrospective study (Canadian Task Force classification III). SETTING: Two university-affiliated hospitals. PATIENTS: Sixty-two patients with postcesarean scar defects were retrospectively analyzed. INTERVENTIONS: All patients with postcesarean scar defects diagnosed using ultrasonography and hysteroscopy underwent hysteroscopic surgery, and were followed up for longer than 1 year. MEASUREMENTS AND MAIN RESULTS: Hysteroscopy revealed that 38 patients had valve-like motions at the incision sites, 22 had dome-like defects, and 2 with a history of 2 previous deliveries via cesarean section had umbilications of 2 different shades. Fifty-seven of 62 patients underwent corrective surgery via hysteroscopy. In another 3 patients, because the left wall of the fundus of the uterus was too thin (<2 mm at ultrasonography) to undergo corrective surgery, only clearance of residual blood and/or suture materials was performed. Of these 57 patients, 5 underwent removal of residual suture materials and endometrial fulguration. No complications were observed in these patients. Furthermore, after surgery, abnormal vaginal bleeding stopped in 38 patients, and its duration was shortened in 20 patients. In addition, dysmenorrhea was alleviated in 15 patients, and resolved in 7 patients. CONCLUSION: Hysteroscopy is an accurate means of diagnosis apart from surgical correction.

Natural killer cells contributed to recurrent miscarriage by SP1-CASP3-PARP1.

Recurrent miscarriage (RM) is an early pregnancy complication. Natural Killer cells are an important part of the innate immune system of endometrial. In this study, weighted gene correlation network analysis was used to study the expression profile data of the endometrial tissue of patients with recurrent miscarriage and selected brown module as key module positively related to the numbers of miscarriages. With metascape tool, natural killer cells mediated cytotoxicity related genes, such as CASP3, were selected. DisNor database showed that CASP3 down-regulates PARP1. According to TRRUST database, CASP3 was regulated by SP1. Through comprehensive analysis of uNK cell related genes, we proposed that natural killer cells contribute to recurrent miscarriage by SP1-CASP3-PARP1.

A novel lncRNA-mRNA-miRNA signature predicts recurrence and disease-free survival in cervical cancer.

Cervical cancer (CC) patients have a poor prognosis due to the high recurrence rate. However, there are still no effective molecular signatures to predict the recurrence and survival rates for CC patients. Here, we aimed to identify a novel signature based on three types of RNAs [messenger RNA (mRNAs), microRNA (miRNAs), and long non-coding RNAs (lncRNAs)]. A total of 763 differentially expressed mRNAs (DEMs), 46 lncRNAs (DELs), and 22 miRNAs (DEMis) were identified between recurrent and non-recurrent CC patients using the datasets collected from the Gene Expression Omnibus (GSE44001; training) and The Cancer Genome Atlas (RNA- and miRNA-sequencing; testing) databases. A competing endogenous RNA network was constructed based on 23 DELs, 15 DEMis, and 426 DEMs, in which 15 DELs, 13 DEMis, and 390 DEMs were significantly associated with disease-free survival (DFS). A prognostic signature, containing two DELs (CD27-AS1, LINC00683), three DEMis (hsa-miR-146b, hsa-miR-1238, hsa-miR-4648), and seven DEMs (ARMC7, ATRX, FBLN5, GHR, MYLIP, OXCT1, RAB39A), was developed after LASSO analysis. The built risk score could effectively separate the recurrence rate and DFS of patients in the high- and low-risk groups. The accuracy of this risk score model for DFS prediction was better than that of the FIGO (International Federation of Gynecology and Obstetrics) staging (the area under receiver operating characteristic curve: training, 0.954 vs 0.501; testing, 0.882 vs 0.656; and C-index: training, 0.855 vs 0.539; testing, 0.711 vs 0.508). In conclusion, the high predictive accuracy of our signature for DFS indicated its potential clinical application value for CC patients.

WGCNA Analysis Identifies Polycystic Ovary Syndrome-Associated Circular RNAs That Interact with RNA-Binding Proteins and Sponge miRNAs.

OBJECTIVE: Dysfunction of cumulus granulosa cells has been suggested as a contributor to abnormal folliculogenesis and the development of polycystic ovary syndrome (PCOS), but the underlying molecular mechanisms remain unclear. Recent studies indicate that circular RNAs (circRNAs) exert important roles for diseases. We aimed to screen crucial circRNAs of PCOS patients and predict their functions. METHODS: The high-throughput datasets of circRNAs (GSE145296), microRNAs (miRNAs; GSE72274) and messenger RNAs (mRNAs; GSE155489) in cumulus cells of PCOS patients and controls were collected from the Gene Expression Omnibus database. Differentially expressed circRNAs (DECs), miRNAs (DEMs) and protein-coding genes (DEGs) were identified by the limma method. The weighted correlation network analysis (WGCNA) was conducted using the DECs to mine PCOS-associated modules. Hub DECs in modules were defined as both of |gene significance| and |module membership| >0.8. The downstream effectors of hub DECs were predicted by constructing DEC-DEM-DEG ceRNA and DEC-RNA binding protein (RBP) networks. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed to explore the functions of circRNAs. RESULTS: A total of 3614 DECs, 3544 DEGs and 1469 DEMs were identified between PCOS and controls. WGCNA analysis yielded five PCOS-related modules, of which 190 DECs were hub circRNAs. Seventeen hub DECs, nine DEMs, and 315 DEGs were identified to construct the ceRNA network, while 56 hub DECs and two DEGs (MBNL2, RBPMS) constituted the circRNA-RBP network. Five hub DECs (hsa_circ_0063309, hsa_circ_0054275, hsa_circ_0056196, hsa_circ_0018108 and hsa_circ_0070987) were overlapped between ceRNA and DEC-MBNL2 regulatory networks and thus they may be pivotal for PCOS. Furthermore, hsa_circ_0099109 could interact with the RBP gene RBPMS. Function analyses showed these circRNAs were inflammation-, apoptosis- or steroidogenesis-related. CONCLUSION: Aberrant expression of six circRNAs that function as RBP regulators or miRNA sponges may be possible mechanisms underlying the pathogenesis of PCOS by affecting apoptosis and steroidogenesis in cumulus cells.

Comprehensive Analysis of the Control of Cancer Stem Cell Characteristics in Endometrial Cancer by Network Analysis.

BACKGROUND: Cancer stem cells play an important role in endometrial cancer (EC). It is closely related to self-renewal and therapeutic resistance of EC. METHODS: In this study, WGCNA (weighted gene coexpression network analysis) was used to analyze the relationship between genes and clinical features. We also performed immune cell infiltration analysis of a key module by using ImmuCellAI (Immune Cell Abundance Identifier). Then, key genes were verified in the GEO database. Finally, causal relationship analysis and protein-protein interaction analysis were performed in DisNor tool and STRING. RESULT: The mRNA expression-based stemness index (mRNAsi) is significantly lower in normal tissues and is significantly higher in individuals with stage IV or high-grade cancer and those who are obese or postmenopausal. Nineteen key genes (ORC6, C1orf112, RAD54L, SGO2, BUB1, PLK4, KIF18B, BUB1B, TTK, NCAPG, XRCC2, CENPF, KIF15, RACGAP1, ARHGAP11A, TPX2, KIF14, KIF4A, and NCAPH) that were enriched mainly in terms related to the cell cycle and DNA replication were selected by weighted gene coexpression network analysis (WGCNA). Based on the key modules, the numbers of NKT cells, NK cells, and neutrophils in the normal group were significantly higher than those in the cancer group. PLK1, CDK1, and MAD2L1, which were correlated with upstream genes, may be an regulated upstream of key genes. CONCLUSION: PLK1, CDK1, and MAD2L1 which were strongly correlated with upstream genes may be a regulated upstream of key genes.

Effect of Epidural Analgesia on Pelvic Floor Dysfunction at 6 Months Postpartum in Primiparous Women: A Prospective Cohort Study.

INTRODUCTION: Epidural analgesia has become a universal intervention for relieving labor pain, and its effect on the pelvic floor is controversial. AIM: To investigate the effect of epidural analgesia on pelvic floor dysfunction (PFD) in primiparous women at 6 months postpartum. METHODS: We performed a prospective cohort study involving 150 primiparous women in preparation for vaginal delivery, with 74 (49.3%) receiving epidural analgesia. Baseline demographic and intrapartum data were collected. At 6 months postpartum, PFD symptoms, including stress urinary incontinence, overactive bladder, defecation disorder, pelvic organ prolapse, and 4 kinds of sexual dysfunction (arousal disorder, low sexual desire, dyspareunia, and orgasm disorder), were evaluated. Pelvic floor muscle (PFM) function and postpartum depression were also assessed. Multivariate logistic regression was applied to identify factors associated with the PFD symptoms affected by epidural analgesia. MAIN OUTCOME MEASURE: PFD symptoms and sexual dysfunction were evaluated through Pelvic Floor Distress Inventory-20 (PFDI-20) and Female Sexual Function Index (FSFI-12). PFM function was examined with palpation and surface electromyography (sEMG). Postpartum depression was assessed using Self-Rating Depression Scale (SDS). RESULTS: At 6 months postpartum, women who delivered with epidural analgesia had a higher incidence of dyspareunia (43.2% vs 26.3%, P <0.05) and longer first, second, and total stage of labor durations (P <0.01) than those who without. No significant difference in other PFD symptoms or PFM function was found between the 2 groups (P >0.05). Multivariate logistic regression revealed that epidural analgesia (OR = 3.056, 95% CI = 1.217-7.671) and SDS scores (OR = 1.066, 95% CI = 1.009-1.127) were independent risk factors for dyspareunia. CONCLUSION: At 6 months postpartum in primiparous women, epidural analgesia was associated with an increased risk of postpartum dyspareunia and longer labor durations, which deserves attention for rehabilitation after delivery. Future studies with a larger sample size are needed to evaluate the impact of epidural analgesia on other PFD symptoms. Du J, Ye J, Fei H, et al. Effect of Epidural Analgesia on Pelvic Floor Dysfunction at 6 Months Postpartum in Primiparous Women: A Prospective Cohort Study. Sex Med 2021;9:100417.

Reactive oxygen species and glutathione dual responsive nanoparticles for enhanced prostate cancer therapy.

Docetaxel (DTX)-based chemotherapy of prostate cancer is still confronted with significant challenges due to insufficient drug accumulation at the tumor sites and the systemic side effects on normal cells and organs. Tumor microenvironment-responsive nanosized drug delivery systems have shown enormous potential to improve the anticancer efficacy and minimize the systemic side effects of chemotherapeutics. However, most of the currently redox-responsive nanoparticles respond only to single stimuli, which compromise the treatment effect. Hence, inspired by the abundance of reactive oxygen species (ROS) and intracellular glutathione (GSH) in cancer cells, we proposed a unique ROS and GSH dual responsive nanocarrier (PCL-SS) for DTX delivery. The DTX-loaded PCL-SS nanoparticles (PCL-SS@DTX NPs) were not only stable in a normal physiological environment but also rapidly triggered DTX release in prostate cancer cells. In vitro experiments showed that PCL-SS@DTX NPs had robust prostate cancer cell cytotoxicity, induced cell apoptosis, inhibited cell migration and invasion and exhibited satisfactory biocompatibility. In mice bearing orthotopic prostate cancer, PCL-SS@DTX NPs could accumulate in orthotopic tumor sites and then significantly weaken tumor growth by inhibiting prostate cancer cell proliferation and inducing cell apoptosis, without obvious damages to major organs. Overall, this dual responsive nanosized drug delivery system may act as a promising therapeutic option for prostate cancer chemotherapy.

Highly Oriented Graphite Aerogel Fabricated by Confined Liquid-Phase Expansion for Anisotropically Thermally Conductive Epoxy Composites.

Graphene-based thermally conductive polymer composites are of great importance for the removal of the excess heat generated by electronic devices. However, due to the orientation of graphene sheets in the polymer matrix, the through-plane thermal conductivity of polymer/graphene composites remains far from satisfactory. We here demonstrate a confined liquid-phase expansion strategy to fabricate highly oriented confined expanded graphite (CEG) aerogels. After being incorporated into epoxy resin (EP), the resulting EP/CEG composites exhibit a high through-plane thermal conductivity (4.14 ± 0.21 W m-1 K-1) at a quite low filler loading of 1.75 wt % (0.91 vol %), nearly 10 times higher than that of neat EP resin and 7.5 times higher than the in-plane thermal conductivity of the composite, indicating that the CEG aerogel has a high through-plane thermal conductivity enhancement efficiency that outperforms those of many graphite/graphene-based fillers. The facile preparation method holds great industrial application potential in fabricating anisotropic thermally conductive polymer composites.