Evaluation of the Efficacy of Laparoscopic Modified Uterine Incision Pressure Repair in Type II-III Cesarean Scar Pregnancy.

Objective: This study aims to assess the efficacy of laparoscopic modified uterine incision pressure repair in treating type II-III cesarean scar pregnancy (CSP). Methods: A total of 20 patients diagnosed with type II-III CSP and admitted to the Affiliated Hospital of Guizhou Medical University between April 2021 and May 2023 were enrolled. The patients were divided into two groups: the study group (Group A), consisting of newly treated surgical patients, and the control group (Group B), including patients with type II-III CSP treated by doctors of similar grade and surgical experience (non-novel). Various parameters, including age, menopause duration, pregnancy and delivery history, cesarean section frequency, preoperative human chorionic gonadotropin (HCG) levels, pregnancy sac size, HCG turnover time, operation duration, intraoperative blood loss, blood transfusion requirements, and hospitalization costs, were compared. Results: When comparing mean age, menopause duration, preoperative HCG levels, pregnancy and cesarean section frequencies, pregnancy sac size, and HCG turnover time, no statistically significant differences were observed (P > .05). The number of transfusions and hospitalization costs in Group A were lower than in Group B, although the differences were not statistically significant (P > .05). However, operative time, intraoperative bleeding, and hospitalization costs were significantly lower in Group A compared to Group B (P < .05). Conclusions: The laparoscopic modified uterine incision pressure repair method demonstrated clinical value with its advantages of short operation time, reduced bleeding, lower costs, and rapid recovery for type II-III CSP.

Relationship Between Emotional Eating and Weight Loss Effect of the 211 Diet Body Weight Management Method in Obese Women of Childbearing Age.

Purpose: To explore the relationship between emotional eating behavior and the weight loss effect of the 211 Diet body weight management method in obese women of childbearing age. Methods: From March 2021 to November 2021, 33 obese women of childbearing age who were recommended by gynecologists to achieve weight management were selected from the gynecological outpatient department of The Affiliated Hospital of Guizhou Medical University via the target sampling method. The participants who met all the study inclusion criteria and did not meet any of the exclusion criteria underwent a 40-day 211 Diet body weight management program. Body mass index (BMI) was collected on the day before the formal start and the first day after 40 days of weight loss. The 7-item Generalized Anxiety Disorder Scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9) and Weight Efficacy Lifestyle Questionnaire-Short Form (WEL-SF) were employed to evaluate participants' anxiety, depression and dietary self-efficacy before and after weight loss. On the day before the formal start of the program, the Dutch Eating Behaviour Questionnaire (DEBQ) was used to investigate the causes of previous induced eating. Results: The weight of the participants before weight loss was positively correlated with the previous emotional eating scores (r = 0.37; P < .05); after 40 days of weight loss, body weight and BMI were significantly lower than before weight loss (P < .05); BMI reduction value = 1.97 + 0.16*PHQ9 D-value (R2 = 0.35, B = 0.16; P < .001); there was no correlation between WEL-SF scores before and after weight loss (P > .05); WEL-SF scores D-value was positively correlated with previous emotional eating scores (r = 0.41; P < .05), WEL-SF D-value = -22.09 + 1.13*emotional eating (R2=0.16, B=1.13; P < .05); there was no difference among WEL-SF, GAD-7 and PHQ-9 scores before and after weight loss (P > .05). Conclusion: The participants' relatively higher body weight before weight loss was related to their previous relatively more significant emotional eating behaviors. In obese women of childbearing age with more obvious previous emotional eating behaviors, the 211 Diet body weight management method may be more beneficial for weight loss.

Bulk RNA-sequencing, single-cell RNA-sequencing analysis, and experimental validation reveal iron metabolism-related genes CISD2 and CYP17A1 are potential diagnostic markers for recurrent pregnancy loss.

BACKGROUND: Recurrent pregnancy loss (RPL) is associated with variable causes. Its etiology remains unexplained in about half of the cases, with no effective treatment available. Individuals with RPL have an irregular iron metabolism. In the present study, we identified key genes impacting iron metabolism that could be used for diagnosing and treating RPL. METHODS: We obtained gene expression profiles from the Gene Expression Omnibus (GEO) database. The Molecular Signatures Database was used to identify 14 gene sets related to iron metabolism, comprising 520 iron metabolism genes. Differential analysis and a weighted gene co-expression network analysis (WGCNA) of gene expression revealed two iron metabolism-related hub genes. Reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemistry were used on clinical samples to confirm our results. The receiver operating characteristic (ROC) analysis and immune infiltration analysis were conducted. In addition, we analyzed the distribution of genes and performed CellChat analysis by single-cell RNA sequencing. RESULTS: The expression of two hub genes, namely, CDGSH iron sulfur domain 2 (CISD2)and Cytochrome P450 family 17 subfamily A member 1 (CYP17A1), were reduced in RPL, as verified by both qPCR and immunohistochemistry. The Gene Ontology (GO) analysis revealed the genes predominantly engaged in autophagy and iron metabolism. The area under the curve (AUC) demonstrated better diagnostic performance for RPL using CISD2 and CYP17A1. The single-cell transcriptomic analysis of RPL demonstrated that CISD2 is expressed in the majority of cell subpopulations, whereas CYP17A1 is not. The cell cycle analysis revealed highly active natural killer (NK) cells that displayed the highest communications with other cells, including the strongest interaction with macrophages through the migratory inhibitory factor (MIF) pathway. CONCLUSIONS: Our study suggested that CISD2 and CYP17A1 genes are involved in abnormal iron metabolism, thereby contributing to RPL. These genes could be used as potential diagnostic and therapeutic markers for RPL.

Corrigendum to "Study of hydrosalpinx on endometrial growth and expression of HOXA10mRNA and related factors" [Heliyon 9(6) (June 2023) e17063].

[This corrects the article DOI: 10.1016/j.heliyon.2023.e17063.].

Study of hydrosalpinx on endometrial growth and expression of HOXA10mRNA and related factors.

Objective: The objective of the study is to extract the patient's endometrium at the time of proliferative stage using hydrosalpinx in order to culture the cells and decidualization induction in vitro. Further, the study is also intended at identifying the expression of HOXA10mRNA and related factors and understand the hydrosalpinx's impact upon the working mechanism of endometrial cells. Methods: Once the extraction of the primary cells is over, the cells are cultured and other activities are performed such as the cell identification, CCK8 assay, cell decidua induction and HE staining. The researchers assessed the expression levels of HOXA10, IGFBP1 and avß3 in either proliferation or secretion of the endometrium. This was accomplished using Western blot assay and real-time fluorescence quantitative PCR. Results: The results confirmed that at the time of endometrial proliferation, there was a decline in the expression of HOXA10 as a result of tubal effusion influence. This affected its expression in the secretory stage i.e., corresponding function. Further, a significant decline was observed in the levels of HOXA10mRNA of endometrial cells that were subjected to continuous tubal effusion, post decidualization. It was found that during decidualization, if thetubal effusion is removed, it is possible to restore the expression of HOXA10mRNA to a certain extent, though it is not possible to reach the general endometrial level. So, in terms of clinical aspects, the expression of HOxa10 mRNA by the endometrial cells decreases significantly when blocking the hydrosalpinx. Conclusions: Among hydrosalpinx patients, one of the major mechanisms that damage the endometrium was found to be the abnormal expression of HOXA10 followed by IGFBP1 and avß3, its downstream genes. This further results in the implantation of the embryo as well. Though it is possible to gradually repair the damage after the removal of hydrosalpinx, the recovery is a time-consuming process.

A Simulation Study on the Growth of Oviduct Mucosa Cells in the Uterine Cavity Microenvironment.

OBJECTIVE: The growth of oviduct mucosa in the uterine cavity was observed by co-culture of oviduct mucosa cells and endometrial cells in different proportions to study the possibility and function of the growth of oviduct mucosa in the uterine cavity. METHODS: The extracted cells were identified by immunofluorescence with cytokeratins 19 (CK19) and vimentin. A Cell Counting Kit-8 (CCK8) experiment, cell decidualization induction, and HE staining were performed after the co-culture of two kinds of cells in different proportions. RESULTS: 1) The cells could grow normally when the two cells were co-cultured indirectly. 2) A CCK8 test of oviduct mucosa cells showed that the growth rate of each group was similar after the indirect co-culture of two kinds of cells in different proportions, which was in line with the growth law of normal cells. 3) Immunofluorescence identification of the cells showed that most of the two kinds of cells in the second passage were CK19 positive and were epithelial cells, while most of the cells in the fifth passage expressed positive vimentin antibody and were stroma cells. 4) After cell decidualization induction, the cell morphology of each group showed deciduation-like changes. 5) After decidualization, the cell morphology of each group was similar after HE staining. CONCLUSION: Oviduct mucosa cells can grow normally in the uterine environment. In the uterine environment with different degrees of endometrial loss, the growth rate of oviduct mucosa cells is not inhibited. Its morphology does not change, and it can undergo decidualization in vitro.

Discussion on operative skills in the embolization of hydrosalpinx by hysteroscopic placement of a microcoil.

This study aims to discuss the operative skills of hysteroscopic tubal embolization and reduce the occurrence of complications.Ninety-four patients were divided into group A and group B. The main surgical technique in group A: when the inner sleeve is sent to the fallopian tube and no longer accessible (but no >3 cm), remove the guide wire and put into the microcoil. But in group B, there are four major surgical techniques. First, the depth at which the guide wire enters the tube was controlled at 2 cm. Second, the inner diameter of the fallopian tube must be explored to determine the type and shape of the coils. Third, saline should be used to separate the catheter. Fourth, it is to control the release speed of the coils. The superiority of the improved operation method was confirmed by comparing the surgical failure rate, incidence of complications, and cost of surgery before and after the procedure.The reoperation rate of group A was 10% (3/30), while that of group B was 2.68% (3/112). The ectopic microcoils rate of group A was 6.67% (2/30), while that of group B was 0.89% (1/112). The microcoil damages rate of group 23.33% (7/30), while that of group B was 8.04% (9/112). All P values were <.01, and the difference was statistically significant.Hysteroscopic tubal embolization is currently a new surgical procedure to block the fallopian tubes and prevent the reverse flow of fluid in the fallopian tubes into the uterine cavity. After we improved surgical techniques, the surgical failure rate, complication rate, and operation cost of fallopian tube embolization were significantly lower than before the improved method was applied. The improved techniques led to a higher success rate.