Radiomics from dual-energy CT-derived iodine maps predict lymph node metastasis in head and neck squamous cell carcinoma.

OBJECTIVE: To develop and validate an iodine maps-based radiomics nomogram for preoperatively predicting cervical lymph node metastasis (LNM) in head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS: A total of 278 patients who pathologically confirmed as HNSCC were retrospectively recruited from two medical centers between June 2012 and July 2022. The training set (n = 152) and internal set (n = 67) were randomly selected from medical center A, and the patients from medical center B were enrolled as the external set (n = 69). The minority group in the training set was balanced by the adaptive synthetic sampling (ADASYN) approach. Radiomics features were extracted from dual-energy CT-derived iodine maps at arterial phase (AP) and venous phase (VP), respectively. Three radiomics signatures were constructed to predict the LNM by using a random forest algorithm. The independent clinical predictors for LNM were identified by multivariate analysis and combined with radiomics signatures to establish a radiomic-clinical nomogram. The performance of radiomic-clinical nomogram was evaluated with respect to its discrimination and clinical usefulness. RESULTS: The AP-VP-incorporated radiomics model exhibited a great predictive performance for LNM prediction with an area under curve (AUC) of 0.885 (95% CI, 0.836-0.933) in ADASYN-training set and confirmed in all validation sets. The nomogram that incorporated AP-VP radiomics signatures, CT-reported LN status, and histological grades yielded AUCs of 0.920 (95% CI, 0.881-0.959) in ADASYN-training set, 0.858 (95% CI, 0.771-0.944) in internal validation, and 0.849 (95% CI, 0.752-0.946) in external validation, with good calibration in all cohorts (p > 0.05). Decision curve analyses indicated the nomogram was clinically useful. In addition, the predictive performance of clinical-radiomics nomogram was also validation in combing cohorts. Stratified analysis confirmed the stability of nomogram, particularly in group negative for CT-reported LNM. CONCLUSION: Clinical-radiomics nomogram based on iodine maps exhibited promising performance in predicting LNM and providing valuable information for making individualized therapy decisions.

Radiation levels outside a patient undergoing177Lu-PSMA radioligand therapy.

Understanding the spatial distribution of radiation levels outside of a patient undergoing177Lu radioligand therapy is not only helpful for conducting correct tests for patient release, but also useful for estimation of its potential exposure to healthcare workers, caregivers, family members, and the general public. In this study, by mimicking the177Lu-labeled prostate-specific membrane antigen radioligand therapy for prostate cancers in an adult male, the spatial distribution of radiation levels outside of the phantom was simulated based on the Monte Carlo software of Particle and Heavy Ion Transport System, and verified by a series of measurements. Moreover, the normalized dose rates were further formulized on the three transverse planes representing the heights of pelvis, abdomen and chest. The results showed that the distributions of radiation levels were quite complex. Multi-directional and multi-height measurements are needed to ensure the external dose rate to meet the release criteria. In general, the radiation level was higher at the horizontal plane where the source was located, and the levels in front and behind of the body were higher than those of the left and right sides at the same height. The ratio of simulated dose rates to measured ones ranged from 0.82 to 1.19 within 1 m away from the body surface in all directions. Based on the established functions, the relative root mean square deviation between the calculated and simulated values were 0.21, 0.25 and 0.23 within a radius of 1 m on the pelvis, abdomen and chest transverse planes, respectively. It is expected that the results of this study would be helpful for guiding the test of extracorporeal radiation to determine the patient's release, and of benefit to estimate the radiation exposure to others.

Soil phosphorus availability alters the correlations between root phosphorus-uptake rates and net photosynthesis of dominant C3 and C4 species in a typical temperate grassland of Northern China.

Phosphorus (P) fertilization can alleviate a soil P deficiency in grassland ecosystems. Understanding plant functional traits that enhance P uptake can improve grassland management. We measured impacts of P addition on soil chemical and microbial properties, net photosynthetic rate (Pn ) and nonstructural carbohydrate concentrations ([NSC]), and root P-uptake rate (PUR), morphology, anatomy, and exudation of two dominant grass species: Leymus chinensis (C3 ) and Cleistogenes squarrosa (C4 ). For L. chinensis, PUR and Pn showed a nonlinear correlation. Growing more adventitious roots compensated for the decrease in P transport per unit root length, so that it maintained a high PUR. For C. squarrosa, PUR and Pn presented a linear correlation. Increased Pn was associated with modifications in root morphology, which further enhanced its PUR and a greater surplus of photosynthate and significantly stimulated root exudation (proxied by leaf [Mn]), which had a greater impact on rhizosheath micro-environment and microbial PLFAs. Our results present correlations between the PUR and the Pn of L. chinensis and C. squarrosa and reveal that NSC appeared to drive the modifications of root morphology and exudation; they provide more objective basis for more efficient P-input in grasslands to address the urgent problem of P deficiency.

Nitrogen and Sulfur Co-doped Carbon Dots as a Turn-Off Fluorescence Probe for the Detection of Cerium and Iron.

Carbon dots has becoming one of the most promising fluorescence sensors to determine the trace level of heavy metals in environments because of their advantages in optical properties, response time, and convenient operation procedures. Herein, a novel nitrogen and sulfur co-doped carbon dots (NS-CDs) were prepared though microwave assisted approach using DL-malic acid and allyl thiourea for the first time. Due to the existence of nitrogen and sulfur, the as-prepared NS-CDs exhibited bright blue fluorescence at 430 nm upon 330 nm excitation, with a fluorescence quantum yield of 19.8%. The sensitivity study of NS-CDs against metal ions and organic molecules has approved that the fluorescence could be further quenched by Ce4+ and Fe3+ ions, with the same linear detection ranges varying from 10 to 90 µM. The limits of detection (LOD) were determined as low as 0.75 µM and 0.67 µM for Ce4+ and Fe3+ ions, respectively. The possible quenching mechanism is explained by inner filter effect and static quenching mechanism for Ce4+ ions, while the quenching effect caused by Fe3+ ions is attributed to the inner filter effect, static and dynamic quenching mechanisms. Additionally, the developed sensor was used for the detection of Ce4+ and Fe3+ ions in tap water with satisfactory recoveries. Finally, the designed NS-CDs sensor possesses good biocompatibility against MA104 cells, suggesting the sensor can be potentially applied to detect Ce4+ and Fe3+ ions in environment and biological systems.

The tumor characteristics, treatment strategy, and prognosis in colorectal cancer patients with synchronous liver metastasis in China and the USA.

PURPOSE: This study performed an analysis of clinicopathological characteristics, surgical treatment strategy, and survival for CRC patients with LM between China and the USA. METHODS: The CRC patients with simultaneous LM were identified from the Surveillance, Epidemiology, and End Results (SEER) registry and the Chinese National Cancer Center (CNCC) database from 2010 to 2017. We assessed 3-year cancer-specific survival (CSS) according to surgical treatment strategy and time period. RESULTS: Differences in patient age, gender, primary tumor location, tumor grade, tumor histology, and tumor stage were observed between the USA and China. Compared to the USA, a larger proportion of patients in China underwent both primary site resection (PSR) and hepatic resection (HR) (35.1% vs 15.6%, P < 0.001), and fewer patients underwent only PSR in China (29.1% vs 45.1%, P < 0.001). From 2010 to 2017, the proportion of patient who underwent both PSR and HR has increased from 13.9% to 17.4% in the USA and from 25.4% to 39.4% in China. The 3-year CSS were increasing over time in both the USA and China. The 3-year CSS of patients receiving HR and PSR were significantly higher than those receiving only PSR and patients treated with no surgery in the USA and China. There were no significant differences of 3-year CSS between the USA and China after adjustment (P = 0.237). CONCLUSIONS: Despite the distinctions of tumor characteristics and surgical strategy in patients with LM between the USA and China, increased adoption of HR has contributed to the profound improvements of survival during recent decade.

Joint application of hybrid iterative reconstruction and adaptive filters on neck-and-shoulder CT imaging: A clinical evaluation.

PURPOSE: To assess whether the joint application of hybrid iterative reconstruction (HIR) and an adaptive filter (AF) could reduce streak artifacts and improve image quality of neck-and-shoulder computed tomography (CT). METHODS: This study included 96 patients with suspicious neck lesions who underwent a routine nonenhanced scan on a 64-slice CT scanner. The raw data were reconstructed using four different settings: filtered back projection (FBP), HIR, FBP + AF, and HIR + AF. Regions of interest were manually drawn in erector spine, axillary fat, latissimus dorsi, and dorsal cervical fat. Mean and standard deviation (SD) of the CT number, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were obtained and compared using Wilcoxon signed-rank tests. The qualitative assessments of five factors were compared by two independent investigators. RESULTS: Compared to the other three settings, HIR + AF reduced noise in the area where the streak artifact of the lower neck were most serious (SD; all p ≤ 0.001). The SNR and CNR were improved significantly (all p ≤ 0.001). Compared to the other three settings, HIR + AF showed a significant improvement in CT image quality regarding the visibility of suspicious lesions, the extent of streaking artifacts, noise, soft-tissue contrast, and visualization of small structures (all p ≤ 0.02). CONCLUSIONS: The combination of HIR and AF can significantly reduce streaking artifacts and improve image quality in neck-and-shoulder CT imaging.

Claudin14 promotes colorectal cancer progression via the PI3K/AKT/mTOR pathway.

Colorectal cancer is the third leading cancer in the world in terms of incidence and mortality. The role of differentially expressed Claudin-14 (CLDN14) in CRC has not been reported. We observed that CLDN14 was associated with the progression of CRC. Our functional studies have shown that CLDN14 promoted the proliferation of CRC cells. In addition, CLDN14 also increased the migration and invasion of CRC cells. In vivo experiments also showed that CLDN14 promoted the growth of colorectal cancer via the PI3K/AKT/mTOR. In summary, our research suggests that CLDN14 promotes the progression of colorectal cancer. Our findings may provide new strategies for clinical management and patient prognosis of CRC.

Association study of polymorphisms of endoplasmic reticulum aminopeptidase 1 gene with preeclampsia in Chinese populations.

OBJECTIVE: To explore the correlation of polymorphisms of endoplasmic reticulum aminopeptidase-1 (ERAP-1) gene in Chinese women with preeclampsia. METHOD: In this case-control study, 51 severely preeclamptic and 48 healthy pregnant women were retrospectively involved in Beijing Obstetrics and Gynecology Hospital from October 2017 to October 2019. The venous blood and umbilical cord blood were collected to analyze different single nucleotide polymorphisms (SNPs) in ERAP-1 gene in both groups. RESULT: We firstly screened nine SNPs that were significantly different between two groups (P< .1) via univariate analysis. Pearson Chi-Square Test and Fisher's Exact Test were performed to verify the correlation of SNPs with preeclampsia. Finally, genotype TC located in 96121524 position was associated with an increased risk of preeclampsia (P= .020, OR = 2.002, 95% CI: 0.687-5.831). CONCLUSION: There might be a correlation between polymorphism of 96121524 in ERAP-1 gene and preeclampsia susceptibility in pregnant women of Han nationality in Beijing.

Association between HLA-A gene polymorphism and early-onset preeclampsia in Chinese pregnant women early-onset.

BACKGROUND: Preeclampsia is an idiopathic disease during pregnancy. This study explores the correlation between HLA-A polymorphism and the onset of preeclampsia. METHODS: The Illumina HiSeq2500 sequencing platform was used to genotyping HLA-A allele in venous blood DNA of 50 preeclampsia pregnant women and 48 normal pregnant women and umbilical cord blood DNA of their children of Han nationality in China. The frequencies and distributions of alleles and genotypes among the mothers and their children were compared between the two groups. The differences of frequencies and distributions of genotypes were compared between the two groups according to the mothers' genotype compatibility. RESULTS: Twenty HLA-A alleles were detected in preeclampsia pregnant women and normal pregnant women; 21 HLA-A alleles were found in preeclampsia group fetuses and 22 HLA-A alleles in control group fetuses. There was no statistical difference in the HLA-A genes' frequency between the two groups of pregnant women and their fetuses. When the sharing antigen was 1, the number of maternal-fetal pairs in the preeclampsia group was more than that in the control group; the difference was statistically significant (P < 0.05). The frequency of neither mother nor fetus carrying the HLA-A * 24: 02 gene in the preeclampsia group was significantly lower than that in the control group (P < 0.05). HLA-A gene homozygosity in fetuses of early-onset preeclampsia group was substantially higher than that of the control group (P = 0.0148); there is no significant difference in pregnant women's genes homozygosity between early-onset preeclampsia group and the control group. CONCLUSIONS: HLA-A * 24: 02 may be a susceptibility gene for early preeclampsia.

Quantitative proteomic analysis of down syndrome biomarkers in maternal serum using isobaric tags for relative and absolute quantification (iTRAQ).

Prenatal diagnosis of Down syndrome (DS) is based on calculated risk involving maternal age, biochemical and ultrasonographic markers, and, more recently, cell-free DNA (cfDNA). The present study was designed to identify Down Syndrome biomarkers in maternal serum. We quantified the changes in maternal serum protein levels between 10 non-pregnant women, 10 pregnant women with healthy fetuses, and 10 pregnant women with DS fetuses using isobaric tags for relative and absolute quantification (iTRAQ). We subsequently conducted a Gene Ontology (GO) analysis. A total of 470 proteins were identified, 11 of which had significantly different serum levels between the DS fetus group and Healthy fetuses group. Our data shows the identified proteins may be relevant to DS and constitute potential DS biomarkers.

Seasonal and Spatial Distribution of Atmospheric Tritiated Water Vapor in Mainland China.

To reveal the distribution of atmospheric tritium water (HTO) vapor and provide a baseline for tritium pollution control, a subnational survey was conducted in mainland China. As the largest study on HTO vapor in China that has ever been formally reported, this study provides a macroimpression of the atmospheric HTO specific activity from March 2017 to March 2018. A total of 102 passive samplers were deployed at 34 sites in 30 provinces to determine the seasonal and spatial distributions of HTO vapor. In general, the HTO specific activity in the atmosphere ranged from lower than the minimum detectable activity (0.18 Bq·L-1) to 5.5 Bq·L-1. Spatially, the specific activity of HTO was positively correlated to the latitude and the distance to proximal coastline. Seasonally, significantly higher HTO specific activities were observed in spring and relatively lower in summer. Based on correlation analysis, the atmospheric HTO distributions were considered to be the consequence of combined factors of the stratospheric-tropospheric net mass flux, the distance from the tropopause to the ground, the fraction of air mass that originated from ocean re-evaporation and long-distance transport from high-latitude continents.

Human Papillomavirus Status in Primary Lesions and Pelvic Lymph Nodes and Its Prognostic Value in Cervical Cancer Patients with Lymph Node Metastases.

BACKGROUND The aim of this study was to assess the presence of HPV DNA in cervical tissues and lymph nodes in patients who have uterine cervical neoplasms with lymphatic metastases and who underwent surgery for invasive cervical cancer and pelvic lymphadenectomy, to establish the utility of HPV type and viral load in predicting disease progression. MATERIAL AND METHODS We retrospectively assessed 88 patients with uterine cervical neoplasms with lymph node metastases. All 88 patients were in FIGO stage IA-IIB. A total of 316 paraffin-embedded archival tissues (88 cervical samples and 228 pelvic lymph node specimens) were acquired. All the samples were analyzed using real-time PCR to determine HPV DNA presence/type and to quantify viral load. RESULTS In total, 17 HPV genotypes were detected in the cervical lesions and pelvic lymph nodes of the patients. The most common HPV type in all samples was HPV16, followed by HPV18. The existence of HPV16 DNA and low HPV16 viral load in cervical lesions were also significantly associated with disease recurrence. Furthermore, lymphovascular space involvement was also correlated with worse disease outcome. CONCLUSIONS HPV16 DNA presence and low viral load in primary lesions can be used to predict disease recurrence. HPV DNA is a favorable prognostic indicator in patients with uterine cervical neoplasms who have lymphatic metastases.

Building a predictive model for successful vaginal delivery in nulliparas with term cephalic singleton pregnancies using decision tree analysis.

AIM: To establish a model predicting successful vaginal delivery (VD) in nulliparas with term cephalic singleton pregnancies. METHODS: We retrospectively identified 6799 term nulliparas with cephalic singletons (6416 VD and 383 cesarean section [CS] due to dystocia) who entered labor (cervical dilation ≥2 cm) between September 2014 and August 2015. Using VD as the dependent variable and age, maternal body height, educational attainment, gravidity, gestational age, pre-pregnancy body mass index (BMI), BMI upon admission for delivery, gestational weight gain, gestational hypertension and gestational diabetes as the independent variables, predictors of VD success were identified using a multivariate binary logistic regression and then ranked with decision-tree analysis. RESULTS: While multiple factors are associated with improved VD success, we found body height, gestational age, and intrapartum BMI to be the best predictors of successful VD. Our predictive model has a classification accuracy, sensitivity and specificity of 76.6%, 96.7% and 16.4%, respectively, and it was subsequently confirmed by both internal and external validation. CONCLUSION: Our predictive model indicates body height, gestational age and intrapartum BMI as the major predictors of successful VD in low-risk patients.

Identifying appropriate pre-pregnancy body mass index classification to improve pregnancy outcomes in women of childbearing age in Beijing, China: a retrospective cohort study.

BACKGROUND AND OBJECTIVES: This study explored the appropriate classification of pre-pregnancy body mass index (BMI) in women of childbearing age in Beijing, China. METHODS AND STUDY DESIGN: Women with singleton pregnancies at more than 28 gestational weeks were retrospectively reviewed. Based on the pre-pregnancy BMI (kg/m2), these patients were divided into 7 groups: <18.5, >=18.5-22.9, >=23-23.9, >=24-24.9, >=25-27.9, >=28-29.9, and >=30. Pregnancy adverse outcomes, including gestational hypertension with or without preeclampsia, gestational diabetes mellitus, initial cesarean section, postpartum hemorrhage, macrosomia, large-for-gestational age infant and so on were recorded. Binary logistic regression analysis was used to calculate the uncorrected and corrected odds ratios and 95% confidence intervals, with the >=18.5-22.9 group serving as a reference. RESULTS: A total of 11,136 pregnant women were analyzed. Incidences of above mentioned six adverse outcomes were greater in women with higher pre-pregnancy BMI. The risks of the abovementioned six adverse outcomes were increased significantly among the >=23-23.9, >=24-24.9, >=25-27.9 groups and substantially higher in the >=28-29.9, >=30 groups after correction. <18.5 group showed an increased risk of small-for-gestational age infants. CONCLUSIONS: For women of childbearing age in Beijing, China, the optimal pre-pregnancy BMI range was >=18.5-22.9 kg/m2, with the cutoff value for overweight status being >=23.0 kg/m2 and the cutoff value for obesity being >=28.0 kg/m2.

A prospective cohort study of early-pregnancy risk factors for gestational diabetes in polycystic ovarian syndrome.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a strong risk factor for gestational diabetes (GDM). However, the association between features of PCOS during early pregnancy and the risk of GDM is not clearly characterized. In this prospective cohort study, we seek to identify early-pregnancy risk factors for GDM in PCOS women. METHODS: Between 2011 and 2013, 248 women with PCOS were followed from their first prenatal visit to delivery. Multiple early-pregnancy metabolic factors were evaluated for their association with the risk of GDM. RESULTS: Among 248 subjects, 75 (30.2%) developed GDM. Single factor analysis identified a number of metabolic risk factors for GDM, including higher body mass index, fasting plasma glucose (FPG) and insulin resistance; abnormal cholesterol; elevated blood pressure and free androgen index; lower level of sex-hormone binding globulin (SHBG); and less gestational weight gain. Multivariate analysis showed that FPG, non-high-density lipoprotein-cholesterol and SHBG are independent predictive factors for GDM. CONCLUSIONS: Our study established strong association of multiple early-pregnancy risk factors with development of GDM in PCOS women. These risk factors are predominantly related to the regulation of glucose, lipid, and androgen metabolism. Among these factors, FPG, non-high-density lipoprotein-cholesterol, and SHBG, predict incident GDM.

High normal blood pressure in early pregnancy also contribute to early onset preeclampsia and severe preeclampsia.

OBJECTIVE: This study was to evaluate effects of high normal blood pressure (HNBP) in early pregnancy on total preeclampsia, early preeclampsia, and severe preeclampsia. METHODS: We conducted a multicenter, national representative retrospective cohort study. HNBP was defined as systolic blood pressure between 130 and 140 mmHg or diastolic blood pressure between 85 and 90 mmHg. We used multivariable logistic regression to examine the associations of HNBP and the risks of above three types of preeclampsia. RESULTS: We included 58 054 women who were normotensive and nulliparous in early pregnancy. 4 809 (8.3%) fulfilled the definition of having HNBP, 16 682 (28.7%) were in normal blood pressure group, and 36 563 (63.0%) were in optimal blood pressure group. The incidence rates of total preeclampsia, early preeclampsia, and severe preeclampsia were 2.1% (1 217), 0.8% (491), and 1.4% (814), respectively. Compared to having optimal blood pressure, women with HNBP had significantly higher odds of total preeclampsia (odds ratio (OR) = 4.028, 95% confidence interval (CI) 3.377, 4.804), severe preeclampsia (OR = 3.542, 95% CI 2.851, 4.400), and early preeclampsia (OR = 8.163, 95% CI 6.219, 10.715). Our restricted cubic spline results supported the dose-response relationship between continuous blood pressure and the odds ratio of three types of preeclampsia. The fraction of early preeclampsia associated with prehypertension was 58.6%, which was higher than those of total preeclampsia (42.2%) or severe preeclampsia (40.5%). CONCLUSION: Women in early pregnancy with HNBP more likely develop total preeclampsia, early preeclampsia and severe preeclampsia, compared to those with optimal blood pressure. HNBP contribute more to early preeclampsia than severe preeclampsia. Our study provided robust epidemiological evidences for monitoring HNBP in early pregnancy to reduce the risks of preeclampsia.

Associations of polymorphisms of CYP2D6 and CYP2C9 with early onset severe pre-eclampsia and response to labetalol therapy.

PURPOSE: Early onset preeclampsia (PPE) contributes to life-threatening maternal complications and fetal demise. Pharmacogenomics is a precision medicine, and metabolizing enzymes responsive to antihypertensive remains understudied. The aim of this study was to evaluate the associations of polymorphisms of cytochrome P450, family 2, subfamily D, polypeptide 6 (CYP2D6) and cytochrome P450, family 2, subfamily C, polypeptide 9 (CYP2C9) with PPE and the relationship among CYP2D6, CYP2C9 polymorphisms and response to labetalol therapy. METHODS: Totally 105 gravidas diagnosed with PPE (case) and 103 healthy gravidas (control) were recruited between August 2013 and July 2016. Labetalol was given to control blood pressures (BP) with PPE. If labetalol administration alone did not exceed the mean dose and effectively controlled the BP, it would be considered to be valid (n = 75). Genotype and allele frequencies of CYP2C9 gene (rs1057910 and rs4918758) and CYP2D6 gene (rs1065852, rs28371725, rs35742686, and rs3892097) were analyzed by TaqMan PCR. Differences in the genotype and allele frequencies were compared between case-control groups, and the responsive and nonresponsive to labetalol in PPE. RESULTS: Out of six variants, only CC and CT genotypes of the CYP2D6 variants (rs28371725) in PPE were significantly higher than those in the control group [18.1% (19/105) vs 14.6% (15/103); 56.2% (59/105) vs 42.7% (44/103); χ2 = 6.707]. However, there were no differences in maternal age, diastolic pressure, BMI, BW, serum triglyceride, and creatinine were observed among women with CC, CT, or TT genotype of CYP2D6 gene rs28371725 in the experimental group (all P > 0.05). Compared with the gravidas with CT or TT genotype of CYP2D6 gene rs28371725, those with CC genotype had longer gestational age [(32.5 ± 2.1) vs (29.5 ± 1.8) and (29.8 ± 2.2) weeks] and higher plasma albumin [(27.2 ± 9.3) vs (20.3 ± 10.4) and (22.5 ± 7.4) g/L], but lower systolic pressure and 24 h urine protein (LSD test, all P < 0.05). The G allele frequency in CYP2D6 gene rs1065852 nonresponsive to labetalol group was higher than that in responsive labetalol group [93.3% (56/60) vs 76.0% (114/150), χ2 = 8.351, P = 0.004]. CONCLUSIONS: The polymorphism of CYP2D6 gene rs28371725 may be associated with PPE, and the allele of G in CYP2D6 gene rs1065852 may be associated with the efficacy of labetalol in treatment of PPE.

[Genetic analysis of 100 fetuses with cleft lip with or without palate].

OBJECTIVE: To explore the genetic basis for fetuses with cleft lip and palate. METHODS: For 100 fetuses diagnosed with cleft lip with or without palate, G-banding chromosomal karyotyping and copy number variation sequencing (CNV-seq) were carried out on chorionic villi, amniotic fluid or cordocentesis samples. RESULTS: No genomic abnormality was found among 49 fetuses with isolated cleft lip and palate, while 12 genomic aberrations were found among 51 fetuses with syndromic cleft lip and palate, which included 4 cases with trisomy 13, 2 cases with trisomy 18, 1 with X chromosome aneuploidy, 2 with other chromosomal aneuploidies and 3 with pathogenic CNVs. CONCLUSION: The incidence of genomic abnormalities in fetuses with cleft lip and palate was high. In addition to chromosomal abnormalities, attention should also be paid to pathogenic CNVs.

Identification of TRADD as a potential biomarker in human uterine leiomyoma through iTRAQ based proteomic profiling.

Recurrent and refractory leiomyoma of uterus is one of the most common diseases in women of reproductive age. Despite its benign nature, uterine leiomyoma has presented an extremely deleterious impact on public health. The etiology of uterine leiomyoma remains unclear and clinical management remains suboptimal, leaving radical hysterectomy the only effective approach. Delineating the molecular mechanism underlying the leiomyoma initiation and progression remains an unmet clinical need. To screen proteins that were differentially expressed in uterine leiomyoma versus normal myometrium, we examined proteomic profile by isobaric tag for relative and absolute quantitation (iTRAQ) labeling coupled with liquid chromatography - tandem mass spectrometry (LC-MS/MS). 72 proteins have been identified as differentially expressed in uterine leiomyoma, including the downregulation of TRADD (tumor necrosis factor receptor type 1-associated DEATH domain protein), which dominates the dysfunctional extrinsic apoptosis pathway and deregulated inflammatory responses. The reduction of TRADD was further validated by Western blot and immunohistochemistry in independent sample cohorts. Our data thus suggest potential biological significance of TRADD mediated inflammatory response in the development of uterine leiomyoma.

Caesarean deliveries in China.

BACKGROUND: The caesarean section rate has risen rapidly in China. The purpose of this retrospective study was to estimate caesarean section rates and indications by hospital facility level in Mainland China to investigate reasons contributing to the high rate. METHODS: This cross-sectional hospital-based study collected data from 39 hospitals in three geographical regions in China, covering 14 different provinces, municipalities, and autonomous regions, including 20 tertiary health hospitals and 19 secondary hospitals. Data from all women who gave birth at these hospitals during 2011 were included. RESULTS: A total of 112,138 women who gave birth after 24 weeks of gestation were surveyed. Of these pregnancies, 54.5% (61,084 cases) resulted in caesarean section, non-indicated caesarean section accounted for 38.4% of caesarean sections. Overall caesarean section rates were higher at the tertiary level hospitals (55.9%) compared to the secondary level hospitals (50.9%). The secondary level hospitals had higher rates of non-indicated caesarean section (48.9% of caesarean sections) compared to tertiary level hospitals (34.5% of caesarean sections). The rate of caesarean section on maternal request was higher in the secondary hospitals (16.6%) than in the tertiary hospitals (10%) (P < 0.001), as well as the caesarean section rate for CPD prior to labour. Operative vaginal deliveries were overall rare (1.2%) with 90.9% (1200/1320 cases) performed in the tertiary hospitals. CONCLUSIONS: Caesarean section on maternal request accounts for a large portion of China's high caesarean section rate, especially in the secondary hospitals. The first step to reduced caesarean section rates is to decrease the number of non-indicated caesarean sections.