Assessing the needs of informal caregivers of patients with chronic non-communicable diseases: A systematic review of self-assessment tools.

AIM: To synthesize self-administrated needs assessment tools of informal caregivers for patients with chronic non-communicable diseases (CNCDs), evaluate the quality of psychometric properties and identify main needs assessment themes. DESIGN: Systematic review. METHODS: Eight electronic databases both in English and Chinese were searched for. The psychometric properties of tools were evaluated according to the quality criteria for good psychometric properties developed by Terwee et al. Both the content analysis and thematic extraction methods were used. Needs assessment themes were categorized based on the 7-level Maslow's Hierarchy of Needs Theory. RESULTS: A total of 17 tools were synthesized. Thirteen of them targeted informal caregivers of patients with cancer. The psychometric properties evaluated for most of these tools were content validity, internal consistency and construct validity. A total of 27 needs themes were identified and matched to six levels based on the 7-level Maslow's Hierarchy of Needs theory, besides the aesthetic needs level. NO PATIENT OR PUBLIC CONTRIBUTION: No primary data are being collected.

Effect of WeChat-based continuous care intervention on the somatic function, depression, anxiety, social function and cognitive function for cancer patients: Meta-analysis of 18 RCTs.

AIM: This meta-analysis systematically reviewed and identified the effects of WeChat-based continuous care (WCC) interventions on various outcomes in cancer patients. DESIGN: Systematic review and meta-analysis. METHODS: In this study, outcome measures included somatic function, anxiety, depression, social function, and cognitive function. The standardized mean differences and 95% CIs of pooled effect sizes were calculated using fixed- and random-effects models. NFail-safe and Begg's tests were performed to evaluate publication bias, and sensitivity analysis was performed to evaluate the robustness of the meta-analysis results. RESULTS: The meta-analysis included 18 RCTs of moderate quality. WCC interventions significantly improved somatic function, depression, anxiety, social function, and cognitive function in cancer patients. There was no significant publication bias, and the sensitivity analysis indicated robust results. PATIENT OR PUBLIC CONTRIBUTION: WCC interventions improved depression, anxiety, social function, and cognitive function in cancer patients.

A mucosal recovery software tool for endoscopic submucosal dissection in early gastric cancer.

Background: Due to the limited diagnostic ability, the low detection rate of early gastric cancer (EGC) is a serious health threat. The establishment of the mapping between endoscopic images and pathological images can rapidly improve the diagnostic ability to detect EGC. To expedite the learning process of EGC diagnosis, a mucosal recovery map for the mapping between ESD mucosa specimen and pathological images should be performed in collaboration with endoscopists and pathologists, which is a time-consuming and laborious work. Methods: 20 patients at the Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College from March 2020 to July 2020 were enrolled in this study. We proposed the improved U-Net to obtain WSI-level segmentation results, and the WSI-level results can be mapped to the macroscopic image of the specimen. For the convenient use, a software pipeline named as "Pathology Helper" for integration the workflow of the construction of mucosal recovery maps was developed. Results: The MIoU and Dice of our model can achieve 0.955 ± 0.0936 and 0.961 ± 0.0874 for WSI-level segmentation, respectively. With the help of "Pathology Helper", we can construct the high-quality mucosal recovery maps to reduce the workload of endoscopists and pathologists. Conclusion: "Pathology Helper" will accelerate the learning of endoscopists and pathologists, and rapidly improve their abilities to detect EGC. Our work can also improve the detection rate of early gastric cancer, so that more patients with gastric cancer will be treated in a timely manner.

Synergistic Activity of Imipenem in Combination with Ceftazidime/Avibactam or Avibactam against Non-MBL-Producing Extensively Drug-Resistant Pseudomonas aeruginosa.

Extensively drug-resistant Pseudomonas aeruginosa (XDRPA) infection is a significant public health threat due to a lack of effective therapeutic options. New ß-lactam-ß-lactamase inhibitor combinations, including ceftazidime-avibactam (CZA), have shown a high resistance rate to XDRPA. This study was therefore conducted to describe the underlying genomic mechanism of resistance for CZA nonsusceptible XDRPA strains that are non-metallo-ß-lactamase (MBL) producers as well as to examine synergism of CZA and other antipseudomonal agents. Furthermore, the synergistic antibacterial activity of the most effective antimicrobial combination against non-MBL-producing XDRPA was evaluated through in vitro experiments. The resistance profiles of 15 CZA-resistant XDRPA strains isolated from clinical specimens in China-Japan Friendship Hospital between January 2017 to December 2020 were obtained by whole-genome sequencing (WGS) analysis. MBL genes blaIMP-1 and blaIMP-45 were found in 2 isolates (2/15, 13.3%); the other underlying CZA-resistance mechanisms involved the decreased OprD porin (13/13), blaAmpC overexpression (8/13) or mutation (13/13), and upregulated efflux pumps (13/13). CZA-imipenem (CZA-IPM) combination was identified to be the most effective against non-MBL-producing XDRPA according to the results of WGS analysis and combined antimicrobial susceptibility tests, with an approximately 16.62-fold reduction in MICs compared to CZA alone. Furthermore, the results of checkerboard analysis and growth curve displayed the synergistic antimicrobial activity of CZA and IPM against non-MBL-producing XDRPA. Electron microscopy also revealed that CZA-IPM combination might lead to more cellular structural alterations than CZA or IPM alone. This study suggested that the CZA-IPM combination has potential for non-MBL-producing XDRPA with blaAmpC overexpression or mutation, decreased OprD porin, and upregulated efflux pumps. IMPORTANCE Handling the infections by extensively drug-resistant Pseudomonas aeruginosa (XDRPA) strains is challenging due to their complicated antibiotic resistance mechanisms in immunosuppressed patients with pulmonary diseases (e.g., cystic fibrosis, chronic obstructive pulmonary disease, and lung transplant), ventilator-associated pneumonia, and bloodstream infections. The current study suggested the potentiality of the ceftazidime-avibactam-imipenem combination against XDRPA with blaAmpC overexpression or mutation, decreased OprD porin, and/or upregulated efflux pumps. Our findings indicate the necessity of combined drug sensitivity tests against XDRPA and also lay a foundation for the development of prevention, control, and treatment strategies in XDRPA infections.

The Prevalence of Ectopic Gestation: A Five-Year Study of 1273 Cases.

OBJECTIVE: This study aims to investigate the prevalence, related risk factors, manifestations, and management of ectopic pregnancy in the first hospital of the Jilin University over a five-year period. METHODS: A retrospective study of ectopic pregnancy was conducted in the First Hospital of the Jilin University between January 1, 2010 and December 31, 2014. The results were analyzed using simple descriptive statistics and reported as frequencies and percentages. RESULTS: The results revealed that out of 16,050 gynecological admissions to the hospital over the five-year period, there were 1273 ectopic pregnancies, with a prevalence rate of 7.93% of all gynecological admissions. The majority of these patients were aged 25-34 y and had a past history of abortion (61%) and uterine cavity surgery (38.6%), and a significant number were nulliparous (549, 43.1%). Bleeding accompanied by abdominal pain were the most common presenting complaints (65.2%). A unilateral salpingectomy was performed for most of these patients. CONCLUSION: Ectopic pregnancy had notable morbidity over the five-year period under study, and a history of abortion and uterine cavity surgery were identified as associated risk factors that limited the future reproductive potential of nulliparous women. Therefore, targeted health education campaigns should be conducted in order to enlighten this group of women and the public at large.

[Retracted] Knockdown of AQP1 inhibits growth and invasion of human ovarian cancer cells.

Following the publication of this paper, it was drawn to the Editors' attention by a concerned reader that certain of the western blotting data shown in Fig. 2B and flow cytometric data shown in Fig. 3B bore unexpected similarities to data appearing in different form in other articles by different authors. Furthermore, there were additional concerns regarding the possibly anomalous appearance of cell migration data shown in Fig. 4B. Owing to the fact that some of the contentious data in the above article had already been published elsewhere, or were already under consideration for publication, prior to its submission to Molecular Medicine Reports, the Editor has decided that this paper should be retracted from the Journal. After having been in contact with the authors, they agreed with the decision to retract the paper. The Editor apologizes to the readership for any inconvenience caused. [the original article was published in Molecular Medicine Reports 16: 5499­5504, 2017; DOI: 10.3892/mmr.2017.7282].

LAPTM4B promotes the progression of bladder cancer by stimulating cell proliferation and invasion.

Bladder cancer is a highly metastatic tumor and one of the most common malignant tumors originating in the urinary system. Due to the complicated etiology and lack of significant early symptoms, the diagnosis and treatment of bladder cancer is difficult. Lysosome-associated transmembrane protein 4ß (LAPTM4B) was reported to be involved in the development and progression of several types of tumor, however, its potential effect on the development and metastasis of bladder cancer is still unclear. Immunohistochemistry was performed to detect the protein expression level of LAPTM4B in bladder cancer tissues and short hairpin RNAs targeting LAPTM4B were transfected into bladder cancer cells to knockdown its expression. MTT and colony formation assays were performed to detect cell proliferation, while wound healing and Transwell invasion assays were performed to detect cell migration and invasion, respectively. In addition, tumor growth assays were performed to confirm the effects of LAPTM4B in mice. The present study demonstrated that LAPTM4B was associated with the prognosis of patients with bladder cancer. In addition, LAPTM4B was associated with clinical characteristics, including tumor stage and recurrence. The results further showed that LAPTM4B knockdown could suppress the proliferation of bladder cancer cell lines. In addition, the migration and invasion of T24 and 5637 cells was suppressed following LAPTM4B knockdown in vitro. The in vivo data confirmed that knockdown of LAPTM4B markedly inhibited tumor growth and metastasis in mice. In summary, the results from the present study provide strong evidence of the effects of LAPTM4B in bladder cancer progression.

Autophagy inhibition facilitates wound closure partially dependent on the YAP/IL-33 signaling in a mouse model of skin wound healing.

Autophagy is a self-phagocytic and highly evolutionarily conserved intracellular lysosomal catabolic system, which plays a vital role in a variety of trauma models, including skin wound healing (SWH). However, the roles and potential mechanisms of autophagy in SWH are still controversial. We firstly investigated the role of autophagy in SWH-induced wound closure rate, inflammatory response, and histopathology, utilizing an inhibitor of autophagy 3-methyladenine (3-MA) and its agonist rapamycin (RAP). As expected, we found 3-MA treatment remarkably increased the wound closure rate, combated inflammation response, and mitigated histopathological changes, while RAP delivery aggravated SWH-induced pathological damage. To further exploit the underlying mechanism of autophagy regulating inflammation, the specific inhibitors of yes-associated protein (YAP), Verteporfin, and Anti-IL-33 were applied. Herein, treating with 3-MA markedly suppressed the expression of tumor necrosis factor-α (TNF-α), IL-1ß, and IL-6, promoted that of IL-10, IL-33, and ST2, while RAP administration reverted SWH-induced the up-regulation of these inflammatory cytokines mentioned above. Importantly, Verteporfin administration not only down-regulated the expression levels of YAP, TNF-α, and IL-6 but also up-regulated that of IL-33 and IL-10. Unexpectedly, 3-MA or RAP retreatment did not have any impact on the changes in IL-33 among these inflammatory indicators. Furthermore, elevated expression of IL-33 promoted wound closure and alleviated the pathological damage, whereas, its antagonist Anti-IL-33 treatment overtly reversed the above-mentioned effects of IL-33. Moreover, 3-MA in combination with anti-IL-33 treatment reversed the role of 3-MA alone in mitigated pathological changes, but they failed to revert the effect of anti-IL-33 alone on worsening pathological damage. In sum, emerging data support the novel contribution of the YAP/IL-33 pathway in autophagy inhibition against SWH-induced pathological damage, and highlight that the autophagy/YAP/IL-33 signal axis is expected to become a new therapeutic target for SWH.

Host sunflower-induced silencing of parasitism-related genes confers resistance to invading Orobanche cumana.

Orobanche cumana is a holoparasitic plant that attaches to host-plant roots and seriously reduces the yield of sunflower (Helianthus annuus L.). Effective control methods are lacking with only a few known sources of genetic resistance. In this study, a seed-soak agroinoculation (SSA) method was established, and recombinant tobacco rattle virus vectors were constructed to express RNA interference (RNAi) inducers to cause virus-induced gene silencing (VIGS) in sunflower. A host target gene HaTubulin was systemically silenced in both leaf and root tissues by the SSA-VIGS approach. Trans-species silencing of O. cumana genes were confirmed for 10 out of 11 target genes with silencing efficiency of 23.43%-92.67%. Knockdown of target OcQR1, OcCKX5, and OcWRI1 genes reduced the haustoria number, and silencing of OcEXPA6 caused further phenotypic abnormalities such as shorter tubercles and necrosis. Overexpression of OcEXPA6 caused retarded root growth in alfalfa (Medicago sativa). The results demonstrate that these genes play an important role in the processes of O. cumana parasitism. High-throughput small RNA (sRNA) sequencing and bioinformatics analyses unveiled the distinct features of target gene-derived siRNAs in O. cumana such as siRNA transitivity, strand polarity, hotspot region, and 21/22-nt siRNA predominance, the latter of which was confirmed by Northern blot experiments. The possible RNAi mechanism is also discussed by analyzing RNAi machinery genes in O. cumana. Taken together, we established an efficient host-induced gene silencing technology for both functional genetics studies and potential control of O. cumana. The ease and effectiveness of this strategy could potentially be useful for other species provided they are amenable to SSA.

Characterization of an NDM-5-producing hypervirulent Klebsiella pneumoniae sequence type 65 clone from a lung transplant recipient.

The emergence of New Delhi Metallo-ß-lactamase (NDM)-producing Klebsiella pneumoniae has aroused critical concern worldwide. Herein, we reported the first emergence of NDM-5-producing K. pneumoniae isolates in a 68-year-old lung transplant recipient, who died of septic shock 13 days after surgery. The K. pneumoniae strain KP22937 isolated from the bloodstream of the patient was analyzed for phenotypes and genotypes. KP22937 belonged to sequence type (ST) 65 and capsule serotype K2, contained iucABCDiutA and iroBCDN virulence clusters, showed high virulence to mice, and was therefore considered a hypervirulent K. pneumoniae. The blaNDM-5 gene was located on a genomic island region of the IncX3-type plasmid pNDM22937, which was successfully transferred to Escherichia coli EC600 with insignificant fitness costs. The transconjugant demonstrated similar antimicrobial susceptibility and growth kinetics to the recipient E. coli EC600. The plasmid pNDM22937 was almost identical to the blaNDM-5-carrying IncX3 plasmids previously reported in K. pneumoniae strains with different ST types and in other species. Our findings raise concerns about the horizontal spread of blaNDM-5 gene mediated by IncX3 plasmid, where hypervirulent K. pneumoniae strains are also involved. Stricter control measures are needed to prevent the dissemination of the novel clone in hospital settings.

A novel inhibition mechanism of aniline on nitrification: Aniline degradation competes dissolved oxygen with nitrification.

Aniline is a toxic aromatic amine and an inhibitor of nitrification. This study explored the inhibition effect and underlying mechanism. After sludge acclimation, 540 mg/L aniline was removed in 24 h and almost all ammonia released from aniline was oxidized to nitrate. However, nitrification never started until no aniline left. The cellular adenosine triphosphate (cATP) concentration of acclimated sludge reduced only by 2% after aniline exposure. Neither transmembrane transport of ammonia nor ammonia monooxygenase (AMO) activity was affected by aniline. Growing initial aniline concentration did not deteriorate the specific nitrification rate (NR). These all revealed that the toxicity of aniline only play a minor role in inhibition. Competition for dissolved oxygen (DO) was proposed to be another possible inhibition mechanism. The oxygen affinity constant (Ks) of aniline degraders and ammonia-oxidizing bacteria (AOB) was calculated to be 0.894 mg/L and 1.274 mg/L respectively, suggesting the former possessed much stronger oxygen affinity (P < 0.01). With aniline and ammonium as initial substrates, increasing aeration intensity advanced nitrification and increased the NR. Max NR of 0.63 mgN/(gMLSS·h) was achieved at the highest aeration intensity of 1000 mL/min. This study brings one step closer to better removal of aniline and derived nitrogen pollutants.

Ethylene Enhances Seed Germination and Seedling Growth Under Salinity by Reducing Oxidative Stress and Promoting Chlorophyll Content via ETR2 Pathway.

Alfalfa (Medicago sativa L.) is an important forage, and salinity is a major stress factor on its yield. In this study, we show that osmotic stress retards alfalfa seedling growth, while ionic/oxidative stress reduces its seed germination. Ethylene treatment can recover the germination rate of alfalfa seeds under salt stress, while ethylene inhibitor silver thiosulfate exacerbates salt effects. ETH reduces the accumulation of MDA and H2O2 and increases POD activity. ETH and ACC improve the salt tolerance of alfalfa by increasing proline content under salt stress. In contrast, STS inhibits alfalfa seed germination by reducing POD activity. NaCl treatment reduces chlorophyll content in alfalfa leaves, while ETH and ACC can increase the chlorophyll content and promote seedling growth. ETH promotes the growth of alfalfa in saline condition by reducing the expression of MsACO and MsERF8 genes, while increases its germination rate by upregulating MsERF11 gene. Silencing of MsETR2, a putative ethylene receptor gene in alfalfa, abolishes ethylene triggered tolerance to salt stress. In summary, we show that ethylene improves salt tolerance in alfalfa via MsETR2 dependent manner, and we also analyze the regulatory mechanism of ethylene during germination of alfalfa seeds under salt stress.

Annexin A1-derived peptide Ac2-26 facilitates wound healing in diabetic mice.

Impaired wound healing is a common complication of diabetes. In diabetic wounds, macrophages present dysfunctional efferocytosis and abnormal phenotypes, which could result in excessive neutrophil accumulation and prolonged inflammation, thereby eventually hindering wound repair. ANXA1 N-terminal peptide Ac2-26 exhibits a high potential in mitigating inflammation and improving repair; however, its efficacy in diabetic wound repair remains unclear. In this study, a cutaneous excisional wound model was built in genetically diabetic mice. Ac2-26 or a vehicle solution was employed locally in wound sites. Subsequently, wound zones were measured and sampled at different time intervals post-wounding. Using hematoxylin-eosin and Masson's trichrome staining, we observed the histopathological variations and collagen deposition in wound samples. Based on immunohistochemistry and immunofluorescence, the numbers of neutrophils, macrophages, and CD206-positive macrophages in the wound samples were determined. Cytokine expression in wound samples was studied by immunoblot assay. Results showed that Ac2-26 treatment could facilitate diabetic wound closure, down-regulate the number of neutrophils, and improve angiogenesis and collagen deposition. In addition, Ac2-26 application expedited macrophage recruitment and up-regulated the percentage of macrophages expressing CD206, which is a marker for M2 macrophages. Moreover, Ac2-26 inhibited the expressions of TNF-α and IL-6 and up-regulated the expressions of IL-10, TGF-ß, and VEGFA during diabetic wound healing. Hence, based on the aforementioned findings, Ac2-26 application in diabetic wounds could exert anti-inflammatory and pro-repair effects by reducing neutrophil accumulation and facilitating M2 macrophage development.

Corrigendum: Ethylene Enhances Seed Germination and Seedling Growth Under Salinity by Reducing Oxidative Stress and Promoting Chlorophyll Content via ETR2 Pathway.

[This corrects the article DOI: 10.3389/fpls.2020.01066.].

Generation of a human embryonic stem cell (WAe001-A-47) with hVGLL4 doxycyclin-inducible expression by the PiggyBac transposon system.

VGLL4 is a new component of the Hippo pathway and bind TEADs to compete with YAP, so as to inhibit tumor progression, but its role in stem cell and organ regeneration remains unclear. Using the PiggyBac transposon system, we generated a VGLL4 doxycycline-inducible expression human embryonic stem cell line (WAe001-A-47). The established hESC line retains its normal morphology and pluripotency markers with in vitro differentiation potential, as well as a normal karyotype.

Prevention of Local Tumor Recurrence After Surgery by Thermosensitive Gel-Based Chemophotothermal Therapy in Mice.

BACKGROUND AND OBJECTIVES: Local recurrence of cancer after surgery has long been a tough problem. In the present study, thermosensitive gel-based chemophotothermal therapy was applied to prevent the recurrence of liver cancer after surgery. STUDY DESIGN/MATERIALS AND METHODS: Mesoporous silica nanoparticles (MSNs) were used as first-level carrier to co-load doxorubicin (DOX) and ICG. Then, the drug-loaded MSNs (D-I@MSN) were incorporated into poloxamer gel. A mimic model of liver cancer recurrence after surgery was prepared by subcutaneously injecting H22 cells into the armpit of mice. Then the two-level composite gel (D-I@MSN/gel) was also subcutaneously injected at the same site before the formation of tumor, followed by 808 nm laser irradiation. RESULTS: The loading efficiency and entrapment efficiency of DOX were as high as 8.85% and 96.9%, and that of ICG were 9.24% and 99.3%, respectively. The results of in vitro cytotoxicity showed that cell viability in D-I@MSN+Laser group was only 5.8% after being irradiated by 808 nm laser for 5 minutes (0.5 W/cm2 ). In animal studies, tumor formation (tumor recurrence) was greatly inhibited in D-I@MSN+Laser group. CONCLUSIONS: The thermosensitive gel-based chemophotothermal therapy showed excellent safety and efficacy when applied in the prevention of mimic local tumor replase after surgery in mice, presenting its great potential clinically. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

A Novel 'Candidatus Liberibacter asiaticus'-Encoded Sec-Dependent Secretory Protein Suppresses Programmed Cell Death in Nicotiana benthamiana.

'Candidatus Liberibacter asiaticus' (CLas) is one of the causal agents of citrus Huanglongbing (HLB), a bacterial disease of citrus trees that greatly reduces fruit yield and quality. CLas strains produce an array of currently uncharacterized Sec-dependent secretory proteins. In this study, the conserved chromosomally encoded protein CLIBASIA_03875 was identified as a novel Sec-dependent secreted protein. We show that CLIBASIA_03875 contains a putative Sec- secretion signal peptide (SP), a 29 amino acid residue located at the N-terminus, with a mature protein (m3875) of 22 amino acids found to localize in multiple subcellular components of the leaf epidermal cells of Nicotiana benthamiana. When overexpressed via a Potato virus X (PVX)-based expression vector in N. benthamiana, m3875 suppressed programmed cell death (PCD) and the H2O2 accumulation triggered by the pro-apoptotic mouse protein BAX and the Phytophthora infestans elicitin INF1. Overexpression also resulted in a phenotype of dwarfing, leaf deformation and mosaics, suggesting that m3875 has roles in plant immune response, growth, and development. Substitution mutagenesis of the charged amino acid (D7, R9, R11, and K22) with alanine within m3875 did not recover the phenotypes for PCD and normal growth. In addition, the transiently overexpressed m3875 regulated the transcriptional levels of N. benthamiana orthologs of CNGCs (cyclic nucleotide-gated channels), BI-1 (Bax-inhibitor 1), and WRKY33 that are involved in plant defense mechanisms. To our knowledge, m3875 is the first PCD suppressor identified from CLas. Studying the function of this protein provides insight as to how CLas attenuates the host immune responses to proliferate and cause Huanglongbing disease in citrus plants.

Nuclear Import of a Secreted "Candidatus Liberibacter asiaticus" Protein is Temperature Dependent and Contributes to Pathogenicity in Nicotiana benthamiana.

"Candidatus Liberibacter asiaticus" (CLas), one of the causal agents of citrus Huanglongbing (HLB), secretes proteins with functions that are largely unknown. In this study, we demonstrated that CLIBASIA_00460, one of the CLas-encoded Sec-dependent presecretory proteins, might contribute to the phytopathogenicity of CLas. CLIBASIA_00460 was conserved in CLas strains and expressed at a significantly higher level in citrus than in Asian citrus psyllid. Agrobacteria-mediated transient expression in Nicotiana benthamiana epidermal cells showed that the mature CLIBASIA_00460 (m460) without the putative Sec-dependent signal peptide was localized in multiple cellular compartments including nucleus at 25°C, but that nuclear accumulation was greatly decreased as the temperature rose to 32°C. When overexpressed via a Potato virus X (PVX)-based expression vector in N. benthamiana, m460 induced no local symptoms, but tiny necrotic spots were scattered on the systemic leaves. However, NLS-m460, which contains the SV40 nuclear localization sequence (NLS) at the N-terminus to promote nuclear import of m460, caused chlorosis and necrosis in the local leaves and severe necrosis in the systemic leaves. Taken together, these data suggest that CLIBASIA_00460 represented a novel virulence factor of CLas, and that nuclear localization of this protein was temperature dependent and positively correlated with its pathogenicity in planta.

Intrauterine cystic adenomyosis: Report of two cases.

BACKGROUND: Cystic adenomyosis is a special type of adenomyosis. Its clinical manifestations lack specificity. Pelvic ultrasound and nuclear magnetic resonance imaging can help clarify the diagnosis. Because cystic uterine adenomyosis is rare in clinical work, it can be easily misdiagnosed or its diagnosis can be missed. Early surgical treatment and postoperative drug treatment can alleviate dysmenorrhea, menorrhagia, anemia, and other symptoms. CASE SUMMARY: Two cases complained about abnormal vaginal bleeding and were diagnosed with intrauterine cystic adenomyosis by gynecological ultrasound and pathological examination. The clinical manifestations included dysmenorrhea, hypermenorrhea, and a history of cesarean section. Both cases underwent a surgery, and chocolate-like liquid was released from the cystic mass in the uterus and the manifestations were relieved. CONCLUSION: Intrauterine cystic adenomyosis could be diagnosed by pathological examination and treated by hysterectomy or hystscopy to release the liquid inside.