A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse.

BACKGROUND: It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011. METHODS: A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided). RESULTS: The number of different procedures during October 1, 2011-September 30, 2018 was more than twice that during October 1, 2004-September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004-September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011-September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P < 0.001). Regarding synthetic mesh surgeries related to POP, the rates of transvaginal placement of surgical mesh (TVM) procedures decreased from 94.1% (4983/5298) to 82.2% (11,603/14,107) (Z = 20.79, P < 0.001), but the rate of laparoscopic sacrocolpopexy (LSC) procedures increased from 5.9% (315/5298) to 17.8% (2504/14,107). CONCLUSIONS: The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly. The rate of TVM procedures decreased while the rate of LSC procedures increased significantly. TRIAL REGISTRATION NUMBER: NCT03620565, https://register.clinicaltrials.gov.

Charge Reversible and Mitochondria/Nucleus Dual Target Lipid Hybrid Nanoparticles To Enhance Antitumor Activity of Doxorubicin.

The experiment aims to increase antitumor activity while decreasing the systemic toxicity of doxorubicin (DOX). Charge reversible and mitochondria/nucleus dual target lipid hybrid nanoparticles (LNPs) was prepared. The in vitro experimental results indicated that LNPs released more amount of DOX in acidic environment and delivered more amount of DOX to the mitochondria and nucleus of tumor cells than did free DOX, which resulted in the reduction of mitochondrial membrane potential and the enhancement of cytotoxicity of LNPs on tumor cells. Furthermore, the in vivo experimental results indicated that LNPs delivered more DOX to tumor tissue and significantly prolonged the retention time of DOX in tumor tissue as compared with free DOX, which consequently resulted in the high antitumor activity and low systemic toxicity of LNPs on tumor-bearing nude mice. The above results indicated that charge reversible mitochondria/nucleus dual targeted lipid hybrid nanoparticles greatly enhanced therapeutic efficacy of DOX for treating lung cancer.

Autophagy plays beneficial effect on diabetic encephalopathy in type 2 diabetes: studies in vivo and in vitro.

OBJECTIVES: The hypothalamus regulates metabolism and feeding behavior by perceiving the levels of peripheral insulin. However, little is known about the hypothalamic changes after aberrant metabolism. In this study, we investigated the changes of insulin and autophagy relevant signals of hypothalamus under diabetes mellitus. METHODS: C57B/L mice were injected with low-dose streptozotocin (STZ) and fed with high-fat diet to induce type 2 diabetes mellitus. In vitro, PC12 cells were treated with oleic acid to mimic lipotoxicity. RESULTS: Results showed that the cholesterol level in the hypothalamus of the diabetic mice was higher than that of the normal mice. The expression of insulin receptors and insulin receptor substrate-1 were downregulated and the number of Fluoro-Jade C positive cells significantly increased in the hypothalamic arcuate nucleus of the diabetic mice. Furthermore, Upregulation of mammalian target of rapamycin (mTOR) and downregulation of LC 3II were obvious in the hypothalamus of the diabetic mice. In vitro, results showed that high-lipid caused PC12 cell damage and upregulated LC3 II expression. Pretreatment of cells with 3-methyladenine evidently downregulated LC3 II expression and aggravated PC12 cell death under high lipid conditions. By contrast, pretreatment of cells with rapamycin upregulated LC3 II expression and ameliorated PC12 cell death caused by lipotoxicity. CONCLUSION: These results demonstrate that autophagy activation confers protection to neurons under aberrant metabolism and that autophagy dysfunction in the hypothalamus occurs in the chronic metabolic disorder such as T2DM.

Relationship between resistin and IL-23 levels in follicular fluid in infertile patients with endometriosis undergoing IVF-ET.

BACKGROUND: Endometriosis (EM) interferes with the reproductive process and affects the success rate of in vitro fertilization (IVF). Inflammatory cytokines are suggested to play a role in infertility in patients with EM. OBJECTIVES: In this study, we aimed to investigate the relationship between resistin and interleukin 23 (IL-23) levels in follicular fluid (FF) and serum together with the severity of endometriosis and in vitro fertilization/ embryo transfer (IVF-ET) outcome. MATERIAL AND METHODS: Samples from 116 infertile women were studied using enzyme-linked immunosorbent assay (ELISA). The study group consisted of 76 infertile patients diagnosed with EM (40 with stages I-II and 36 with stages III-IV) undergoing IVF-ET. The control group included 40 women with tubal factor infertility. FF and serum samples were collected on the day of follicle aspiration and hCG administration, respectively. RESULTS: The serum and FF resistin levels were significantly higher in the EM group than in the control group (p-value <0.05). The FF resistin and IL-23 levels were significantly higher in EM stages III-IV than in stages I-II (p-value <0.05), and the serum resistin and IL-23 levels were also significantly (p-value <0.01) higher in stages III-IV than in stages I-II. The E2 level on the day of hCG administration and the implantation rate were both significantly lower in the EM group than in the control group. However, there were no differences in the Gn duration and dose, and the cleavage, implantation and clinical pregnancy rates between the 2 groups. CONCLUSIONS: Our results suggest that patients with EM exhibit increased resistin level in FF and serum. Advanced EM may contribute to infertility via decreased embryo implantation rates because of inflammation and immune rejection. No influence was observed on pregnancy outcomes after IVF-ET.

Fiber-modified adenovirus-mediated suicide gene therapy can efficiently eliminate bladder cancer cells in vitro and in vivo.

Adenovirus-mediated gene therapy is a promising strategy for bladder cancer treatment. However, the loss of the coxsackie and adenovirus receptor (CAR) in bladder cancer cells decreases the infection efficiency of the therapeutic adenovirus. In this study, we constructed an Arg-Gly-Asp (RGD)-modified adenovirus, RGDAd-UPII-TK, that carries a suicide gene called HSV-TK that is driven by a human UPII promoter. Then, we tested the bladder cancer specificity of the UPII promotor and the expression of the HSV-TK protein. Additionally, we observed a potent cytotoxic effects of RGDAd-UPII-TK and ganciclovir (GCV) on bladder cancer as demonstrated by reduced cell survival and morphology changes in vitro. Furthermore, we confirmed that RGDAd-UPII-TK in combination with a GCV injection could significantly reduce the established T24 tumor growth and increase apoptosis in vivo. Altogether, our results indicated that the recombinant adenovirus RGDAd-UPII-TK could target bladder cancer through valid gene therapy.

Adenovirus-mediated downregulation of the ubiquitin ligase RNF8 sensitizes bladder cancer to radiotherapy.

The ubiquitin ligase RNF8 promotes the DNA damage response (DDR). We observed that the expression of RNF8 was increased in bladder cancer cells and that this change in RNF8 expression could be reversed by adenovirus-mediated shRNA treatment. Moreover, we found that RNF8 knockdown sensitized bladder cancer cells to radiotherapy, as demonstrated by reduced cell survival. Additionally, the absence of RNF8 induced a high rate of apoptosis and impaired double-strand break repair signaling after radiotherapy. Furthermore, experiments on nude mice showed that combining shRNF8 treatment with radiotherapy suppressed implanted bladder tumor growth and enhanced apoptotic cell death in vivo. Altogether, our results indicated that RNF8 might be a novel target for bladder cancer treatment.

Dual subcellular compartment delivery of doxorubicin to overcome drug resistant and enhance antitumor activity.

In order to overcome drug resistant and enhance antitumor activity of DOX, a new pH-sensitive micelle (DOX/DQA-DOX@DSPE-hyd-PEG-AA) was prepared to simultaneously deliver DOX to nucleus and mitochondria. Drug released from DOX/DQA-DOX@DSPE-hyd-PEG-AA showed a pH-dependent manner. DOX/DQA-DOX@DSPE-hyd-PEG-AA induced the depolarization of mitochondria and apoptosis in MDA-MB-231/ADR cells and A549 cells, which resulted in the high cytotoxicity of DOX/DQA-DOX@DSPE-hyd-PEG-AA against MDA-MB-231/ADR cells and A549 cells. Confocal microscopy confirmed that DOX/DQA-DOX@DSPE-hyd-PEG-AA simultaneously delivered DQA-DOX and DOX to the mitochondria and nucleus of tumor cell. After DOX/DQA-DOX@DSPE-hyd-PEG-AA was injected to the tumor-bearing nude mice by the tail vein, DOX was mainly found in tumor tissue. But DOX was widely distributed in the whole body after the administration of free DOX. Compared with free DOX, the same dose of DOX/DQA-DOX@DSPE-hyd-PEG-AA significantly inhibited the growth of DOX-resistant tumor in tumor-bearing mice without obvious systemic toxicity. Therefore, dual subcellular compartment delivery of DOX greatly enhanced the antitumor activity of DOX on DOX-resistant tumor. DOX/DQA-DOX@DSPE-hyd-PEG-AA has the potential in target therapy for DOX-resistant tumor.

Brain aging and AD-like pathology in streptozotocin-induced diabetic rats.

OBJECTIVE: Numerous epidemiological studies have linked diabetes mellitus (DM) with an increased risk of developing Alzheimer's disease (AD). However, whether or not diabetic encephalopathy shows AD-like pathology remains unclear. RESEARCH DESIGN AND METHODS: Forebrain and hippocampal volumes were measured using stereology in serial coronal sections of the brain in streptozotocin- (STZ-) induced rats. Neurodegeneration in the frontal cortex, hypothalamus, and hippocampus was evaluated using Fluoro-Jade C (FJC). Aß aggregation in the frontal cortex and hippocampus was tested using immunohistochemistry and ELISA. Dendritic spine density in the frontal cortex and hippocampus was measured using Golgi staining, and western blot was conducted to detect the levels of synaptophysin. Cognitive ability was evaluated through the Morris water maze and inhibitory avoidant box. RESULTS: Rats are characterized by insulin deficiency accompanied with polydipsia, polyphagia, polyuria, and weight loss after STZ injection. The number of FJC-positive cells significantly increased in discrete brain regions of the diabetic rats compared with the age-matched control rats. Hippocampal atrophy, Aß aggregation, and synapse loss were observed in the diabetic rats compared with the control rats. The learning and memory of the diabetic rats decreased compared with those of the age-matched control rats. CONCLUSIONS: Our results suggested that aberrant metabolism induced brain aging as characterized by AD-like pathologies.

Spatial memory impairment is associated with hippocampal insulin signals in ovariectomized rats.

Estrogen influences memory formation and insulin sensitivity. Meanwhile, glucose utilization directly affects learning and memory, which are modulated by insulin signals. Therefore, this study investigated whether or not the effect of estrogen on memory is associated with the regulatory effect of this hormone on glucose metabolism. The relative expression of estrogen receptor ß (ERß) and glucose transporter type 4 (GLUT4) in the hippocampus of rats were evaluated by western blot. Insulin level was assessed by ELISA and quantitative RT-PCR, and spatial memory was tested by the Morris water maze. Glucose utilization in the hippocampus was measured by 2-NBDG uptake analysis. Results showed that ovariectomy impaired the spatial memory of rats. These impairments are similar as the female rats treated with the ERß antagonist tamoxifen (TAM). Estrogen blockade by ovariectomy or TAM treatment obviously decreased glucose utilization. This phenomenon was accompanied by decreased insulin level and GLUT4 expression in the hippocampus. The female rats were neutralized with hippocampal insulin with insulin antibody, which also impaired memory and local glucose consumption. These results indicated that estrogen blockade impaired the spatial memory of the female rats. The mechanisms by which estrogen blockade impaired memory partially contributed to the decline in hippocampal insulin signals, which diminished glucose consumption.

Cellular uptake and antitumor activity of DOX-hyd-PEG-FA nanoparticles.

A PEG-based, folate mediated, active tumor targeting drug delivery system using DOX-hyd-PEG-FA nanoparticles (NPs) were prepared. DOX-hyd-PEG-FA NPs showed a significantly faster DOX release in pH 5.0 medium than in pH 7.4 medium. Compared with DOX-hyd-PEG NPs, DOX-hyd-PEG-FA NPs increased the intracellular accumulation of DOX and showed a DOX translocation from lysosomes to nucleus. The cytotoxicity of DOX-hyd-PEG-FA NPs on KB cells was much higher than that of free DOX, DOX-ami-PEG-FA NPs and DOX-hyd-PEG NPs. The cytotoxicity of DOX-hyd-PEG-FA NPs on KB cells was attenuated in the presence of exogenous folic acid. The IC50 of DOX-hyd-PEG-FA NPs and DOX-hyd-PEG NPs on A549 cells showed no significant difference. After DOX-hyd-PEG-FA NPs were intravenously administered, the amount of DOX distributed in tumor tissue was significantly increased, while the amount of DOX distributed in heart was greatly decreased as compared with free DOX. Compared with free DOX, NPs yielded improved survival rate, prolonged life span, delayed tumor growth and reduced the cardiotoxicity in tumor bearing mice model. These results indicated that the acid sensitivity, passive and active tumor targeting abilities were likely to act synergistically to enhance the drug delivery efficiency of DOX-hyd-PEG-FA NPs. Therefore, DOX-hyd-PEG-FA NPs are a promising drug delivery system for targeted cancer therapy.

PEG-detachable lipid-polymer hybrid nanoparticle for delivery of chemotherapy drugs to cancer cells.

The experiment aimed to increase the drug-delivery efficiency of poly-lactic-co-glycolic acid (PLGA) nanoparticles. Lipid-polymer hybrid nanoparticles (LPNs-1) were prepared using PLGA as a hydrophobic core and FA-PEG-hyd-DSPE as an amphiphilic shell. Uniform and spherical nanoparticles with an average size of 185 nm were obtained using the emulsification solvent evaporation method. The results indicated that LPNs-1 showed higher drug loading compared with naked PLGA nanoparticles (NNPs). Drug release from LPNs-1 was faster in an acidic environment than in a neutral environment. LPNs-1 showed higher cytotoxicity on KB cells, A549 cells, MDA-MB-231 cells, and MDA-MB-231/ADR cells compared with free doxorubicin (DOX) and NNPs. The results also showed that, compared with free DOX and NNPs, LPNs-1 delivered more DOX to the nuclear of KB cells and MDA-MB-231/ADR cells. LPNs-1 induced apoptosis in KB cells and MDA-MB-231/ADR cells in a dose-dependent manner. The above data indicated that DOX-loaded LPNs-1 could kill not only normal tumor cells but also drug-resistant tumor cells. These results indicated that modification of PLGA nanoparticles with FA-PEG-hyd-DSPE could considerably increase the drug-delivery efficiency and LPNs-1 had potential in the delivery of chemotherapeutic agents in the treatment of cancer.

Protective effects of carbenoxolone are associated with attenuation of oxidative stress in ischemic brain injury.

Accumulating evidence has suggested that the gap junction plays an important role in the determination of cerebral ischemia, but the underlying mechanisms remain to be elucidated. In this study, we assessed the effect of a gap-junction blocker, carbenoxolone (CBX), on ischemia/reperfusion-induced brain injury and the possible mechanisms. By using the transient cerebral ischemia model induced by occlusion of the middle cerebral artery for 30 min followed by reperfusion for 24 h, we found that pre-administration of CBX (25 mg/kg, intracerebroventricular injection, 30 min before cerebral ischemic surgery) diminished the infarction size in rats. And this was associated with a decrease of reactive oxygen species generation and inhibition of the activation of astrocytes and microglia. In PC12 cells, H2O2 treatment induced more coupling and apoptosis, while CBX partly inhibited the opening of gap junctions and improved the cell viability. These results suggest that cerebral ischemia enhances the opening of gap junctions. Blocking the gap junction with CBX may attenuate the brain injury after cerebral ischemia/reperfusion by partially contributing to amelioration of the oxidative stress and apoptosis.

Prospective study of transobturator mesh kit (Prolift™) in pelvic reconstructive surgery with vaginal hysterectomy after 3 years' follow-up.

INTRODUCTION AND HYPOTHESIS: This study is to analyze prospectively the anatomical and functional outcomes of transvaginal pelvic reconstructive surgery using the Prolift™ system for pelvic organ prolapse (POP) with hysterectomy. METHODS: A prospective, observational, noncomparative study was conducted in 80 patients with prolapse ≥ 2. Postoperative pelvic organ prolapse quantification stage was the main outcome measure. Anatomical cure was defined as vaginal vault stage 0 and improvement as stage 1. Secondary outcomes include pelvic floor distress inventory-20, incontinence impact questionnaire short form-7, and pelvic floor impact questionnaire short form-7. RESULTS: A total of 80 patients were recruited. The cure and improvement rates were 96.3 % (77/80) and 3.7 % (3/80) respectively at 1 year. At the follow-up of 3-years, the cure rates were 93.3 % (70/75). Among the five patients, three had stage 2 anterior wall prolapse, two had stage 2 posterior wall prolapse. Only one patient with intraoperative adverse event (rectal perforation) was encountered. Postoperative complications included prolonged catheterization in three patients (3.7 %), postoperative stress urinary incontinence in five patients (6.25 %) and asymptomatic mesh extrusions in five patients (6.25 %). All of them occurred within 1 year follow-up. Significant improvements in quality of life were detected at 1 and 3 years compared with baseline. CONCLUSION: The total Prolift™ system surgery represents a safe, simple and useful treatment for severe POP with satisfactory objective clinical outcomes.

[Study on modified Prolift for pelvic floor reconstruction in the prevention of stress urinary incontinence].

OBJECTIVE: To evaluate the safety and efficacy of modified Prolift pelvic floor reconstruction with improving the placement of Prolift-A in treatment of severe pelvic floor dysfunction and stress urinary incontinence (SUI). METHODS: From July 2008 to September 2010, 170 cases with severe pelvic organ prolapse (POP) treated by modified Prolift pelvic floor reconstruction surgery in Fuzhou General Hospital were enrolled in this study. The Prolift-A was laid tension-free under the mid-urethra with the position of Prolift-A displaced from the neck of bladder to the mid-urethra. No concomitant tension-free urethra suspender via vagina was performed. Primary outcomes were assessed with POP quantitation (POP-Q) system to evaluate the postoperative anatomical replacement stage. Secondary outcome measure were: urogenital distress inventory 6 (UDI-6), the incontinence impact questionnaire 7 (IIQ-7) and the pelvic floor incontinence questionnaire 7 (PFIQ-7) to evaluate the impact on life quality at the follow-up of 1, 6, 12 months. RESULTS: At 6 and 12 months after surgery, 168 cases and 163 cases were followed up. The anatomical cure rates were 98.8% (166/168) at 6 months and 97.5% (159/163) at 12 months, respectively. One case with bladder injury and 1 case with rectum injury were observed. Five cases with recurrence were observed, including 2 cases with anterior vagina prolapse, 2 cases with uterine prolapse and 1 case with posterior vagina prolapse. Meanwhile, 3 cases with hematoma and 7 cases with mesh erosion were observed. Quality of life of all patients were improved significantly by UDI-6, IIQ-7 and PFIQ-7 scoring system evaluation. Among 79 POP patients with SUI, the cure rate of SUI was 93.7% (74/79). Of 5 cases with symptomatic SUI, 2 cases were needed surgical intervention. Twenty-three cases were found with minimal SUI symptoms and subjective satisfaction without objective influence on quality of life. Seven patients presented dysuria after surgery, 5 cases recovered urination with 10 days, 1 case recovered with 1 months, and 1 case with 6 months by bladder drainage. Eleven cases with discomfort urination and 3 cases with slow urination were found. CONCLUSIONS: The modified Prolift pelvic reconstructive surgery was safe and efficacy intervention in treatment of POP and prevention of SUI.

Methylprednisolone improves the survival of new neurons following transient cerebral ischemia in rats.

Cerebral ischemia induced the proliferation and differentiation of neural stem cells in discrete regions of brain. However, only a small fraction of the neural stem/progenitor cells survives. In this report, the effects of methylprednisolone (MP) on proliferation, differentiation and survival of neural progenitor cells were explored through early MP administration after occlusion of the middle cerebral artery (MCAo). Transient cerebral ischemia was induced by middle cerebral artery occlusion in Sprague Dawley male rats. One hour, 1 day, 3 days, 14 days, and 28 days after MCAo, neurological examination was performed to evaluate the neurological deficit. MCAo rats were randomly divided into two groups, MP-group was injected MP (30 mg/kg, i.p.) at 3 h, 12 h, and 24 h after MCAo, and vehicle group was injected equal saline (i.p.). Animals were sacrificed at 3 days, 14 days, and 28 days after MCAo. MP was found to decrease apoptosis and TNF-alpha and IL-6 expression at 3 days after MCAo in the ipsilateral striatum. Moreover, MP significantly increased the migrated new neurons (BrdU+/ DCX+) and immature neurons (BrdU+/Tuj1+) at day 14 after MCAo in the ipsilateral striatum. Likewise, MP increased the number of mature neurons (BrdU+/MAP2+) at 28 days after MCAo. However, MP did not affect the progenitor cell proliferation (BrdU+ and Nestin+) at day 3 after MCAo in the subventricular zone (SVZ), but improved the neurological deficit at day 1 and day 3 after MCAo. These results indicate that early MP administration can improve the neurological deficit and enhance the survival of new neurons in the ipsilateral striatum by inhibiting apoptosis and downregulation of inflammatory response after transient cerebral ischemia in rats.

[Effect of airborne particulate matter exposure on pregnancy and fetal development in female mice].

OBJECTIVE: To investigate subacute exposure of airborne particulate matter (PM) on pregnancy and fetal development in female mice. METHODS: Forty female and forty male ICR adult mice were caged separately by 1:1 to get access to pregnancy. The pregnant mice were randomized into control group (A), small (B), middle (C), large (D) or overdose (E) PM challenge groups (n = 8-11), and were administered with 30 µl of phosphate buffered solution (A) or resuspended standard PM SRM 1649a at 0.09 (B), 0.52 (C), 1.85 (D) or 69.2 (E) µg/µl, once per trid from d 0 till d 19 of pregnancy via instillation onto the base of the tongue. Fetal mice were harvested by cesarean section at the time when spontaneous delivery occurred. Body weight of the pregnant mice, gestational days, intrauterine survival and growth, hepatic and pneumonic histopathological changes of the fetal mice were investigated. Lung/body and liver/body weight ratios were calculated. Expressions of mRNA and protein of CYP1A1 in the fetal lung and CYP1A2 in the fetal liver were assayed. RESULTS: (1) All of the pregnant mice survived pregnancy throughout the entire experiment. Body weight of the pregnant mice was not significantly different among all the groups at gestational d 1 and 7 (P > 0.05), but significantly lower in group E [(41.8 ± 5.8) and (48.9 ± 8.9) g] than in group A [(45.9 ± 1.8) and (56.2 ± 4.9) g] at gestational d 14 and 18 (P < 0.05). The gestational days were significantly decreased in group E [(19.3 ± 1.3) d] when compared with group A [(20.5 ± 0.7) d; P < 0.05] and were not significantly different among groups A, B, C and D (P > 0.05). Lung/body and liver/body weight ratios of the fetal mice were significantly increased in group E [(1.21 ± 0.18) and (4.68 ± 0.21)%] as compared with groups A, B, C and D (P < 0.05). (2) Mortality rates of the fetuses were significantly higher in group E (23.0%) than in groups A (0.8%), B (0.9%), C (1.7%) and D (3.7%) (P < 0.05), but were not significantly different among groups A, B, C and D (P > 0.05) despite of an increasing tendency. (3) Pathological changes in the liver and lung of the fetuses were conspicuous in group E. The fetal liver injury was histopathologically evidenced by deranged tissue structure, degenerated parenchyma of hepatic cells, and mildly stained cytoplasm. Adipose degeneration was represented by clear-boundary intracytoplasmic vacuoles in most of the liver cells, and cell pyknosis with heavily stained cytoplasm was observed in some of the liver cells. Inflammatory cell infiltration and focal necrosis were occasionally found in the hepatic tissue. The fetal lung exhibited bronchiole with narrow lumina, vascular engorgement in the submucosal layer, interstitial and alveolar edema, thickened alveolar septum, granulocyte and lymphocyte infiltrations within the pulmonary alveoli and around the bronchioles. The above pathological changes were lesser in groups C and D, and were not or least found in groups A and B. (4) Protein expressions of CYP1A1 in the fetal lung and CYP1A2 in the fetal liver were significantly increased in group E (1.20 ± 0.40 and 2.55 ± 0.89) when compared with group A (0.77 ± 0.36 and 2.08 ± 0.31) (P < 0.05). mRNA expressions of CYP1A1 in the fetal lung were significantly increased in groups C (0.36 ± 0.12), D (0.41 ± 0.08) and E (0.43 ± 0.11) compared with group A (0.21 ± 0.10), and significantly increased in groups D and E compared with group B (0.28 ± 0.10, P < 0.05). mRNA expressions of CYP1A2 in the fetal liver were significantly increased in groups C (0.37 ± 0.13), D (0.36 ± 0.14) and E (0.43 ± 0.16) compared with group A (0.21 ± 0.03), and significantly increased in group E compared with group B (0.24 ± 0.11, P < 0.05). CONCLUSIONS: PM elicited embryotoxigenicity and resulted in adverse pregnancy outcomes in mice by intrauterine exposure of overdose PM. The expressions of cancer-related genes CYP1A1 and CYP1A2 were up-regulated in organs after the middle- and large-dose subacute exposure of PM, which may have a potential role on the future development.

[Instillation of diesel exhaust particles on the posterior wall of pharynx on reproductive function in female mice].

OBJECTIVE: The present work aims to investigate the effects of subacute exposure to diesel exhaust particles (DEP) on reproductive function in female mice. METHODS: A total of 168 ICR (Institute of Cancer Research) mice were randomly divided into four groups by numeration table method, including the low (B), middle (C), high (D) dose DEP exposure groups and the control group (A). Each group consisted of 42 mice. Mice were inoculated with 30 µl DEP suspension at 0.8 (B), 3.0 (C), 12.0 (D) µg/µl, respectively, or the same volume of phosphate-buffered saline (A) on pharynx posterior wall per triduum for 4 times. The body weight and ovary weight were tested and ovary weight/body weight ratios were calculated. Rates of survival, germinal vesicle breakdown, extrusion of the first polar body, in-vitro fertilization and quantity of mitochondrial DNA for the oocytes were investigated. Ultrastructural changes of the oocytes were observed. RESULTS: The ovary weight/body weight ratios were (15.4 ± 7.3) × 10(-5), (14.1 ± 6.8) × 10(-5), (8.2 ± 0.7) × 10(-5) and (7.2 ± 2.5) × 10(-5) in groups A, B, C and D (F = 3.841, P < 0.05). In groups A, B, C and D at 48 h post-insemination, rates of oocyte survival were 64.3%, 56.8%, 39.5% and 32.9% (χ(2) = 21.575, P < 0.05), rates of extrusion of the first polar body were 75.5%, 65.3%, 37.0% and 27.1% (χ(2) = 52.772, P < 0.05), rates of 2-cell embryos were 27.9%, 39.1%, 17.6% and 12.5% (χ(2) = 20.148, P < 0.05), and rates of embryos over 2 cells were 45.3%, 32.2%, 12.5% and 13.9% (χ(2) = 32.135, P < 0.05), respectively, and were significantly lower in groups C and D compared with group A (P < 0.05). Logarithmic values of mitochondrial DNA copy numbers were 6.54 ± 0.13, 6.48 ± 0.09, 5.57 ± 0.15 and 5.41 ± 0.07 in groups A, B, C and D, respectively, and were significantly lower in groups C and D compared with group A or B (F = 89.241, P < 0.05). A number of mitochondria of the oocytes exhibited tremendous tumescence and vacuolization in groups C and D, which was contrast to a roughly normal appearance in groups A and B. CONCLUSIONS: DEP is noxious to murine female reproduction. Subacute exposure to DEP injures the ovary and oocyte resulting in compromised ovarian function and fertilizability of the oocyte.

[Expression of matrix metalloproteinases-9 and tissue inhibitors of matrix metalloproteinases-1 in connective tissue of vaginal wall of women with stress urinary incontinence].

OBJECTIVE: To study semi-quantitatively mRNA expression of matrix metalloproteinase-9 (MMP-9) and its inhibitor, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), in vaginal wall connective tissue in women with stress urinary incontinence (SUI) compared to continent controls, and to explore the relationship between MMP-9, TIMP-1 and SUI. METHODS: Vaginal wall tissues were obtained from 24 women with SUI who were followed-up (12 cases are > 60 years old and 12 cases < or = 60 years old). Seven patients undergoing total hysterectomy for carcinoma in situ of cervix without urinary incontinence served as control group. RNA was extracted and quantified. Semi-quantitative competitive reverse transcription was carried out with oligo-nucleotide primers to quantify MMP-9 and TIMP-1 mRNA expression. RESULTS: We used GeneSnap to analyze the data. MMP-9 in three groups (> 60, < or = 60 years and control) was 0.56 +/- 0.20, 0.56 +/- 0.19, 0.37 +/- 0.18, significantly decreased (P < 0.05). There was no difference between > 60 and < or = 60 year age groups (P > 0.05). TIMP-1 in three groups was 0.23 +/- 0.11, 0.31 +/- 0.12, 0.41 +/- 0.13, significantly increased (P < 0.05). There was a great difference between > 60 and < or = 60 year age groups in TIMP expression (P > 0.05). The ratio of MMP-9/TIMP-1 in > 60, < or = 60 year age groups and control group was 2.49 +/- 1.82, 1.82 +/- 1.58, 0.90 +/- 1.38, significantly decreased (P < 0.05). CONCLUSION: Stress urinary incontinent women demonstrate a significant increase in MMP-9 mRNA expression and significant decrease in TIMP-1 mRNA expression. In SUI patients, proportion of MMP-9 and TIMP-1 was overbalanced. Both these findings are consistent with increased collagen breakdown and may play an important role in the onset and development of SUI.

[Clinical analysis of different surgeries for women with stress urinary incontinence].

OBJECTIVE: To compare the efficacy of four kinds of suspender surgery: tension-free vaginal tape (TVT), trans-obturator tape (TOT), Goebell-Stoeckel fascia lata sling (Lata) and Burch urethropexy (Burch) in the treatment of stress urinary incontinence. METHOD: In this controlled, retrospective study, 103 patients were enrolled, including 53 patients who were operated on by TVT, 16 patients by TOT, 19 patients by Lata and 15 patients by Burch. RESULTS: The cure rate was as follows: TVT 94% (50/53), TOT 94% (15/16), Lata 95% (18/19), and Burch 87% (13/15) three months after the operation. The operative time for TVT, TOT, Lata and Burch was (28 +/- 7), (16 +/- 5), (125 +/- 13), and (43 +/- 6) min, whereas the duration of postoperative catheterization was (26 +/- 3), (3 +/- 1), (120 +/- 6), and (72 +/- 5) h, respectively. Two cases in TVT group had bladder perforation, one case in TVT group and two cases in Lata group had urinary retention postoperatively. CONCLUSIONS: The efficacy of the four kinds of suspender surgery is obvious. TVT and TOT have the advantage of minimal invasion, quick recovery, and short duration of hospitalization and catheterization, with the possibility of accompanying operations of uterine and vaginal prolapse at the same time. Burch can also be operated on concomitantly with other gynecological operations.