Association between polycystic ovary syndrome and risk of non-alcoholic fatty liver disease: a meta-analysis.

INTRODUCTION: There have been many studies assessing whether abnormal metabolic and hormone levels among women with polycystic ovary syndrome (PCOS) are associated with a greater risk of non-alcoholic fatty liver disease (NAFLD). However, previous studies repported no consistent outcomes. To provide a comprehensive evaluation regarding the role of PCOS in the risk of NAFLD, we updated the published literature and conducted this systemic review and meta-analysis. MATERIAL AND METHODS: Electronic databases (Web of Science and PubMed) were searched for literature up to October 2022. We used STATA 12.0 software to compute odds ratios (ORs) and 95% confidence intervals (CIs), to evaluate the association between PCOS and risk of NAFLD. RESULTS: The study indicated that PCOS was significantly related to an elevated risk of NAFLD (OR = 2.93, 95% CI 2.38 to 3.62, I2 = 83.7%, p < 0.001). Meta-regression analysis showed that age and body mass index (BMI) were not responsible for heterogeneity across the studies (age: p = 0.096; BMI: p = 0.418). Sensitivity analysis indicated no alteration in the direction of effect when any study was eliminated. Begg's test, Egger's test, Begg's test, and funnel plot indicated a significant risk of publication bias (Egger's test: p = 0.028; Begg's test: p < 0.001). CONCLUSION: This meta-analysis reported that PCOS was associated with an elevated risk of NAFLD. Early proper detection of NAFLD for PCOS women is essential. All patients with PCOS should undergo appropriate diagnostics for early detection of fatty liver and fibrosis.

Transvaginal small bowel evisceration after cervical loop electrosurgical excision procedure: a case report.

Transvaginal small bowel evisceration is a life-threatening condition, which is usually seen in postmenopausal women with a history of gynecological surgery. Cervical loop electrosurgical excision procedure (LEEP) is widely used in the treatment of cervical intraepithelial neoplasia (CIN), and its surgical risk and postoperative complications are relatively low because of the simplicity of the operation. However, improper operation may result in perforation of the uterus, which can cause prolapse of the small bowel into the vagina. We here reported an extremely rare case of a young woman with transvaginal small bowel evisceration after cervical LEEP, achieving a good prognosis after the prolapsed bowel was reduced. The patient underwent cervical LEEP as a treatment for CIN III, but the LEEP resulted in a laceration of about 4.0 cm × 3.5 cm on the peritoneum of the uterovesical peritoneal reflection and a laceration of about 2.0 cm × 1.5 cm on the anterior wall of the cervical canal. Through the two lacerations, the pelvic cavity is connected to the vagina and the small intestine prolapsed into the vagina. Due to aggressive surgical intervention, the patient achieved a favorable prognosis after successfully reducing the prolapsed bowel.

Association Between Metformin Use and the Risk, Prognosis of Gynecologic Cancer.

Background: For gynecological cancer patients, the beneficial effect of metformin use remains controversial due to inconsistent results of published articles. By conducting a meta-analysis, we aimed to evaluate the effect of metformin in reducing the risk and improving the survival of gynecological cancer among women with diabetes mellitus (DM). Methods: Articles exploring association between metformin use and the risk, as well as prognosis of gynecologic cancer in DM, were searched in the databases: PubMed, Web of Science, SCOPUS, EMBASE, EBSCO, and PROQUEST. Articles were published before May 2022. All the studies were conducted using STATA 12.0 software. Results: The meta-analysis showed no significant association between metformin use and risk of gynecologic cancer in DM with a random effects model [odds ratio (ORs)/relative risk (RR) = 0.91, 95% confidence intervals (CI) 0.77 to 1.08, I2 = 84.2%, p < 0.001]. Metformin use was associated with reduced overall survival (OS) and progression-free survival (PFS) of gynecologic cancer in DM with random effects models [OS: hazard ratio (HR) = 0.60, 95% CI 0.49-0.74, I2 = 55.2%, p = 0.002; PFS: HR = 0.55, 95% CI 0.33-0.91, I2 = 69.1%, p = 0.006], whereas no significant association was showed between metformin use and recurrence-free survival (RFS), as well as cancer-specific survival (CSS) of gynecologic cancer in DM with random effects models (RFS: HR = 0.60, 95% CI 0.30-1.18, I2 = 73.7%, p = 0.010; CSS: HR = 0.78, 95% CI 0.43-1.41, I2 = 72.4%, p = 0.013). Conclusions: In conclusion, this meta-analysis indicated that metformin may be a useful adjuvant agent for gynecological cancer with DM, especially for patients with ovarian cancer and endometrial cancer.

Acceptor engineering of small-molecule fluorophores for NIR-II fluorescence and photoacoustic imaging.

Fluorescence imaging in the second near-infrared window (NIR-II) has been an emerging technique in diverse in vivo applications with high sensitivity/resolution and deep tissue penetration. To date, the design principle of the reported NIR-II organic fluorophores has heavily relied on benzo[1,2-c:4,5-c']bis([1,2,5]thiadiazole) (BBTD) as a strong electron acceptor. Here, we report the rational design and synthesis of a NIR-II fluorescent molecule with the rarely used [1,2,5]thiadiazolo[3,4-f]benzotriazole (TBZ) core to replace BBTD as the electron acceptor. Thanks to the weaker electron deficiency of the TBZ core than BBTD, the newly yielded NIR-II molecule (BTB) based nanoparticles have a higher mass extinction coefficient and quantum yield in water. In contrast, the nanoparticle suspension of its counterpart with BBTD as the core is nearly nonemissive. The NIR-II BTB nanoparticles allow video-rate fluorescence imaging for vasculature imaging in ears, hindlimbs, and the brain of the mouse. Additionally, its large absorptivity in the NIR-I region also promotes bioimaging using photoacoustic microscopy (PAM) and tomography (PAT). Upon surface conjugation with the Arg-Gly-Asp (RGD) peptide, the functionalized nanoparticles ensured targeted detection of integrin-overexpressed tumors through both imaging modalities in two- and three-dimensional views. Thus, our approach to engineering acceptors of organic fluorophores offers a promising molecular design strategy to afford new NIR-II fluorophores for versatile biomedical imaging applications.

Contribution of xeroderma pigmentosum complementation group D gene polymorphisms in breast and ovarian cancer susceptibility: A protocol for systematic review and meta analysis.

BACKGROUND: The role of xeroderma pigmentosum complementation group D (XPD) gene polymorphisms in breast and ovarian cancer development has long been controversial and existing data were inconsistent. Here, we conducted a comprehensive systemic review and meta-analysis to better clarify the association. METHODS: Relevant case-control studies published in electronic data base from October 1999 to September 2019 were assessed. The statistical analyses of the pooled odds ratios (ORs) and the corresponding 95% confidence intervals (95%CIs) were calculated by using Revman 5.2 software (Cochrane Collaboration, Copenhagen). RESULTS: 31 articles including 38 case-control studies and 2 XPD polymorphisms (rs1799793 and rs238406) were analyzed. The results showed statistical significance in heterozygous mutants among Asian population for rs1799793 (GA vs GG + AA: OR = 1.38, 95%CI = 1.21-1.56), and Caucasian population for rs238406 (CA vs AA + CC: OR = 0.63, 95%CI = 0.49-0.80), while the rest comparisons including overall groups and subgroups stratified by cancer types and ethnicity failed to indicate any association with breast and ovarian cancer risk. CONCLUSIONS: The current meta-analysis suggested no concrete correlation of XPD rs1799793(G/A) and rs238406(C/A) polymorphisms with breast cancer or ovarian cancer susceptibility. However, it indicated that heterozygous genotypes might share different pathophysiologic mechanism from not only homozygous wildtypes but also homozygous mutants. More case-control studies with well-adjusted data and diverse populations are essential for validation of our conclusion.

Photoacoustic and Magnetic Resonance Imaging Bimodal Contrast Agent Displaying Amplified Photoacoustic Signal.

Progress in photoacoustic (PA) and magnetic resonance imaging (MRI) bimodal contrast agents has been achieved mainly by utilizing the imaging capability of single or multiple components and consequently realizing the desired application for both imaging modalities. However, the mechanism of the mutual influence between components within a single nanoformulation, which is the key to developing high-performance multimodal contrast agents, has yet to be fully understood. Herein, by integrating conjugated polymers (CPs) with iron oxide (IO) nanoparticles using an amphiphilic polymer, a bimodal contrast agent named CP-IO is developed, displaying 45% amplified PA signal intensity as compared to bare CP nanoparticle, while the performance of MRI is not affected. Further experimental and theoretical simulation results reveal that the addition of IO nanoparticles in CP-IO nanocomposites contributes to this PA signal amplification through a synergistic effect of additional heat generation and faster heat dissipation. Besides, the feasibility of CP-IO nanocomposites acting as PA-MRI bimodal contrast agents is validated through in vivo tumor imaging using mice models. From this study, it is demonstrated that a delicately designed structural arrangement of various components in a contrast agent could potentially lead to a superior performance in the imaging capability.

Bright Aggregation-Induced-Emission Dots for Targeted Synergetic NIR-II Fluorescence and NIR-I Photoacoustic Imaging of Orthotopic Brain Tumors.

Precise diagnostics are of significant importance to the optimal treatment outcomes of patients bearing brain tumors. NIR-II fluorescence imaging holds great promise for brain-tumor diagnostics with deep penetration and high sensitivity. This requires the development of organic NIR-II fluorescent agents with high quantum yield (QY), which is difficult to achieve. Herein, the design and synthesis of a new NIR-II fluorescent molecule with aggregation-induced-emission (AIE) characteristics is reported for orthotopic brain-tumor imaging. Encapsulation of the molecule in a polymer matrix yields AIE dots showing a very high QY of 6.2% with a large absorptivity of 10.2 L g-1 cm-1 at 740 nm and an emission maximum near 1000 nm. Further decoration of the AIE dots with c-RGD yields targeted AIE dots, which afford specific and selective tumor uptake, with a high signal/background ratio of 4.4 and resolution up to 38 µm. The large NIR absorptivity of the AIE dots facilitates NIR-I photoacoustic imaging with intrinsically deeper penetration than NIR-II fluorescence imaging and, more importantly, precise tumor-depth detection through intact scalp and skull. This research demonstrates the promise of NIR-II AIE molecules and their dots in dual NIR-II fluorescence and NIR-I photoacoustic imaging for precise brain cancer diagnostics.

Primary debulking surgery vs. neoadjuvant chemotherapy followed by interval debulking surgery for patients with advanced ovarian cancer.

OBJECTIVES: To compare the survival of patients with stage IIIC or IV epithelial ovarian cancer (EOC) who were treated with neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) or primary debulking surgery (PDS), and to investigate how to improve the survival of patients with advanced epithelial ovarian cancer. METHOD: We retrospectively reviewed 339 patients with stage IIIC or IV EOC from January 2005 to December 2010 treated at West China Women's and Children's Hospital wherein 114 and 225 patients underwent NAC followed by IDS and PDS, respectively. RESULTS: No difference was observed in progression-free survival (PFS) or overall survival (OS) between NAC group and PDS group (PFS: 11 vs. 10 months, p = 0.629; OS: 25 vs. 25 months, p = 0.992). Patients with residual tumors that measured 0.1-1 cm at IDS following NAC had a statistically significant lower median OS compared to patients with no residual tumor, but comparable to that with residual tumors that measured >1 cm at IDS following NAC. The independent predictors of OS are size of residual tumor (p < 0.001), FIGO stage (p < 0.001), and age (p = 0.003). CONCLUSIONS: NAC followed by IDS provides equal survival compared with PDS. Debulking to small residual tumors with a maximum diameter of less than 1 cm provides a smaller but still significant benefit for patients with PDS but a relatively minor effect with IDS following NAC. To improve the survival of patients with advanced ovarian cancer, the definition of "optimal" in IDS following NAC should be defined as no residual tumor.

Immunotherapy of tumors with human telomerase reverse transcriptase immortalized human umbilical vein endothelial cells.

Human umbilical endothelial cells (HUVECs) have been proven to be effective in tumor anti-angiogenesis but the mechanism remained to be further demonstrated. The restricted ability of HUVECs to proliferate in vitro also limits their application on a large scale. In the present study, we immortalized HUVECs with hTERT genes by lentiviral infection and explored the antitumor immunity of hTERT-expressing HUVECs (HUVEC-TERTs). Results showed that HUVEC-TERTs maintained high telomere activity and expressed CD31, VEGFR-II and integrin α5. Passage-30 HUVEC-TERTs were able to form vascular tubes in vitro without showing signs of senescence. In vivo HUVEC-TERTs elicited antitumor immunity in mouse LL2 and CT26 models protectively and therapeutically. Both humoral and cellular immunity participated in the tumor anti-angiogenesis as HUVEC-neutralizing sera antibodies and HUVEC-specific CTL were detected. The subsets of activated spleen T lymphocytes included both CD4(+) T cells and CD8(+) T cells. Moreover, MDSCs and Tregs were decreased while T lymphocytes were aggregated in the tumor microenvironment. Collectively, the present study is the first to confirm the antitumor immunity of hTERT-immortalized HUVECs. Both anti-angiogenesis and tumor microenvironmental regulation participated in the antitumor activity. Transducing hTERT genes might be a new strategy to allow HUVECs to be applied on a large scale in cancer immunotherapy.

Gene Polymorphisms of Toll-Like Receptor 9 -1486T/C and 2848G/A in Cervical Cancer Risk.

OBJECTIVE: This work aims to explore whether Toll-like receptor 9 (TLR9) -1486T/C and 2848G/A polymorphisms are associated with cervical cancer risk. METHODS: A comprehensive electronic search of studies published from January 1999 to October 2014 was conducted in Medline (Ovid), Embase, PubMed, Wanfang, Weipu, and CNKI. The algorithm included "TLR," "Toll-like receptor," "polymorphism," "variant," "mutation," and "cervical cancer." Seven articles, including 9 studies, were pooled using Revman 5.2 (Cochrane Collaboration, Copenhagen, Denmark). Odds ratio (OR) was used to explore the involvement of minor allele C (C vs T and CC + CT vs TT) of TLR9 (-1486T/C, rs187084) and minor allele A (A vs G and AA + AG vs GG) of TLR9 (2848G/A, rs352140) in cervical cancer risk. RESULTS: Toll-like receptor 9 (-1486T/C, rs187084) polymorphisms were associated with an elevated risk of cervical cancer (C vs T: OR, 1.15; 95% confidence interval [CI], 1.03-1.29; CC + CT vs TT: OR, 1.30; 95% CI, 1.11-1.53). We found no significant association between TLR9 (2848G/A, rs352140) polymorphisms and cervical cancer risk (A vs G: OR, 1.15; 95% CI, 0.87-1.54; AA + AG vs GG: OR, 1.27; 95% CI, 0.75-2.17). CONCLUSIONS: This meta-analysis indicates that TLR9 (-1486T/C, rs187084)-but not TLR9 (2848G/A, rs352140)-may be a risk factor for cervical cancer.

Association between HSD17B1 rs605059 polymorphisms and the risk of uterine diseases: a systemic review and meta-analysis.

The aim of this study was to evaluate the HSD17B1 gene polymorphisms in the risks of endometrial cancer, endometriosis and uterine leiomyoma by meta-analysis. A comprehensive electronic search was conducted in PubMed, Medline (Ovid), Embase, Weipu, Wanfang and CNKI. The pooled ORs were performed using the Revman 5.2 softerware. 8 case-control studies were included: 3 were about endometrial cancer, 4 were about endometriosis and 1 was about uterine leiomyoma. The result showed no significant association between HSD17B1 rs605059 gene polymorphisms and risks of endometrial cancer (AA vs. AG+GG: OR = 1.11, 95% CI = 0.94-1.32; AA+AG vs. GG: OR = 1.79, 95% CI = 0.42-7.52; AG vs. AA+ GG: OR = 0.87, 95% CI = 0.76-1.00; AA vs. GG: OR = 1.43, 95% CI = 0.62-3.30; A vs. G: OR = 1.00, 95% CI = 0.91-1.11) or endometriosis (AA vs. AG+GG: OR = 0.99, 95% CI = 0.75-1.32; AA+AG vs. GG: OR = 1.73, 95% CI = 0.92-3.25; AG vs. AA+ GG: OR = 1.24, 95% CI = 1.00-1.53; AA vs. GG: OR = 1.54, 95% CI = 0.79-2.97; A vs. G: OR = 1.23, 95% CI = 0.90-1.68). No association was found in a subgroup analysis based on Asian ethnicity for endometriosis. This meta-analysis suggested that HSD17B1 rs605059 polymorphisms were not associated with the risks of endometrial cancer and endometriosis. Further studies are needed to validate the conclusion and clarify the relationship between HSD17B1 rs605059 polymorphisms and the risk of uterine leiomyoma.

[Effect of laparoscopic proctectomy and open proctectomy on plasma levels of vascular endothelial growth factor].

OBJECTIVE: To investigate the effect of laparoscopic and open proctectomy on plasma levels of vascular endothelial growth factor (VEGF). METHODS: From January 2011 to December 2012, 100 rectal cancer patients in Shantou Central Hospital were enrolled in the study. Patients were divided into laparoscopic (LR) group and open (OR) group based on the decision of the patients. There were 63 patients in the LR group (44 cases undergoing low anterior resection and 19 abdominoperineal resection) and 37 patients in the OR group(26 cases undergoing low anterior resection and 11 abdominoperineal resection). Double antibody sandwich enzyme-linked immunohistochemistry was used to detect the level of VEGF on 1-day before and 1-day, 3-day, 7-day after operation. RESULTS: In the LR group, the postoperative levels of VEGF increased slowly, and the level of VEGF was significantly higher than that before operation until the 7-day after operation(P<0.05) regardless of the procedure. In the OR group, all the postoperative levels of VEGF were significantly increased(P<0.05). There was no significant difference of the VEGF level on 1-day before and 1-day after operation between the two groups(all P>0.05). The VEGF level in the OR group was significantly higher than that in the LR group on the day 3 and day 7 after operation(P<0.05). CONCLUSION: Compared with open approach, laparoscopic proctectomy has smaller short-term impact on the plasma level of VEGF in rectal cancer patients.

[The role of microRNAs in the pathogenesis of cervical cancer and its relationship to HPV].

A lot of miRNAs have participated in the regulation of numerous biological processes such as cell proliferation, apoptosis, invasion and migration in cervical cancer, and closely associated with prognosis and susceptibility of cervical cancer. The oncogenic proteins E6, E7 and E5 expressed by HPV directly or indirectly lead to the dysregulation of multiple miRNAs such as miR-34a,miR-218, miR-29a and miR-146a, subsequently contribute to the initiation and progression of cervical cancer. In turn, some miRNAs such as miR-203 and miR-125b also play roles in the regulation of HPV DNA duplication. In addition, the latest advances on miRNA basic research and its potential significance in the diagnosis and treatment of malignant tumors are also reviewed in this paper.

Anti-inflammation and antioxidant effect of Cordymin, a peptide purified from the medicinal mushroom Cordyceps sinensis, in middle cerebral artery occlusion-induced focal cerebral ischemia in rats.

Cordymin is a peptide purified from the medicinal mushroom Cordyceps sinensis. The present study investigated the effects of Cordymin in prevention of focal cerebral ischemic/reperfusion (IR) injury. The right middle cerebral artery occlusion model was used in the study. The effects of Cordymin on mortality rate, neurobehavior, grip strength, glutathione content, lipid Peroxidation, glutathione peroxidase activity, glutathione reductase activity, catalase activity, Na(+)K(+)ATPase activity glutathione S transferase activity and on the regulation of C3 and C4 protein level, polymorphonuclear cells, interleukin-1ß and tumor necrosis factor-α in a rat model were studied respectively. Treatment (orally) of Cordymin significantly boosted the defense mechanism against cerebral ischemia by increasing antioxidants activity related to lesion pathogenesis. Restoration of the antioxidant homeostasis in the brain after reperfusion may have helped the brain recover from ischemic injury. Moreover, Cordymin significantly inhibited infiltration of polymorphonuclear cells and IR-induced up-regulation of the brain production of C3 protein level, interleukin-1ß and tumor necrosis factor-α. Cordymin significantly improved the outcome in rats after cerebral ischemia and reperfusion in terms of neurobehavioral function. Our findings suggest that cordymin have a neuroprotective effect in the ischemic brain, which is due to the inhibition of inflammation and increase of antioxidants activity related to lesion pathogenesis. Cordymin can be used as potential preventive agent against cerebral ischemia-reperfusion injury.

The mobilization of autologous bone marrow stem cells in the treatment of heart failure with Chinese medicine.

Heart failure (HF) is a severe heart disease. The use of autologous bone marrow stem cells (BMCs) mobilization in the treatment of HF has been a hot topic to research both in Western medicine and Chinese medicine (CM). There are many clinical trials and experiments on study of BMCs mobilization for HF therapy, including integrative medicine. The effect of BMCs mobilization is favorable for cardiac repair, while some advantages of CM support the advanced study of its application in BMCs mobilization to treat HF. In addition, with mechanisms of autologous BMCs mobilization for the treatment of HF that will be revealed in the future, especially stem cells niches, integrative medicine would play an important role in this clinical thought of therapy model gradually. Simultaneously, CM should adapt the new approaches of stem cells progresses on HF treatment as holding characteristics of itself.

[Clinical significance of multi-slice spiral CT angiography in radical resection of gastric cancer].

OBJECTIVES: To explore the clinical significance of preoperative abdominal multi-slice spiral CT angiography (MSCTA) in radical resection of gastric cancer. METHODS: One hundred and three patients with gastric cancer were divided into two groups according to their desires. Group I( included 57 patients who underwent preoperative MSCTA and group II( included 46 patients who underwent surgery without preoperative MSCTA. All these patients were operated by the same surgical team. RESULTS: Six patients(10.5%) with abnormal gastric artery in group I( were discovered. The diagnostic concordance rate between MSCTA and intraoperative findings was 100% in group I( in the locations and alignments of main perigastric vessels and their relationship with cancer lesions. Operative time in group I( was shorter than that in group II( [(206 ± 23) min vs. (257 ± 32) min, P=0.044]. Operative time [(190 ± 50) min] of patients with abnormal gastric artery of group I( was shorter than that [(255 ± 62) min] of patients with abnormal gastric artery discovered during operation of group II( (P=0.048). However there were no differences in blood loss, extent of lymph node dissection, complication rate, length of hospital stay, and hospitalization cost between the two groups(P>0.05). CONCLUSION: Preoperative MSCTA is beneficial to the evaluation of vascular structure of the cancer and the adjacent tissues, which may reduce postoperative complications.

[Clinical study on needle-pricking therapy for treatment of polycystic ovarial syndrome].

OBJECTIVE: To probe into the clinical effect of needle-pricking therapy for treatment of polycystic ovarial syndrome. METHODS: One hondred and twenty-one cases of polycystic ovarial syndrome were divided into a needle-pricking therapy group of 61 cases and a medication group of 60 cases with randomized and controlled method. The needle-pricking therapy group were treated by needle-pricking therapy at sacral plexus stimulating points on both sides of the spine and lateral points of Dazhui (CV 14), and the medication group by oral administration of domiphen and intramuscular injection of chorionic gonadotropin (HCG). Levels of hormones and symptoms in the patients before treatment, after treatment of 3 cycles and at the sixth cycle after treatment were investigated. RESULTS: After treatment of 3 cycles, the level of hormone and B type ultrasound examination were significantly improved in the two groups (P < 0.01). At the sixth cycle after treatment, the conditions of the patients in the medication group were returned to the original levels before treatment, while the conditions in the needle-pricking therapy group still kept at the post-therapeutic level, and their menstruation and ovulation restored to normal state, and the ovulation mucosa and the pregnancy rate were significantly higher than those in the medication group (all P < 0.01). CONCLUSION: Needle-pricking therapy has obvious effect on polycystic ovarial syndrome, and has a good long-term therapeutic effect.