Predictors of response to ovulation induction using letrozole in women with polycystic ovary syndrome.

BACKGROUND: This study aimed to evaluate the predictive value of the initial screening characteristics of women with anovulatory polycystic ovary syndrome (PCOS) who did or did not respond to 2.5 mg letrozole (LET). METHODS: The clinical and laboratory characteristics of women with PCOS who underwent LET treatment were evaluated. Women with PCOS were stratified according to their responses to LET (2.5 mg). The potential predictors of their responses to LET were estimated using logistic regression analysis. RESULTS: Our retrospective study included 214 eligible patients with a response to 2.5 mg LET (n = 131) or no response to 2.5 mg LET (n = 83). PCOS patients who responded to 2.5 mg LET showed better outcomes than those who did not (2.5 mg LET) for pregnancy rate, live birth rate, pregnancy rate per patient, and live birth rate per patient. Logistic regression analyses showed that late menarche (odds ratio [OR], 1.79 [95% confidence intervals (CI), 1.22-2.64], P = 0.003), and increased anti-müllerian hormone (AMH) (OR, 1.12 [95% CI, 1.02-1.23], P = 0.02), baseline luteinizing hormone (LH)/ follicle stimulating hormone (FSH) (OR, 3.73 [95% CI, 2.12-6.64], P < 0.001), and free androgen index (FAI) (OR, 1.37 [95% CI, 1.16-1.64], P < 0.001) were associated with a higher possibility of no response to 2.5 mg LET. CONCLUSIONS: PCOS patients with an increased LH/FSH ratio, AMH, FAI, and late menarche may need an increased dosage of LET for a treatment response, which could be helpful in designing a personalized treatment strategy.

Correlation between biochemical and clinical hyperandrogenism parameter in polycystic ovary syndrome in relation to age.

BACKGROUND: To assess the correlation between clinical and biochemical hyperandrogenism parameters in polycystic ovary syndrome (PCOS) according to age. METHODS: This prospective study included 256 PCOS patients diagnosed according to the Rotterdam criteria in a university-based hospital. Androgen levels were measured using liquid chromatography-tandem mass spectrometry. Hirsutism, acne, and alopecia were assessed using the modified Ferriman-Gallwey (mF-G) score, Comprehensive Acne Severity Scale (CASS), and the Ludwig scale, respectively. The correlation between biochemical and clinical hyperandrogenism parameters was assessed in younger and older women with PCOS. RESULTS: The 256 PCOS patients were classified by age into two groups: age 18-29 years (n = 151) and age 30-40 years (n = 84). In women with PCOS, mF-G was significantly positively correlated with the free androgen index (FAI), dehydroepiandrosterone (DHEA), and DHEA sulfate (DHEA-S). CASS had a significant positive correlation with DHEA. mF-G was positively correlated with FAI in those aged 18-29 years, but the correlations were not significant in those aged 30-40 years. The positive correlation between specific body regions of clinical hyperandrogenism, especially mF-G of chin, lower abdomen, and thighs, and testosterone, as well as with FAI, was highest in those aged 18-29 years. In those aged 30-40 years clinical hyperandrogenism was mainly affected by DHEA, DHEA-S, and dihydrotestosterone. CONCLUSION: The correlation between biochemical and clinical hyperandrogenism parameters varied with age in our East Asian population. Clinical hyperandrogenism was positively correlated with FAI in younger women with PCOS. The correlation between biochemical and clinical hyperandrogenism was not significant in older women with PCOS.

Breast tumor segmentation via deep correlation analysis of multi-sequence MRI.

Precise segmentation of breast tumors from MRI is crucial for breast cancer diagnosis, as it allows for detailed calculation of tumor characteristics such as shape, size, and edges. Current segmentation methodologies face significant challenges in accurately modeling the complex interrelationships inherent in multi-sequence MRI data. This paper presents a hybrid deep network framework with three interconnected modules, aimed at efficiently integrating and exploiting the spatial-temporal features among multiple MRI sequences for breast tumor segmentation. The first module involves an advanced multi-sequence encoder with a densely connected architecture, separating the encoding pathway into multiple streams for individual MRI sequences. To harness the intricate correlations between different sequence features, we propose a sequence-awareness and temporal-awareness method that adeptly fuses spatial-temporal features of MRI in the second multi-scale feature embedding module. Finally, the decoder module engages in the upsampling of feature maps, meticulously refining the resolution to achieve highly precise segmentation of breast tumors. In contrast to other popular methods, the proposed method learns the interrelationships inherent in multi-sequence MRI. We justify the proposed method through extensive experiments. It achieves notable improvements in segmentation performance, with Dice Similarity Coefficient (DSC), Intersection over Union (IoU), and Positive Predictive Value (PPV) scores of 80.57%, 74.08%, and 84.74% respectively.

Effects of Tuina Combined With Moxibustion on Breast Cancer-Related Lymphedema: A Randomized Cross-Over Controlled Trial.

The objective of this study is to evaluate the effect of Tuina combined with moxibustion on relieving breast cancer-related lymphedema (BCRL). A randomized cross-over controlled trial was conducted at our institution. All patients with BCRL were assigned to 2 groups: Group A and Group B. In the first period (weeks 1-4), tuina and moxibustion were performed in Group A and pneumatic circulation and compression garment in Group B. The washout period took place from weeks 5 to 6. In the second period (weeks 7-10), pneumatic circulation and compression garment were performed in Group A, and tuina and moxibustion in Group B. Therapeutic efficacy was evaluated by measuring the affected arm volume, circumference, and Visual Analog Scale for swelling. Regarding the results, a total of 40 patients were included, and 5 cases were dropped. After treatment, both the traditional Chinses medicine (TCM) treatment and complete decongestive therapy (CDT) was found to reduce the volume of the affected arm (P < .05). At the endpoint (visit 3), compared with CDT, the effect of the TCM treatment was more evident than that of CDT (P < .05). After the TCM treatment, the arm circumference at the elbow crease and proximal 10 cm to elbow crease was reduced, which was statistically different from that before treatment (P < .05). Post-CDT treatment, the arm circumference at proximal 10 cm to wrist crease and the elbow crease and proximal 10 cm to elbow crease decreased, which was statistically different from that before treatment (P < .05). At the endpoint (visit 3), the arm circumference at proximal 10 cm to elbow crease of the patients treated with TCM was less than that of CDT (P < .05). Moreover, the VAS scores for swelling were better after compared with before TCM treatment and CDT (P < .05). At the endpoint (visit 3), the subjective relief of swelling by TCM treatment was greater than CDT (P < .05). Ultimately, tuina combined with moxibustion can alleviate BCRL symptoms, which is primarily reflected in reducing the affected arm volume and circumference and relieving swelling.Trial registration: Chinese Clinical Trial Registry (Registration Number ChiCTR1800016498).

Increasing trends in rainfall-runoff erosivity in the Source Region of the Three Rivers, 1961-2012.

As the head source of the two longest rivers in China and the longest river in Southeast Asia, the East Qinghai-Tibetan Plateau (QTP) is experiencing increasing thaw snowmelt and more heavy precipitation events under global warming, which might lead to soil erosion risk. To understand the potential driving force of soil erosion and its relationship with precipitation in the context of climate change, this study analyzed long-term variations in annual rainfall-runoff erosivity, a climatic index of soil erosion, by using the Mann-Kendall statistical test and Theil and Sen's approach in the Source Region of the Three Rivers during 1961-2012. The results showed the followings: (i) increasing annual rainfall-runoff erosivity was observed over the past 52years, with a mean relative trend index (RT1) value of 12.1%. The increasing trend was more obvious for the latest two decades: RT1 was nearly three times larger than that over the entire period; (ii) more precipitation events and a higher precipitation amount were the major forces for the increasing rainfall-runoff erosivity; (iii) similar rising trends in sediment yields, which corresponded to rainfall-runoff erosivity under slightly increasing vegetation coverage in the study area, implied a large contribution of rainfall-runoff erosivity to the increasing sediment yields; and (iv) high warming rates increased the risk of soil destruction, soil erosion and sediment yields. Conservation measures, such as enclosing grassland, returning grazing land to grassland and rotation grazing since the 1980s, have maintained vegetation coverage and should be continued and strengthened.

Comparative evaluation of the antioxidant effects of the natural vitamin C analog 2-O-ß-D-glucopyranosyl-L-ascorbic acid isolated from Goji berry fruit.

2-O-ß-D-Glucopyranosyl-L-ascorbic acid (AA-2ßG) is a natural derivative of vitamin C (Lascorbic acid, AA) isolated from Goji berry (Lycium barbarum L.) fruit. We evaluated the antioxidant activities of AA-2ßG and AA using in vitro and in vivo model systems. In vitro radical scavenging assays demonstrated that AA-ßG was capable of scavenging 1,1-diphenyl-2-picryl-hydrazyl and hydroxyl peroxide and inhibiting H(2)O(2)-induced hemolysis better than AA. AA-2ßG and AA had similar hydroxyl radical scavenging capabilities, but AA-2ßG was incapable of scavenging superoxide anion radicals, and its capacity to scavenge nitrite (NO(2) (-)) was lower than that of AA. The overall in vitro reduction capability of AA-2ßG was also significantly lower than that of AA. Moreover, in vivo studies demonstrated that AA-2ßG was capable of protecting the liver against carbon tetrachloride-induced acute liver injury in mice. These results suggest that AA-2ßG is an important antioxidant component of Goji berry fruit, which may share similar but distinct antioxidant mechanistic properties with AA. This study furthers our understanding of the mechanisms of Goji berry fruit pharmacological activities on antiaging and antitumor properties as a traditional medicine and dietary supplement.