A retrospective study of ovarian tissue cryopreservation in female patients with hematological diseases for fertility preservation.

PURPOSES: To investigate the effect and safety of ovarian tissue cryopreservation (OTC) for fertility preservation in female patients with hematological diseases. METHODS: We designed a retrospective study. The clinical data of patients with hematological diseases undergoing OTC admitted to Peking University People's Hospital from April 2017 to January 2023 were analyzed and summarized. RESULTS: A total of 24 patients were included in the study, including 19 patients with malignant hematological diseases and 5 patients with non-malignant hematological diseases. The former included 14 patients with acute leukemia, 1 patient with chronic leukemia, and 4 patients with myelodysplastic syndrome, while the latter 5 patients were aplastic anemia (AA). 16 patients had received chemotherapy before OTC. The average age of 24 patients was 22.80 ± 6.81 years. The average anti-Mullerian hormone (AMH) was 1.97 ± 2.12 ng/mL, and the average follicle-stimulating hormone (FSH) was 7.01 ± 4.24 IU/L in examination before OTC. FSH was greater than 10.0 IU/L in 4 cases. The pre-OTC laboratory tests showed that the average white blood cell (WBC) count was (3.33 ± 1.35) × 109/L, the average hemoglobin was 91.42 ± 22.84 g/L, and the average platelet was (147.38 ± 114.46) × 109/L. After injection of recombinant human granulocyte colony-stimulating factor (rhG-CSF), blood transfusion, and iron supplementation in pre-OTC treatment, the average WBC count was (4.91 ± 3.07) × 109/L, the average hemoglobin was 98.67 ± 15.43 g/L, and the average platelet was (156.38 ± 103.22) × 109/L. Of the 24 patients, 22 underwent laparoscopic bilateral partial oophorectomy and oophoroplasty, and 2 underwent laparoscopic unilateral oophorectomy. The average duration of OTC was 59.54 ± 17.58 min, and the average blood loss was 32.1 ± 41.6 mL. The maximum blood loss was 200 mL. There was no significant difference in WBC count and hemoglobin concentration after OTC compared to pre-OTC period. Only the platelet count after OTC surgery was significantly different from that before surgery ([134.54 ± 80.84 vs. 156.38 ± 103.22] × 109/L, p < 0.05). None of the 24 patients had serious complications after OTC. 2 patients had mild infection symptoms, but both recovered well. 23 patients underwent hematopoietic stem cell transplantation (HSCT) after OTC. The median and interquartile range from OTC to the pretreatment of HSCT was 33 (57) days, and the median and interquartile range from OTC to HSCT was 41 (57) days. Seven of them began pretreatment of HSCT within 20 days and began HSCT within 30 days after OTC. All patients were followed up. Of the 23 patients who underwent HSCT after surgery, 22 presented with amenorrhea and 1 with scanty menstrual episodes. Seven patients underwent hormone replacement therapy (HRT) after HSCT. A patient with AA underwent ovarian tissue transplantation (OTT) 3 years after HSCT and resumed regular menstruation 6 months after OTT. CONCLUSIONS: Ovarian tissue cryopreservation has a promising future in fertility protection in patients with hematological diseases. However, patients with hematological malignancies often have received gonadotoxic therapy before OTC, which may be accompanied by myelosuppression while patients with non-malignant hematological diseases often present with severe hemocytopenia. So perioperative complete blood count of patients should be paid attention to. There was no significant difference in the WBC count and hemoglobin concentration in patients with hematological diseases before and after OTC surgery, and the platelet count decreased slightly within the normal range. Infection is the most common post-OTC complication, and HSCT pretreatment can be accepted as early as the 10th day after OTC. OTC has no adverse effects on patients with hematological diseases and does not delay HSCT treatment. For young patients with hematological diseases, OTC is an effective method of fertility preservation.

Performance and mechanism of Chlorella in swine wastewater treatment: Roles of nitrogen-phosphorus ratio adjustment and indigenous bacteria.

The effects of adjusting the nitrogen-phosphorus (N/P) ratio of wastewater and indigenous bacteria on swine wastewater treatment by Chlorella sp. HL were investigated. The optimal N/P ratio of Chlorella in swine wastewater was 20 by adjusting the phosphorus concentration. The participation of indigenous bacteria increased total extracellular polymeric substances content, which was beneficial to maintain the stability of the algal-bacterial consortium, and improved the algal density and the removal rate of total nitrogen, total phosphorus, and chemical oxygen demand by 47.8%, 24.0%, 30.7%, and 326.7%, respectively. Proteobacteria was the dominant phylum with the relative abundance of 71.58% in the algal-bacterial system at optimal N/P ratio, and Brevundimonas, Chryseobacterium, and Pseudomonas played positive roles in the establishment of symbiotic systems at the genus level. These results provide a theoretical basis for the construction of an efficient algal-bacterial symbiotic system in swine wastewater treatment and support for commercial scale-up.

Stress upregulates 2-arachidonoylglycerol levels in the hypothalamus, midbrain, and hindbrain, and it is sustained by green nut oil supplementation in SAMP8 mice revealed by DESI-MSI.

The endocannabinoid 2-arachidonoylglycerol (2AG) is an important modulator of stress responses. Its level in the brain increases in response to stress, but region-specific effects of stress on brain 2AG are not well known yet. Moreover, green nut oil (GNO), oil extracted from the seeds of Plukenetia volubilis has several health benefits, but its effects on brain 2AG levels are unknown. Therefore, we conducted this study to explore the effects of stress and GNO supplementation on 2AG levels in specific brain regions of senescence-accelerated mouse prone 8 (SAMP8). In this study, desorption electrospray ionization-mass spectrometry imaging (DESI-MSI) revealed that water-immersion stress for three days significantly increased 2AG levels in several brain regions of SAMP8 mice, including the hypothalamus, midbrain, and hindbrain. No significant change was observed in the relative abundance of brain 2AG in stress given SAMP8 mice after eighteen days of removing stress load compared to control SAMP8 mice. GNO supplementation also increased brain 2AG in SAMP8 mice without stress load. Additionally, GNO supplementation sustained the increased brain 2AG levels in stress given SAMP8 mice after eighteen days of removing stress load. Among all brain regions, a relatively higher accumulation of 2AG was noted in the hypothalamus, midbrain, and hindbrain of GNO-fed SAMP8. Our data explored the potentiality of GNO supplementation to improve brain 2AG levels which might be used to treat anxiety and depressive behaviors.

Effects of platelet-rich plasmapheresis during cardiovascular surgery: A meta-analysis of randomized controlled clinical trials.

OBJECTIVE: This study aimed to explore the effects of platelet-rich plasmapheresis (PRP) on the amount of postoperative blood loss and the requirements for allogeneic fresh frozen plasma (FFP) and red blood cell (RBC) transfusions during cardiovascular surgery. METHODS: A literature search of 7 online databases was conducted. Randomized control trials (RCT) comparing intraoperative PRP or appropriate control groups were considered suitable for this current study. RESULTS: Fifteen RCTs enrolling a total of 1002 patients, including 501 patients who received PRP and 501 control patients. Meta-analysis of the data from these trials showed that PRP reduced the total volume of postoperative blood loss (standardized mean difference [SMD], -0.74; 95% confidence interval [CI], -1.18 to -0.31; P < 0.05), reduced postoperative fresh frozen plasma (FFP) transfusion (SMD, -0.38; 95%CI, -0.69 to -0.08; P < 0.05), reduced postoperative RBCs transfusion (SMD, -0.44; 95%CI, -0.77 to -0.10; P < 0.05), and reduced the proportion of patients receiving postoperative allogeneic RBC transfusions (relative risk [RR], 0.44; 95%CI, 0.21-0.91, P < 0.05) during cardiovascular surgery. CONCLUSION: Conducting PRP before cardiopulmonary bypass (CPB) and transfusing autologous platelet-rich plasma (aPRP) after reversal of heparin could reduce postoperative blood loss, the requirements for blood products transfusion during cardiovascular surgery. A higher mean platelet count in aPRP may improve the final outcome. However, there was a high degree of undetermined heterogeneity among the analyzed trials, and larger and more precise RCTs are needed to confirm these conclusions.

Botulinum toxin type-A injection to treat patients with intractable anismus unresponsive to simple biofeedback training.

AIM: To evaluate the efficacy of botulinum toxin type A injection to the puborectalis and external sphincter muscle in the treatment of patients with anismus unresponsive to simple biofeedback training. METHODS: This retrospective study included 31 patients suffering from anismus who were unresponsive to simple biofeedback training. Diagnosis was made by anorectal manometry, balloon expulsion test, surface electromyography of the pelvic floor muscle, and defecography. Patients were given botulinum toxin type A (BTX-A) injection and pelvic floor biofeedback training. Follow-up was conducted before the paper was written. Improvement was evaluated using the chronic constipation scoring system. RESULTS: BTX-A injection combined with pelvic floor biofeedback training achieved success in 24 patients, with 23 maintaining persistent satisfaction during a mean period of 8.4 mo. CONCLUSION: BTX-A injection combined with pelvic floor biofeedback training seems to be successful for intractable anismus.

Role of mitochondrial permeability transition in human hepatocellular carcinoma Hep-G2 cell death induced by rhein.

Rhein, a compound found as a glucoside in the root of rhubarb, is currently a subject of interest for its antitumor properties. The apoptosis of tumor cell lines induced by rhein was observed, and the involvement of mitochondria was established; however, the role of mitochondrial permeability transition (MPT) remains unknown. Here we report that MPT plays an important role in the apoptosis of human hepatocellular carcinoma Hep-G2 cells induced by rhein. After adding rhein to the isolated hepatic mitochondria, swelling effects and the leakage of Ca(2+) were observed. These alterations were suppressed by cyclosporin A (CsA), an MPT inhibitor. Furthermore, in Hep-G2 cells, the decrease of ATP production, the loss of mitochondrial transmembrane potential (MTP), the release of cytochrome c (Cyto c), and the activation of caspase 3 were also observed. These toxic effects of rhein can also be attenuated by CsA as well. Moreover, TUNEL assay confirmed that in the presence of CsA, rhein-induced apoptosis was largely inhibited. These results suggest that MPT plays a critical role in the pathogenesis of Hep-G2 cell injury induced by rhein, and imply that MPT may contribute to the anti-cancer activity of rhein.

[Observation and multifactor analysis of refractory medium-severe heart failure by micro-inflammation modification in uremic patients].

OBJECTIVE: To investigate the therapeutic strategies and prognostic factors of refractory medium-severe heart failure in uremic patients. METHODS: A single center, self control clinical research was conducted, and the data consisted of 30 uremic patients with refractory medium-severe heart failure undergoing maintenance hemodialysis (MHD), who received routine combined modality therapy and Xuebijing injection (to modify micro-inflammation). The systolic function of the left ventricle was compared before and after therapy. Multiple linear regression models were established to predict the improvements of systolic function of ventricle. Relationship between the accumulated dose of Xuebijing injection and changes of C-reactive protein (ΔCRP) was observed. RESULTS: The values of left ventricle ejection fraction (LVEF), fractional shortening (FS), and stroke volume (SV) after therapy were improved compared with those before therapy [LVEF: 0.42±0.07 vs. 0.34±0.04, FS: (21.07±3.83)% vs. (16.33±2.43)%, SV: 66.83±7.00 ml vs. 52.20±7.62 ml, all P<0.01]. In terms of cardiac output (CO), there was no statistical difference before and after therapy (4.77±0.65 L/min vs. 4.49±0.68 L/min, P>0.05). In the multiple linear regression models of ΔLVEF, ΔFS and ΔSV, the independent variables that affect dependent variables included age, ΔCRP, changes of hemoglobin (ΔHb), accumulated dose of Xuebijing injection, changes of HCO(3)(-) (Δ HCO(3)(-)), changes of serum creatinine (ΔSCr), Hb and CRP after therapy, the factors and weights of which had slight variation on accordance with different dependent variables. There was significant positive correlation between accumulated dose of Xuebijing injection and ΔCRP (r=0.561, P=0.001). CONCLUSIONS: Xuebijing injection can improve heart function in uremic patients by modifying micro-inflammation, whose accumulated dose and therapeutic effect show positive correlation. In addition the improvement of heart failure has something to do with age, ΔHb, Hb after therapy, the correction of acidosis and dialysis sufficiency.

Tanshinone IIA protects rat primary hepatocytes against carbon tetrachloride toxicity via inhibiting mitochondria permeability transition.

Tanshinone IIA (Tan IIA), one of the key components of Salvia milthorrhiza Bunge (Lamiaceae), is used to treat liver disease. The present study was carried out to investigate the possible mechanisms involved in the hepatoprotective effects of Tan IIA on carbon tetrachloride (CCl(4))-induced hepatocyte toxicity. In cultures treated with 1 or 2 microM CCl(4), Tan IIA (10-75 microM) significantly increased hepatocyte survival rates. However, only at a concentration of 75 microM could Tan IIA partially reverse the CCl(4) (3 microM)-induced decrease of survival rate (34 +/- 3% vs. 18 +/- 3%, n = 8, p < 0.01). In isolated mitochondria energized with succinate, Tan IIA could inhibit the large swelling effect induced by CCl(4) (1 and 2 microM). Base on these results, Tan IIA could protect rat primary cultured hepatocytes from CCl(4)-induced toxicity partially by the inhibitory effect on the opening of mitochondrial permeability transition (MPT).

Protective activity of Jiang-Zhi-Li-Gan against carbon tetrachloride-induced hepatic injury in mice.

The administration of carbon tetrachloride (CCl(4)) to mice produced hepatotoxicity, showing a significant increase in the serum levels of alanine transaminase (ALT) and aspartate aminotransferase (AST). Mice pretreated with Jiang-Zhi-Li-Gan (JZLG, 100-900 mg/kg, p.o.), a domestic remedy for liver disease in Rui-Jin Hospital, showed a significant decrease in serum ALT and AST levels when compared to the group treated with CCl(4) alone. The standard drug, bifendate (200 mg/kg, p.o.), also exhibited similar results. In the acute toxicity study, JZLG did not show any mortality up to a dose of 32 g/kg body weight. Based on the results obtained, it can be concluded that JZLG seems to possess hepatoprotective activity in mice. These results support the use of this prescription against chemical hepatic injury.

Catalytic kinetic spectrophotometry for the determination of trace amount of oxalic acid in biological samples with oxalic acid-rhodamine B-potassium dichromate system.

A new catalytic kinetic spectrophotometric method was proposed for determining trace oxalic acid based on the catalytic effect of oxalate on the oxidation of potassium dichromate with rhodamin B in 0.10 M of sulfuric acid. Good linearity is obtained over the concentration range 0.40-6.0 microg/mL of oxalic acid. After the reactions of the catalytic and non-catalytic systems were terminated by using 2.00 mL of 4 M sodium hydroxide solution, they can be stable for 3 h at room temperature. The apparent activation energy of the catalytic reaction is 12.44 kJ/mol. The effect of 50 coexisting substances was observed. The method was used to determine trace oxalic acid in tea, spinach and urine samples with satisfactory results.