Association between sleep quality and ovarian reserve in women of reproductive age: a cross-sectional study.

OBJECTIVE: To evaluate the association between sleep quality and ovarian reserve among women of reproductive age. DESIGN: Cross-sectional study. SETTING: Not applicable. PATIENT(S): A total of 1,070 female participants aged 20-40 years enrolled from February 2023 to January 2024. INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): A questionnaire was administered to the participants to collect baseline information related to reproductive and lifestyle factors. Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. The assessment was conducted on ovarian reserve, including total antral follicle count (AFC), antimüllerian hormone (AMH) level, and basal sex hormone level. RESULT(S): The study sample of 1,070 women had a mean age of 31.67 ± 4.41 years. A total of 314 participants (29.35%) were classified under the poor sleep group (PSQI score >5). Significant differences were observed in the follicle-stimulating hormone (FSH), luteinizing hormone, estradiol, testosterone, AFC, and AMH between the two groups. The poor sleep group exhibited significantly lower levels of AMH and AFC. The FSH levels in the poor sleep group were higher. After the adjustment for confounding factors, multivariate regression analysis results indicated that the per unit increase in PSQI score was associated with increased odds of diminished ovarian reserve (adjusted odds ratio [AOR] of 1.28 for AMH <1.1 ng/mL; 95% confidence interval [CI], 1.20-1.37; AFC <7; AOR, 1.34; 95% CI, 1.25-1.43; FSH ≥10 mIU/mL; AOR, 1.16; 95% CI, 1.08-1.25; AMH <1.1 ng/mL or AFC <7 or FSH ≥10 mIU/mL; AOR, 1.29; 95% CI, 1.22-1.37). Compared with the PSQI ≤5 group, subjects with PSQI >5 had increased odds of diminished ovarian reserve (odds ratio, 3.80; 95% CI, 2.82-5.13; AOR, 4.43; 95% CI, 3.22-6.14). After stratification by age and body mass index, compared with the PSQI ≤5 group, all subgroups of the PSQI >5 group had increased odds of diminished ovarian reserve, especially <35-year-old and body mass index ≤18.4 kg/m2 subgroups. CONCLUSION(S): Poor sleep quality is associated with diminished ovarian reserve in women of reproductive age.

CYP24A1 affected macrophage polarization through degradation of vitamin D as a candidate biomarker for ovarian cancer prognosis.

Ovarian cancer (OC) is a fatal gynecological malignancy with a poor prognosis in which mitochondria-related genes are involved deeply. In this study, we aim to screen mitochondria-related genes that play a role in OC prognosis and investigate its effects. Through single-cell sequencing technology and bioinformatics analysis, including TCGA ovarian cancer data analysis, gene expression signature analysis (GES), immune infiltration analysis, Gene Ontology (GO) enrichment analysis, Gene Set Enrichment Analysis (GSEA), and Principal Component Analysis (PCA), our findings revealed that CYP24A1 regulated macrophage polarization through vitamin D (VD) degradation and served as a target gene for the second malignant subtype of OC through bioinformatics analyses. For further validation, the expression and function of CYP24A1 in OC cells was investigated. And the expression of CYP24A1 was much higher in carcinoma than in paracancerous tissue, whereas the VD content decreased in the OC cell lines with CYP24A1 overexpression. Moreover, macrophages were polarized towards M1 after the intervention of VD-treated OC cell lines and inhibited the malignant phenotypes of OC. However, the effect could be reversed by overexpressing CYP24A1, resulting in the polarization of M2 macrophages, thereby promoting tumor progression, as verified by constructing xenograft models in vitro. In conclusion, our findings suggested that CYP24A1 induced M2 macrophage polarization through interaction with VD, thus promoting the malignant progression of OC.

Inflammatory myofibroblastic tumor of the pancreatic neck: A case report and review of literature.

BACKGROUND: Pancreatic inflammatory myofibroblastic tumor (IMT) is a relatively rare disease that is often confused with pancreatic cancer or pancreatic neuroendocrine tumors. The histological features of IMTs show that tissue from this type of tumor contains an intermingling of fibroblast and myofibroblast proliferation, accompanied by a varying degree of inflammatory cell infiltration. CASE SUMMARY: The management of an IMT occurring at the neck of the pancreas is presented in this paper. A 66-year-old female patient was diagnosed with a pancreatic neck mass after a series of tests. The patient underwent enucleation of the pancreatic neck tumor after a pathological diagnosis of IMT. Previous research on the clinical features, pathological diagnosis and treatment of pancreatic IMTs was reviewed. Compared with previous reports, this is a unique case of enucleation of a pancreatic IMT. CONCLUSION: The enucleation of pancreatic IMTs may be a safe and efficient surgical method for managing such tumors with a better prognosis. Further cases are required to explore surgical measures for pancreatic IMTs.

ACE2 and TMPRSS2 Expression in Hepatocytes of Chronic HBV Infection Patients.

Background: Pre-existing liver disease is a risk factor for the worse prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We aimed to evaluate whether chronic hepatitis B (CHB) and hepatocellular carcinoma (HCC) affect the expression of viral receptor angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) in the liver. Methods: Twelve pairs of matched liver tissues of HCC and para-carcinoma were collected from the First Affiliated Hospital of Zhejiang University School of Medicine. And 20 liver biopsies from CHB patients were collected from Peking University People's Hospital. The expression of ACE2 and TMRPSS2 were detected using immunofluorescence staining, western blot, and RT-qPCR. The effects of hepatitis B virus (HBV) replication or interferon on ACE2 and TMPRSS2 expression were tested in hepatic cell lines. Results: The mRNA expression of TMPRSS2 in HCC tissues was six-fold higher than that of para-carcinoma tissues (P = 0.002), whereas that of ACE2 was not statistically different between HCC and para-carcinoma tissues. Hepatocellular ACE2 expression was detected in 35% (7/20) of CHB patients and mostly distributed in the inflammatory areas. However, there was no difference in TMPRSS2 expression between areas with or without inflammation. IFN-α2b slightly induced ACE2 expression (2.4-fold, P = 0.033) in HepG2 cells but not in Huh-7, QSG-7701, and L-02 cells. IFN-α2b did not affect TMPRSS2 expression in these cell lines. In addition, HBV replication did not alter ACE2 expression in HepAD38 cells. Conclusions: Although HBV replication does not directly affect the expression of ACE2 and TMPRSS2, intrahepatic inflammation and carcinogenesis may increase their expression in some patients, which, in turn, may facilitate SARS-CoV-2 infection in hepatocytes.