Hydrothermal carbonization of coking sludge: Formation mechanism and fuel characteristic of hydrochar.

In this study, the chemical structures, fuel characteristic, and formation mechanism of hydrochar during hydrothermal carbonization (HTC) at 150-270 °C for 0-120 min were investigated using coking sludge (CS) as the feedstock. The results showed that the yield decreased from 96.86 to 60.98%, whereas the carbonization rate increased from 6.74 to 93.41% at 270 °C. More stable structures with aromatic and N-heterocycles rings were formed through hydrolysis and polymerization. The H/C and O/C ratio decreased from 1.75 to 0.60 to 1.04 and 0.09, and the combustion stability index (Hf) decreased from 0.86 to 0.60 °C.103, and the flammability index (S) increased from 24.16 to 26.42 %/(min2 °C3) 10-8, indicating an improvement of fuel performance. A kinetic model to describe the conversion of organic components of CS was developed to elucidate the formation mechanism of hydrochar combined with the change of water-soluble intermediates (SM). The solid-solid conversion reaction of protein and humus components was the predominant hydrochar formation pathway, with an activation energy (Ea) of 26.06 kJ/mol. The polymerization of aromatic compounds slightly participated in the hydrochar formation, with an Ea of 86.12 kJ/mol. The water-soluble intermediates mostly transformed into inorganic substances (IS) through decarboxylation, deamination, or decomposition reaction, with an Ea of 5.73 kJ/mol. This study provided insights for understanding the formation of hydrochar from CS through HTC, which is vital for controlling the polymerization of intermediates and solid-solid conversion to enhance the carbonization efficiency.

Improved solid/liquid separation performance of hydrochar from sludge via hydrothermal carbonization.

A solid-liquid separation process is crucial for the utilization of hydrochar from biomasses through hydrothermal carbonization (HTC). This study aimed to evaluate the separation performance of hydrochar from coking sludge (CS) and municipal sludge (MS) via HTC and propose its mechanistic insights. The results indicated that the separation performance of hydrochar was enhanced, and relatively severe hydrothermal temperatures exerted a relatively stronger dewatering effect (53.25% and 77.05% reductions in the total water contents in CS and MS, respectively) and a superior separation efficiency (the specific resistance to filtration of products obtained from CS and MS decreased form 7.21 × 1011 and 2.46 × 1012 to 1.92 × 1010 m/kg and 2.14 × 1011 m/kg, respectively). Mechanism investigation involved analyzing the surface functional groups of hydrochar and changes in organic components. It was demonstrated that the improvement in dewatering effect predominantly resulted from the release of bound water due to the decomposition of carbohydrates and proteins. Specifically, the release of bound water depended on the decomposition of carbohydrates at 180 °C, while it relied on the decomposition of proteins in the 210-300 °C range. Compared with particle size, the hydrophilicity of the particle played a more important role in improving the separation efficiency. The HTC reaction eliminated hydrophilic groups, such as hydroxyl and carboxyl groups, and induced the formation of aromatic structures, thus reducing the hydrophilicity of hydrochar particles. Moreover, it was found that the lower heating value of hydrochar from CS and MS increased from 3.51 to 1.94 to 8.32 and 4.60 MJ/kg due to the improvement of the separation efficiency. These comprehensive findings provide valuable mechanistic insights into the solid-liquid separation process and controlling the dewaterability of hydrochar.

Effect mechanism of iron conversion on adsorption performance of hydrochar derived from coking sludge.

In this study, Fe conversion during hydrothermal carbonization (HTC) of coking sludge were investigated, and the effect mechanism of Fe component on the adsorption performance of coking sludge hydrochar (CHC) was explored. The results showed that after HTC treatment, more than 95 % of Fe remained in the CHC. Fe3+ was reduced to Fe2+ by sugar and amino acids. Fe was stabilized during the HTC process and was still predominantly in the Fe manganese oxidation state. The CHC prepared at 270 °C exhibited excellent adsorption capacities for Congo red (CR), tetracycline (TC), and Cr (VI). Their maximum adsorption capacities were 140.85, 147.06, and 19.92 mg/g, respectively. Quantitative adsorption mechanism experiments, XRD and VSM characterization revealed that Fe component played a significant role in adsorption, and CHC with more Fe3O4 exhibited better adsorption capacity. The results of the XPS characterization of CHC before and after adsorption showed that Fe3O4 provided rich Fe adsorption sites on the surface of CHC to strengthen the adsorption efficiency of pollutants through Fe3+/Fe2+ reduction and complexation of Fe-O/N. In addition, the formed Fe3O4 also imparted CHC with magnetic properties (Ms = 4.12 emu/g) to facilitate the subsequent separation and recovery. These results demonstrated that the prepared CHC has great potential for treating actual wastewater containing CR and TC.

Efficient extraction of biodiesel feedstock and dehydration of kitchen waste: A method based on co-dissolution of liquefied dimethyl ether and water.

In the context of low-carbon development, as a waste rich in lipids, kitchen waste (KW) has received increasing attention for resource utilization and low-carbon utilization. In this study, we explored a method for efficient extraction of lipids and dehydration using liquefied dimethyl ether (L-DME) to address the problem of high lipids and the difficulty of dewatering of KW. A closed DME reaction vessel was used to conduct experiments on the effects of lipids extraction and dehydration of KW under different reaction times, mass ratios, temperatures and moisture contents. It was found that DME could extract more than 90% of the lipids and the dehydration rate could reach approximately 80%. The main components of the lipids in the liquid phase extract were fatty acids (C18:2, C18:1, C16:0, and C18:0) whose good thermal properties made them suitable for use as a feedstock for biodiesel production. Moreover, the greatly increased heating value of the solid residue facilitated low-carbon utilization. This study also demonstrated a promotion effect of the co-dissolution system of L-DME and water on the extraction of lipids and explored the related mechanism.

Transformation mechanism of polycyclic aromatic hydrocarbons and hydrogen production during the gasification of coking sludge in supercritical water.

In this study, the characteristic of hydrogen production and polycyclic aromatic hydrocarbons (PAHs) transformation during supercritical water gasification (SCWG) of coking sludge (400 °C - 450 °C, 1 min-30 min) were explored. The total gas yield was between 0.62 mol/kg OM and 1.05 mol/kg OM (on dry basis), and the proportion of CH4 and H2 was only between 5.41% and 6.44%. PAH content were increased from 194.92 mg/kg to 326.04 mg/kg, and mainly high molecular weight PAHs, which were formed from the Diels-Adler reaction of single aromatic hydrocarbon and the addition reaction of low molecular weight PAHs. High reaction temperature favored more active PAH formation than reaction time. The possible control methods for PAH formation during SCWG of coking sludge was proposed. H2O2 and KOH addition effectively reduce PAHs amount in solid residues by 46.67% and 38.33%, and KOH performed positive effect on hydrogen production. The work revealed that the inhibition of PAHs and hydrogen production were achieved from SCWG of coking sludge with KOH addition.

GALNT14 regulates ferroptosis and apoptosis of ovarian cancer through the EGFR/mTOR pathway.

Background: Chemoresistance usually occurs in ovarian cancer. We aimed to explore the mechanisms of chemoresistance. Methods: Western blotting assay was used to detect the expression of GALNT14. Further cell function experiments were performed to investigate the effect of GALNT14 in ovarian cancer. Results: GALNT14 is significantly upregulated in ovarian cancer. Downregulation of GALNT14 significantly inhibits both apoptosis and ferroptosis of ovarian cancer cells. A further mechanism assay illustrated that downregulation of GALNT14 suppresses the activity of the mTOR pathway through modifying O-glycosylation of EGFR. Finally, an additive effect promoting cell death occurs with a combination of an mTOR inhibitor and cisplatin. Conclusion: Our study might provide a promising method to overcome cisplatin resistance for patients with ovarian cancer.

Mechanism of separation and removal of water from oily sludge using liquid dimethyl ether to dissolve hydrocarbons.

The effective disposal of oily sludge generated from the petroleum industry has received increasing concern. The primary difficulty for the reduction and resource utilization of oily sludge is dewatering. Therefore, finding an efficient and energy-saving dewatering technology is an urgent need for the treatment of oily sludge. In this study, an innovative developed method using liquefied dimethyl ether (L-DME) for dewatering is employed to deal with oily sludge for the first time. Oily sludge from a refinery was used to conduct experiments in sequencing dissolution-separation reactors. Changes in the dehydration rate, oil recovery, group components (hydrocarbon series of petroleum, including saturates, aromatics, resins and asphaltenes) at different extraction time, temperatures and L-DME additions were measured. The results revealed that L-DME removed 90% of the water and recovered 40% of the oil, which was an amazing dehydration effect for oily sludge. The water-binding form of oily sludge is different from sewage sludge and other biomass and the water in oily sludge is in a stable water-in-oil (W/O) suspension emulsified state. L-DME was mixed with semi-colloidal like oily sludge to break the structure of the water-in-oil emulsion, making the mixture into a solid-liquid two phase substances that were easy to separate, thus achieving a high degree of separation of water. The dissolution of saturated hydrocarbons, aromatic hydrocarbons, and small amounts of colloid by L-DME played an important auxiliary role in water removal.

Intratumoral levels and prognostic significance of Fusobacterium nucleatum in cervical carcinoma.

Growing evidence suggests that microbes can influence the onset of cancer and its consequent development. By researching samples from patients afflicted by cervical cancer, we aimed to explore the associated dynamics and prognostic value of intratumoral levels of F. nucleatum. We used qPCR to analyze tumor tissues obtained from 112 cervical cancer patients in order to characterize the levels and influences of intratumoral levels of the F. nucleatum. Especially for recurrent tissues, there was a distinct observation of higher levels of F. nucleatum in cervical cancer. Patients with high burdens of F. nucleatum intratumoral infiltration exhibited correspondingly poor rates of both overall survival and progression-free survival. Measures of the levels of F. nucleatum were found to have been reliable independent prognostic factors that could predict rates of PFS for afflicted patients (HR = 4.8, 95%CI = 1.2-18.6, P = 0.024). Notably, the levels ofF. nucleatum were positively correlated with tumor differentiation. Cancer cells from patients with relatively high levels of F. nucleatum were observed to possess the characteristics of cancer stem cells (CSCs). We propose that F. nucleatum might be one potential cervical cancer diagnostic and prognostic biomarker, and these findings will help to provide a sound rationale and merit for further study of this bacterium.

Association between small intestinal bacterial overgrowth and beta-cell function of type 2 diabetes.

AIMS: Previous studies suggest that small intestinal bacterial overgrowth (SIBO) is associated with type 2 diabetes. However, few studies have evaluated the association between SIBO and beta-cell function in type 2 diabetes. The aim of this study was to evaluate whether beta-cell function was associated with SIBO. MATERIALS AND METHODS: One hundred four patients with type 2 diabetes were included in this study. Based on the presence of SIBO, the patients were divided into SIBO-positive and SIBO-negative groups. Oral glucose tolerance tests were performed. Insulin sensitivity was measured using 1/homeostasis model assessment of insulin resistance (1/HOMA-IR) and the insulin sensitivity index (ISIM). Insulin release was calculated by HOMA-ß, early-phase insulin secretion index InsAUC30/GluAUC30, and total-phase insulin secretion index InsAUC120/GluAUC120. RESULTS: Compared with the SIBO-negative group, patients in the SIBO-positive group showed a higher glucose level at 120 minutes, HbA1c, 1/HOMA-IR, and ISIM and a lower HOMA-ß level, early-phase InsAUC30/GluAUC30, and total-phase InsAUC120/GluAUC120. Multiple linear regression analysis showed that body mass index, glucose at 0 minutes, and SIBO were independently associated with the early-phase and total-phase insulin secretion. CONCLUSION: SIBO may be involved in lower levels of insulin release and worse glycemic control.

Compound Danshen Dripping Pills Prevented Leptin Deficiency-Induced Hepatic ER Stress, Stimulated Autophagy, and Improved Insulin Resistance of ob/ob Mice.

Compound Danshen dripping pills (CDDP) is widely used for the treatment of coronary arteriosclerosis and ischemic heart diseases for decades of years. In our study, we interestingly discovered the effects and mechanism of CDDP on insulin resistance that increase the risk factor of cardiovascular diseases. Effects of CDDP on fasting blood glucose, the insulin tolerance test (ITT), the oral glucose tolerance test (OGTT), hepatic function, and underlying mechanism were analyzed in ob/ob mice. CDDP was found improving the impaired insulin signal sensitivity of ob/ob mice by ameliorating insulin and glucose tolerance, improving hepatic phosphorylation of the insulin receptor substrate-1 on Ser 307 (pIRS1) of ob/ob mice, and restoring hepatic function by decreasing serum ALT and AST, which increased in ob/ob mice serum. Decreasing hepatic phosphorylation of pancreatic ER kinase (PERK) and inositol-requiring enzyme-1 (IRE1) regulating hepatic ER stress in the liver of ob/ob mice were increased by CDDP. Furthermore, CDDP was also found stimulating ob/ob mice hepatic autophagy by increasing the expression of Beclin1 and LC3B, while decreasing P62 expression. Our study discovered an important role of CDDP on improving ob/ob mice insulin resistance and liver function probably through relieving hepatic ER stress and stimulating hepatic autophagy, which would broaden the application value and provide more benefits for treating cardiovascular patients. This trial is registered with NCT01659580.

Salvianolic acid B improved insulin resistance through suppression of hepatic ER stress in ob/ob mice.

Impaired insulin sensitivity of insulin-sensitive tissues plays a major role in the pathogenesis of type 2 diabetes, salvianolic acid B (SalB), a natural antioxidant usually treated various cardiovascular diseases was also reported potential utility on diabetes and dyslipidemia. Based on these, we aimed to explored whether the antioxidant effect of SalB play a pivotal role in the molecular mechanisms leading to insulin resistance. We found that SalB improved glucose tolerance and insulin sensitivity, decreased serum ALT, AST and ALP levels of ob/ob mice. Also, transcription of Bip and CHOP, phosphorylation of PERK and IRE1 for endoplasmic reticulum stress (ER) and phosphorylation of IRS-1 for insulin sensitivity in the liver of ob/ob mice were relieved by SalB. Further, SalB decreased phosphorylation of PERK, IRE1 and IRS1 and transcription of Bip and CHOP stimulated by palmitate of hepatic cells HL7702, but did not reversed phosphorylation of JNK and IRS1 and transcription of Bip and CHOP when ER stress was stimulated by tunicamycin. These data shows that SalB improved insulin resistance of ob/ob mice through suppression of hepatic ER stress.

Mechanism of separation and removal of water from dewatered sludge using L-DME to dissolve hydrophilic organic matter.

Difficulties in advanced dewatering of dewatered sludge hinder sludge reduction and resource utilization. L-DME (liquified dimethyl ether) has been recently used for dewatering, but the effect of organic matter dissolution using L-DME during desorption and dehydration on water removal is not clear. In this study, dewatered sludge from urban sewage treatment plants was used to conduct experiments in sequencing dissolution-separation reactors. The changes in the dehydration rate, bound water and various organic matter levels at different times, L-DME additions, and the temperature were measured. The results show that L-DME can remove 90% of water, 100% of lipids, and 8-12% of organic matter in dewatered sludge. L-DME was mixed with the semi-like colloidal sludge, and high separation of water was achieved by mixing the L-DME with water and dissolving the hydrophilic organic matter to convert the solid-like into a two-phase (solid and liquid) substance, which can be easily separated. The dissolution of hydrophilic organic matter such as polysaccharides and proteins by L-DME promotes the conversion of bound water into free water, which is key to total water removal.

Intravenous leiomyomatosis with different surgical approaches: Three case reports.

BACKGROUND: Intravenous leiomyomatosis (IVL) is a rare and complicated disease, which requires surgery by a multidisciplinary team. However, the optimal surgical approach has not been determined. CASE SUMMARY: Here we report three cases of IVL treated with different surgical approaches. All patients presented with circulation symptoms. Two patients had lower extremity edema and the other had cardiopalmus. The diagnosis of IVL was confirmed based on the imagining examinations and pathological findings. All patients underwent surgical treatment and were discharged without any complications. CONCLUSION: Preoperative examination is crucial for surgical planning and surgical approach is dependent on the patient's condition and tumor involvement.

Clinical analysis of modified laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse / 中国实用妇科与产科杂志

OBJECTIVE: To explore clinical effectiveness of modified laparoscopic sacrocolpopexy by using double-mesh in the treatment of pelvic organ prolapse.METHODS: A retrospective analysis was conducted in 61 patients with pelvic organ prolapse who received LSC from September 1,2012 to September 30,2017.Among 61 patients,32 cases received modified LSC(modified group)and 29 cases received traditional Y-mesh LSC(traditional group).The intraoperative and postoperative parameters were compared between the two groups and the improvement in subjective symptoms was evaluated by using the simple questionnaire(PFIQ-7)and subjective cure rate was assessed.RESULTS: The difference was of statistical significance in operation time[(127.34+7.88)min vs.(143.28+15.38)min]between the modified group and the traditional group(P0.05).The median follow-up time of 61 patients was 28 months.In the modified group and traditional group,the objective cure rates were 96.86% and 89.65%,respectively.After operation each indicator point was recovered anatomically according to POP-Q,and there was statistical difference compared with before operation.The score of postoperative PFIQ-7 was obviously reduced compared to the preoperative parameter.The subjective cure rates of the modified group and traditional group were 100% and 94.74%,respectively.There was no new complications occurring in the modified group.There were 3 cases of postoperative mesh exposure in the traditional group.The symptoms of urinary incontinence disappeared after TVT-O in both groups.Two new cases of urinary incontinence occured in both groups after surgery.CONCLUSION: Both of the two operations for pelvic organ prolapse are safe and effective.The modified LSC is an alternative surgical option for ptatients with pelvic organ prolapse because of its advantages,such as simpler operation,shorter operation time,and fewer longterm complications.

Inhibition of SphK2 Stimulated Hepatic Gluconeogenesis Associated with Dephosphorylation and Deacetylation of STAT3.

BACKGROUND: Sphingosine kinase (SphK) is considered as a potential target for developing novel therapeutics of cancer and other diseases including diabetes. As the major SphK isoform in the liver, much less is known the role of SphK2 involved in regulating hepatic glucose metabolism. METHOD: In this study, RNA interference, real time RT-PCR, western blot and immunoprecipitation method was used to investigate the regulation of SphK2 in hepatic glucose metabolism. RESULTS: Both siRNA and SphK2 inhibitor ABC294640 stimulated expression of gluconeogenetic gene PEPCK and G6Pase but not enzymes of hepatic glycogenolysis, glycolysis and glycogen synthesis. Inhibition of SphK2 also prevented insulin repressed PEPCK and G6Pase expression as well as glucose production levels. Furtherly, inhibition of SphK2 inactivated STAT3 by decreasing both phosphorylation on Tyr705 and acetylation on lysine residue, and led to stimulation of PEPCK and G6Pase expression. Inhibition of SphK2 also prevented IL-6 dependent activation of STAT3 and suppression of PEPCK and G6pase expression both in vitro and in vivo. CONCLUSION: Our study suggests that SphK2 participates in hepatic glucose metabolism related to activation of STAT3.

3-(2-amino-ethyl)-5-[3-(4-butoxyl-phenyl)-propylidene]-thiazolidine-2,4-dione (K145) ameliorated dexamethasone induced hepatic gluconeogenesis through activation of Akt/FoxO1 pathway.

3-(2-amino-ethyl)-5-[3-(4-butoxyl-phenyl)-propylidene]-thiazolidine-2,4-dione (K145) is identified as a selective SphK2 inhibitor. It was previously reported as an anti-tumor agent, in this study we demonstrated that K145 was able to regulate hepatic gluconeogenesis and improve glucose intolerance in mice. C57BL/6 mice treated with dexamethasone injection were used as experimental animals, which exhibited impaired glucose tolerance and increased gluconeogenetic enzymes. After K145 treatment, we found that the impairment of glucose tolerance and gluconeogenetic genes mRNA expression were improved. Besides, both in vivo and in votro studies suggested that K145 stimulated insulin dependent Akt phosphorylation and subsequently activates FoxO1 phosphorylation therefore inhibited gluconeogenetic genes expression including PEPCK and G6pase. Our study figures out a potential extent increase the value of developing K145 as therapeutic candidate for diabetes.

The value of hysteroscopic management of cesarean scar pregnancy: a report of 44 cases.

OBJECTIVE: With the incidence of cesarean scar pregnancy (CSP) rising, the reports of serious adverse outcomes of it have increased gradually. The management of CSP remains an inadequately explored clinical field, and there is no consensus on it presently. The present study was performed to investigate the efficacy and safety of operative hysteroscopy in the diagnosis and treatment of CSP. MATERIALS AND METHODS: Forty-four patients with CSP underwent operative hysteroscopy for removal of scar ectopic pregnancy in our institution. Among them, hysteroscopy was combined with laparoscopy in two patients, three cases with massive hemorrhage were pretreated with bilateral uterine artery embolization before hysteroscopic surgery, and four patients were pretreated with mifepristone (200 mg for 3 days) and methotrexate (25 mg for 2 days). Clinical data, serum ß-human chorionic gonadotropin, myometrial thickness, residual conceptus, cesarean scar defect, operation time, blood loss, and hospital stay were recorded. RESULTS: All of the ectopic gestations were removed entirely by operative hysteroscopy. Mean operation time was 34.8±16.5 minutes (range 20-120 minutes), and mean blood loss was 35.3±24.4 mL (range 5-100 mL). The mean hospital stay was 5.0±3.01 days (range 1-19 days). Cesarean scar defect could be diagnosed in 70% (31/44) of patients, while in 20/32 cases (63%), a conceptus remained after uterine curettage only was performed. CONCLUSION: Operative hysteroscopy might be recommended as a first-line treatment modality for patients with a cesarean scar ectopic pregnancy, especially when myometrium thickness between bladder and gestational sac is more than 3 mm.

Assessment of the relationship between non-alcoholic fatty liver disease and diabetic complications.

AIMS/INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is a metabolic disorder of the liver. The relationship between NAFLD and type 2 diabetes remains largely unknown. The aim of the present study was to determine the incidence of complications arising from the interaction between NAFLD and type 2 diabetes. MATERIALS AND METHODS: A total of 212 individuals with type 2 diabetes were included in the study. The presence of NAFLD was determined in individuals using abdominal ultrasonography for the diagnosis of fatty liver disease. Patients were divided into three groups based on the duration of diabetes and NAFLD diagnosis. Type 2 diabetes patients were placed in group A; patients with type 2 diabetes longer than NAFLD were placed in group B; and patients with NAFLD longer than type 2 diabetes were placed in group C. All individuals had undergone electrocardiogram, blood pressure measurements, and thorough medical history and physical examinations (Doppler ultrasound, electrophysiology, fundoscopy, cardiac computed tomography). Laboratory measurements included fasting blood glucose, glycated hemoglobin, oral glucose tolerance test, liver and renal function, lipid profile, and urinary albumin excretion. RESULTS: Compared with groups A and B, the patients of group C showed a higher prevalence of significant coronary artery disease and hypertension (P < 0.05). Compared with groups A and B, the patients of group C showed a lower prevalence of diabetic retinopathy and diabetic peripheral neuropathy (P < 0.05). There was no significant difference in the prevalence of diabetic nephropathy among the three groups (P > 0.05). CONCLUSIONS: NAFLD combined with type 2 diabetes is associated with the presence of significant coronary artery disease and hypertension.

Treatment of Early Stage Endometrial Cancer by Transumbilical Laparoendoscopic Single-Site Surgery Versus Traditional Laparoscopic Surgery: A Comparison Study.

To compare the outcomes of transumbilical laparoendoscopic single-site surgery (TU-LESS) versus traditional laparoscopic surgery (TLS) for early stage endometrial cancer (EC).We retrospectively reviewed the medical records of patients with early stage EC who were surgically treated by TU-LESS or TLS between 2011 and 2014 in a tertiary care teaching hospital. We identified 18 EC patients who underwent TU-LESS. Propensity score matching was used to match this group with 18 EC patients who underwent TLS.All patients underwent laparoscopic-assisted vaginal hysterectomy, bilateral salpingo-oophorectomy, and systematic pelvic lymphadenectomy by TU-LESS or TLS without conversion to laparoscopy or laparotomy. Number of pelvic lymph nodes retrieved, operative time and estimated blood loss were comparable between 2 groups. Satisfaction values of the cosmetic outcome evaluated by the patient at day 30 after surgery were significantly higher in TU-LESS group than that in TLS group (9.6 ±â€Š0.8 vs 7.5 ±â€Š0.7, P < 0.001), while there was no statistical difference in postoperative complications within 30 days after surgery, postoperative hospital stay, and hospital cost.For the surgical management of early stage EC, TU-LESS may be a feasible alternative approach to TLS, with comparable short-term surgical outcomes and superior cosmetic outcome. Future large-scale prospective studies are needed to identify these benefits.

[Longitudinal analysis of vaginal microbiota in women with recurrent vulvovaginal candidiasis].

OBJECTIVE: To investigate the vaginal flora in patients with recurrent vulvovaginal candidiasis (RVVC). METHODS: Vaginal swabs were collected at different time points from 6 RVVC patients and 5 healthy women of child-bearing age. The dynamic changes, microbiota composition, alpha diversity and beta diversity in the two groups were assessed by analyzing the 16S rRNA V4 hypervariable region amplified from the total genomic DNA from the swabs. RESULTS: Lactobacillus was the predominant species in healthy women with similar proportions of L.iners and L.crispatus; small proportions of Gardnerella, Prevotella and other genus were also detected. In some healthy women, the vaginal flora showed a high relative abundance of anaerobic bacteria such as Gardnerella, Prevotella, Atopobium, Sneathia. Compared with the healthy women, patients with RVVC showed a significantly reduced diversity of vaginal flora, where L.iners was the predominant species and the content of L.crispatus decreased significantly. In healthy women, the vaginal flora fluctuated with the menstrual cycle, and the fluctuation was the most prominent during menstruation; the dominant species either alternated regularly or maintain an absolute superiority in the menstrual cycle. The vaginal flora showed attenuated fluctuation in women with RVVC, were highly conserved within the menstrual cycle, and maintained a similar composition in the episodes and intermittent periods. CONCLUSION: The vaginal flora of RVVC patients do not undergo regular variations with the menstrual cycle and shows a similar composition between the episodes and intermittent periods. Promoting the production of L.iners or inhibiting the colonization of L.crispatus to restore the composition of the vaginal flora may help in the treatment of RVVC.