The role of the left dorsolateral prefrontal cortex in conflict control during insomnia disorder.

BACKGROUND: Patients with insomnia are often accompanied by cognitive dysfunction, which seriously affects the quality of life of patients. Repetitive transcranial magnetic stimulation (rTMS) can induce brain neuroplasticity, regulate brain cognitive function and inhibitory control ability. OBJECTIVE: To explore the intervention effect of rTMS on conflict control and sleep quality in patients with insomnia. METHODS: In this single-blind, randomized controlled trial, 39 people with insomnia disorder were randomly divided into real stimulation group and sham stimulation group. The stimulation parameters were stimulation frequency 1 Hz, stimulation intensity 80 % resting motor threshold (RMT), total pulse number 1500 times, time 25 min, and the whole course of treatment lasted 7 days. The Insomnia Severity Index(ISI)、Pittsburgh Sleep Quality Index(PSQI)、Multidimensional Fatigue Inventory(MFI) and Beck Anxiety Inventory(BAI) were assessed at pretest (baseline) and posttest (day 7 after intervention), and the color-word stroop task was used to measure the conflict control ability of the subjects. RESULTS: The sleep quality, correct rate and reaction time of the posttest in the real stimulus group were higher than those in the pretest. However, there was no significant difference between the pretest and posttest in the sham stimulation group. CONCLUSIONS: rTMS stimulation of the left dorsolateral prefrontal cortex (LDLPFC) in patients with insomnia can significantly improve the conflict control ability and sleep quality of patients with insomnia.

A study of application effects of next-generation sequencing based preimplantation genetic testing for aneuploidies in advanced maternal age women.

OBJECTIVE: To investigate if next-generation sequencing-based preimplantation genetic testing for aneuploidies could improve pregnancy outcomes in women of advanced maternal age. MATERIALS AND METHODS: A retrospective analysis. The clinical data of 1099 couples treated in the First Medical Center of the Chinese PLA General Hospital from January 2019 to December 2021 were analyzed. They were divided into two groups based on whether they underwent a Next-generation sequencing-based preimplantation genetic test for aneuploidies. We analyzed and compared the biochemical pregnancy rate, clinical pregnancy rate, abortion rate, and live birth rate between the two groups. RESULTS: The Preimplantation genetic testing for aneuploidies (PGT-A) group was associated with higher rate of biochemical pregnancy and clinical pregnancy than the non-PGT-A group, which were 63.9% vs. 56.4% (P = 0.009) and 54.4% vs. 45.6% (P < 0.001), respectively. The abortion rate was significantly lower in the PGT-A group compared to the non-PGT-A group (2.3% vs. 14.7%, P < 0.001). In addition, the live birth rate was significantly higher in the PGT-A group compared to the non-PGT-A group (52.1% and 30.9%, respectively, P < 0.001). CONCLUSION: Next-generation sequencing-based preimplantation genetic testing for aneuploidies significantly improved the pregnancy outcomes in women of advanced maternal age.

Single-cell sequencing of immune cells after marathon and symptom-limited cardiopulmonary exercise.

Vigorous-intensity leisure-time physical activity, such as marathon, has become increasingly popular, but its effect on immune functions and health is poorly understood. Here, we performed scRNA-seq analysis of peripheral blood mononuclear cells (PBMCs) after a bout of symptom-limited cardiopulmonary exercise (CPX) test or marathon. Time-series single-cell analysis revealed the detailed series of landscapes of immune cells in response to short and long vigorous-intensity activities. Reduction of effective T cells was observed with the cell migration and motility pathways enriched in circulation following marathon. Baseline values of PBMCs abundance were reached around 1 h after CPX and 24 h following marathon, but longer time was required for expression recovery of cytotoxicity genes. The ratio of effector/naive T cells was found to change uniformly among the participants and could serve as a better indicator for exercise intensity than the CD4+/CD8+ T cell ratio. Moreover, we identified time-dependent monocyte state transitions after marathon.

Artificial intelligence-assisted smartphone-based sensing for bioanalytical applications: A review.

Artificial intelligence (AI) has received great attention since the concept was proposed, and it has developed rapidly in recent years with applications in many fields. Meanwhile, newer iterations of smartphone hardware technologies which have excellent data processing capabilities have leveraged on AI capabilities. Based on the desirability for portable detection, researchers have been investigating intelligent analysis by combining smartphones with AI algorithms. Various examples of the application of AI algorithm-based smartphone detection and analysis have been developed. In this review, we give an overview of this field, with a particular focus on bioanalytical detection applications. The applications are presented in terms of hardware design, software algorithms, and specific application areas. We also discuss the existing limitations of AI-based smartphone detection and analytical approaches, and their future prospects. The take-home message of our review is that the application of AI in the field of detection analysis is restricted by the limitations of the smartphone's hardware as well as the model building of AI for detection targets with insufficient data. Nevertheless, at this juncture, while bioanalytical diagnostics and health monitoring have set the pace for AI-based smartphone applicability, the future should see the technology making greater inroads into other fields. In relation to the latter, it is likely that the ordinary or average person will play a greater participatory role.

Clinical Application of Double Ovulation Stimulation in Patients with Diminished Ovarian Reserve and Asynchronous Follicular Development Undergoing Assisted Reproduction Technology.

OBJECTIVE: This study aimed to compare the clinical effects of double ovulation stimulation (DouStim) applied during the follicular and luteal phases with the antagonist protocol in patients with diminished ovarian reserve (DOR) and asynchronous follicular development undergoing assisted reproductive technology (ART). METHODS: The clinical data of patients with DOR and asynchronous follicular development receiving ART from January 2020 to December 2021 were retrospectively analyzed. The patients were divided into two groups according to their ovulation stimulation protocol: DouStim group (n=30) and antagonist group (n=62). Assisted reproduction and clinical pregnancy outcomes were compared between the two groups. RESULTS: In the DouStim group, the number of oocytes retrieved, metaphase II (MII) oocytes, two-pronuclei (2PN), day 3 (D3) embryos, D3 high-quality embryos as well as blastocyst formation, implantation, and human chorionic gonadotropin-positive rates were significantly greater than those in the antagonist group (all P<0.05). No significant differences were found in MII, fertilization, or continued pregnancy rates at the first frozen embryo transfer (FET), in-vitro fertilization (IVF) cancellation, or early medical abortion rates between the groups (all P>0.05). Except for the early medical abortion rate, the DouStim group generally had favorable outcomes. In the DouStim group, the dosage and duration of gonadotropin and the fertilization rate were significantly greater in the first ovulation stimulation induction than in the second ovulation stimulation induction (P<0.05). CONCLUSION: The DouStim protocol efficiently and economically obtained more mature oocytes and high-quality embryos for patients with DOR and asynchronous follicular development.

Zinc Alters the Supramolecular Organization of Nucleic Acid Complexes with Full-Length TIA1.

T-Cell Intracellular Antigen-1 (TIA1) is a 43 kDa multi-domain RNA-binding protein involved in stress granule formation during eukaryotic stress response, and has been implicated in neurodegenerative diseases including Welander distal myopathy and amyotrophic lateral sclerosis. TIA1 contains three RNA recognition motifs (RRMs), which are capable of binding nucleic acids and a C-terminal Q/N-rich prion-related domain (PRD) which has been variously described as intrinsically disordered or prion inducing and is believed to play a role in promoting liquid-liquid phase separation connected with the assembly of stress granule formation. Motivated by the fact that our prior work shows RRMs 2 and 3 are well-ordered in an oligomeric full-length form, while RRM1 and the PRD appear to phase separate, the present work addresses whether the oligomeric form is functional and competent for binding, and probes the consequences of nucleic acid binding for oligomerization and protein conformation change. New SSNMR data show that ssDNA binds to full-length oligomeric TIA1 primarily at the RRM2 domain, but also weakly at the RRM3 domain, and Zn 2+ binds primarily to RRM3. Binding of Zn 2+ and DNA was reversible for the full-length wild type oligomeric form, and did not lead to formation of amyloid fibrils, despite the presence of the C-terminal prion-related domain. While TIA1:DNA complexes appear as long "daisy chained" structures, the addition of Zn 2+ caused the structures to collapse. We surmise that this points to a regulatory role for Zn 2+ . By occupying various "half" binding sites on RRM3 Zn 2+ may shift the nucleic acid binding off RRM3 and onto RRM2. More importantly, the use of different half sites on different monomers may introduce a mesh of crosslinks in the supramolecular complex rendering it compact and markedly reducing the access to the nucleic acids (including transcripts) from solution.

In-Memory Tactile Sensor with Tunable Steep-Slope Region for Low-Artifact and Real-Time Perception of Mechanical Signals.

A tactile sensor needs to perceive static pressures and dynamic forces in real-time with high accuracy for early diagnosis of diseases and development of intelligent medical prosthetics. However, biomechanical and external mechanical signals are always aliased (including variable physiological and pathological events and motion artifacts), bringing great challenges to precise identification of the signals of interest (SOI). Although the existing signal segmentation methods can extract SOI and remove artifacts by blind source separation and/or additional filters, they may restrict the recognizable patterns of the device, and even cause signal distortion. Herein, an in-memory tactile sensor (IMT) with a dynamically adjustable steep-slope region (SSR) and nanocavity-induced nonvolatility (retention time >1000 s) is proposed on the basis of a machano-gated transistor, which directly transduces the tactile stimuli to various dope states of the channel. The programmable SSR endows the sensor with a critical window of responsiveness, realizing the perception of signals on demand. Owing to the nonvolatility of the sensor, the mapping of mechanical cues with high spatiotemporal accuracy and associative learning between two physical inputs are realized, contributing to the accurate assessment of the tissue health status and ultralow-power (about 25.1 µW) identification of an occasionally occurring tremor.

Prevalence and Potential Risk Factors for Occupational Low Back Pain Among Male Military Pilots: A Study Based on Questionnaire and Physical Function Assessment.

Objectives: Low back pain (LBP) has negative implications for the military's combat effectiveness. This study was conducted to determine the prevalence and risk factors of LBP among pilots through a questionnaire and physical function assessments. Methods: Data on the demographic and occupational characteristics, health habits, physical activity, and musculoskeletal injuries of 217 male pilots (114 fighter, 48 helicopter, and 55 transport pilots) were collected using a self-reported questionnaire and physical function assessments. Results: LBP prevalence was 37.8% in the total cohort and 36.0, 45.8, and 34.5% among fighter, helicopter, and transport pilots, respectively. Multivariate regression analysis revealed that the risk factors significantly associated with LBP were neck pain [odds ratio (OR): 3.559, 95% confidence interval (CI): 1.827-6.934], transversus abdominis activation (OR: 0.346, 95% CI: 0.172-0.698), and hip external rotator strength (OR: 0.001, 95% CI: 0.000-0.563) in the total cohort; neck pain (OR: 3.586, 95% CI: 1.365-9.418), transversus abdominis activation (OR: 0.268, 95% CI: 0.094-0.765), hip external rotator strength (OR: 0.000, 95% CI: 0.000-0.949), and weekly flying hours (OR: 3.889, 95% CI: 1.490-10.149) in fighter pilots; irregular strength training (OR: 0.036, 95% CI: 0.003-0.507) and hip external rotator strength (OR: 0.000, 95% CI: 0.000-0.042) in helicopter pilots; and neck pain (OR: 6.417, 95% CI: 1.424-28.909) in transport pilots. Conclusions: High volume flight schedules and weak core muscle functions have significant negative effects on pilots' back health. LBP is commonly associated with high weekly flying hours, worsening neck pain, transversus abdominis insufficient activation, and reduced hip extensor/rotator strength. Risk factors vary among pilots of different aircraft. Thus, specific core muscle training would be especially important for military pilots.

Micellar TIA1 with folded RNA binding domains as a model for reversible stress granule formation.

TIA1, a protein critical for eukaryotic stress response and stress granule formation, is structurally characterized in full-length form. TIA1 contains three RNA recognition motifs (RRMs) and a C-terminal low-complexity domain, sometimes referred to as a "prion-related domain" or associated with amyloid formation. Under mild conditions, full-length (fl) mouse TIA1 spontaneously oligomerizes to form a metastable colloid-like suspension. RRM2 and RRM3, known to be critical for function, are folded similarly in excised domains and this oligomeric form of apo fl TIA1, based on NMR chemical shifts. By contrast, the termini were not detected by NMR and are unlikely to be amyloid-like. We were able to assign the NMR shifts with the aid of previously assigned solution-state shifts for the RRM2,3 isolated domains and homology modeling. We present a micellar model of fl TIA1 wherein RRM2 and RRM3 are colocalized, ordered, hydrated, and available for nucleotide binding. At the same time, the termini are disordered and phase separated, reminiscent of stress granule substructure or nanoscale liquid droplets.

A Gas Leakage Localization Method Based on a Virtual Ultrasonic Sensor Array.

In traditional sensory array-based acoustic emission methods that are used for gas leakage localization, the localization resolution depends on the spatial aperture of the array, that is, the number of sensors. Most of the existing methods use small arrays that can only achieve low-resolution localization results because of limitations such as the amplitude and phase consistency, the complexity and cost of the system. This paper reports the first application of a virtual phased array for gas leakage detection to obtain high-resolution localization results. This method uses a virtual linear ultrasonic sensor array composed of only two sensors to acquire leakage signals. Then, we use the virtual beamforming algorithm based on the cross-power spectrum to estimate the location of the leakage source. Several experiments were conducted to evaluate the effectiveness and operability of the proposed method. The impacts of various factors on the performance of the localization technique are compared and discussed, including factors such as the number of sensors and the distance between the leak hole and virtual array. The results demonstrate that the proposed method accurately and reliably localizes gas leakages.

Diagnosis and surgical therapy of the retroperitoneal ectopic pregnancy: A case report.

INTRODUCTION: Retroperitoneal ectopic pregnancy (REP) is a rare type of gestation that is difficult to diagnose and treat. To date, only several published cases are available and no specific guideline has been developed to manage this disease. As the lesions are located closely to the large retroperitoneal blood vessels, surgical resection of the gestational tissue might incur risks such as associated hemorrhage, injury of blood vessels or nerves. On the other hand, the therapeutic effect of conservative treatment using methotrexate is not satisfactory. PRESENTATION OF CASE: A case of retroperitoneal ectopic pregnancy which was diagnosed in the PLA general hospital was reported here. A 34-year-old woman, gravida 2, parturition 0, was admitted via the emergency department on July 7, 2015 with the main complaint of missed period for 52 days and bellyache for 16 h. DISCUSSION: The mechanisms of retroperitoneal embryo migration and related literatures are reviewed and discussed. CONCLUSION: We have presented a scarce case of REP. As the ectopic pregnancy could not be readily detected by laparotomy, unusual locations such as the retroperitoneum should be carefully examined.

Target-induced cyclic DNAzyme formation for colorimetric and chemiluminescence imaging assay of protein biomarkers.

A target-induced cyclic strategy for DNAzyme formation was proposed to achieve simple, sensitive and universal detection of protein biomarkers with convenient colorimetric or chemiluminescence imaging readout. In the assay, the target protein was recognized by a pair of DNA-labeled antibodies (Ab1-DNA1 and Ab2-DNA2) to form a proximate complex, which could hybridize with the conjugate DNA3/DNA4 to release the guanine-rich DNA4 and thus formed G-quadruplex/hemin horseradish peroxidase-mimicking DNAzyme. The process could be further recycled with Exonuclease III by cleaving DNA3 to free the proximate complex, resulting in the cyclic formation of DNAzyme. The G-quadruplex/hemin DNAzyme could catalyze the H2O2-mediated oxidation of 3,3,5,5-tetramethylbenzidine to produce the color change from colorless to blue or enhance the chemiluminescence of a luminol-H2O2 system. Thus the signal could be read out with the naked eye, and by colorimetry and chemiluminescence imaging. Using a carcinoembryonic antigen as a model target, the proposed assay showed a detection range of 4 orders of magnitude along with detection limits of 170 and 16 pg mL-1 for colorimetric and chemiluminescence imaging assays respectively. This assay had the advantages of easy operation, sensitive detection, target flexibility and diversified signal readout, providing a great opportunity for commercial application.

The clinical outcomes of vaginoplasty using tissue-engineered biomaterial mesh in patients with Mayer-Rokitansky-Küster-Hauser syndrome.

OBJECTIVE: The aim of the study is to evaluate the clinical outcomes of vaginoplasty using tissue-engineered biomaterial mesh in the patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. PATIENTS AND METHODS: Patients with MRKH syndrome underwent the vaginoplasty using tissue-engineered biomaterial mesh between January 2006 and August 2014 in PLA general hospital. We analyzed the anatomic results and collected the standardized FSFI (Female Sexual Function Index) questionnaire from each patient. RESULTS: Totally forty patients with MRKH syndrome were enrolled in the present study. The surgical procedures were performed without any major complication except that intraoperative bladder injury occurred in one case and was repaired successfully. The mean duration of surgery was 85.3 min (SD = 8.7), the mean blood loss was 58.7 ml (SD = 36.5). The mean hospital stay after surgery was 8.8 days (SD = 4.7). Three monthes after surgery, superduper mucosa was found in the neovagina of all enrolled patients. Twelve weeks after surgery, a satisfactory vaginal length of at least 9 cm was attained in all patients, and vaginal cross-sectional diameter more than 2 cm. The scar contracture, necrosis or rejection did not occurred in any patient. The anatomic success rate was 100%. All these sexually active patients answered the FSFI questionnaire and completed all the 19 items in the questionnaire. The mean total FSFI score of these patients was 25.2. CONCLUSIONS: The vaginoplasty using tissue-engineered biomaterial mesh procedure can act as a safe and effective surgical strategy for patients with MRKH syndrome. However, larger scale studies with longer follow-up profiles are needed to justify its widespread utilization.

Effects of anti-CD44 monoclonal antibody IM7 carried with chitosan polylactic acid-coated nano-particles on the treatment of ovarian cancer.

Failure in early diagnosis and ineffective treatment are the major causes of ovarian cancer mortality. Hyaluronan and its receptor, cluster of differentiation (CD)44, have been considered to be valid targets for treating cancer. The anti-CD44 monoclonal antibody IM7 is effective in treating ovarian cancer; however, its toxicity should not be ignored. The present study has developed a new drug carrier system composed of chitosan nano-particles coated with polylactic acid (PLA) to improve the treatment efficacy and reduce toxicity. An ionic crosslinking method and 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride/N-hydroxysuccinimide were used to prepare the IM7 antibody, which was loaded with chitosan nano-particles. The surfaces of the nano-particles were coated with PLA to generate PLA-chitosan-IM7. Subsequently, transmission electron microscopy (TEM) was used to observe the size and zeta potential of the nano-particles. In addition, a spectrophotometer was used to calculate the loading rate and release rate of the nano-particles in acidic and neutral environments. MTT assay was used to evaluate the anti-proliferative effect of PLA-chitosan-IM7 on the human ovarian cancer cell line HO-8910PM. In addition, an in vivo imaging system was used to further investigate the effect of PLA-chitosan-IM7 on the treatment of mice with ovarian cancer. A total of 35 days subsequent to PLA-chitosan-IM7 treatment, all animals were sacrificed by CO2, and the tumors were removed and weighted. The PLA-chitosan-IM7 nano-particles were successfully prepared, since TEM revealed that their size was 300-400 nm and their zeta potential was +25 mV. According to the spectrophotometry results, the loading rate was 52%, and PLA-chitosan-IM7 exhibited good resistance to acids. MTT assay demonstrated that PLA-chitosan-IM7 could suppress the proliferation of HO-8910PM cells in vitro. The in vivo imaging system revealed that PLA-chitosan-IM7 was effective in controlling the development of human ovarian cancer cells and the tumor weight. These results suggest that PLA-chitosan-IM7 could be effective in treating cancers in vitro and in vivo, which may provide a novel approach to enhance the effectiveness of anti-CD44 treatment while reducing its toxicity.

Long-term results of robotic sacral hysteropexy for pelvic organ prolapse in China Single medical center.

OBJECTIVE: To evaluate the long-time clinical outcomes of robotic sacral hysteropexy for pelvic organ prolapse (POP). METHODS: Five women who underwent robotic sacral hysteropexy for the treatment for POP. Blood loss, operative time, length of stay, blood transfusion, pulmonary embolus, gastrointestinal or genitourinary tract injury, ileus, bowel obstruction, post-operative fever, and urinary retention were recorded for all patients. RESULTS: All the operative procedures were successfully performed using the robotic approach. In one case with perineal laceration, perineal repair was simultaneously performed, and in one patient with combined leiomyoma, myomectomy was performed first. The other three cases underwent no additional procedures during the surgery. Neither intra-nor post-operative complications occurred in all 5 cases. After follow-up one year, all patients declared their satisfaction with the achieved anatomical and functional results. CONCLUSIONS: The robotic sacral hysteropexy is a minimally invasive technique for POP repair. We found low complication rates and high patient satisfaction with a minimum of 1 year followup. Larger series with longer follow-up data are needed to justify its widespread use.

Clinical efficacy and safety of laparoscopic nerve-sparing radical hysterectomy for locally advanced cervical cancer.

OBJECTIVE: To evaluate the feasibility and safety of laparoscopic nerve-sparing radical hysterectomy (LNRH) for locally advanced cervical cancer (LACC) after neoadjuvant chemotherapy (NACT). METHODS: 120 patients with stage Ib2 and IIa2 cervical cancer were treated with surgery combined with preoperative NACT in the Department of Obstetrics and Gynecology, PLA General Hospital. Eligible patients were divided into two groups according to surgery type: patients who underwent LNRH were assigned to one group, while the second group included patients who underwent laparoscopic radical hysterectomy (LRH) after administration of NACT. We compared these patients' general clinical information and surgical characteristics, and we assessed their bladder function and intestinal function recovery by questionnaire. RESULTS: No significant differences were found between the groups in patients' age or surgical characteristics. The mean duration of postoperative catheterization in the LNRH group was shorter than in the LRH group (P < 0.001). The intestinal and bladder function of patients in the LNRH group also recovered better than that of patients in the LRH group. CONCLUSION: LNRH is a feasible and safe procedure for LACC after NACT and reduces surgical complications.

[Robotic surgery in the management of early ovarian malignancy tumors].

OBJECTIVE: To apply robotic surgery of early ovarian malignancy tumors clinically and evaluate its feasibility in management for early ovarian cancer. METHODS: Using the da Vinci robotic surgical system, seven patients with early ovarian malignancy tumors (stage I) underwent robotic surgery from April 2012 to September 2013. The average age was 45.7 years. Robotic surgeries approaches contained salpingo-oophorectomy, para-aortic lymphadenectomy, pelvic lymphadenectomy, omentectomy and appendectomy. Perioperative and follow-up clinical data were recorded. RESULTS: All robotic surgeries were successfully completed without the conversion to laparotomy. The mean operative time was 225 minutes (100-330 minutes). The average estimated blood loss was 171 ml (20-600 ml). No patients received blood transfusions. No intraoperative and postoperative complications were observed. The average number of pelvic lymph node dissected were 18.3 (11-34). The average number of para-aortic lymph node dissected were 3.7 (3-4). The mean follow-up time was 26.0 months after surgery (20-36 months). Currently, all patients had no tumor recurrence and survived. CONCLUSION: Robotic surgery is feasible as a novel alternative approach in the treatment of early ovarian malignancy tumors.

Robotic nerve-sparing radical hysterectomy for locally advanced cervical cancer after neoadjuvant chemotherapy.

OBJECTIVE: To evaluate the feasibility and safety of robotic nerve-sparing radical hysterectomy for locally advanced cervical cancer (LACC). METHODS: In a retrospective study, data were analyzed for patients treated for cervical cancer at a center in Beijing, China, between December 2011 and September 2013. Patients were subdivided into those with early-stage disease (FIGO stage IA2-IB1) who were treated by robotic surgery (group 1), and those with LACC (stage IB2-IIB) who were treated by robotic surgery after neoadjuvant chemotherapy (NACT; group 2). Therapeutic outcomes and complications were compared. RESULTS: Group 1 included 32 patients and group 2 included 22 patients. Two patients in group 2 did not respond to NACT and did not undergo surgery. The operative outcomes and incidences of complications did not differ significantly between the two groups (P>0.05 for all). There were no differences in nodal yield, lengths of parametrium removed, or vaginal cuff length (P>0.05 for all). During a mean follow-up of 26months, no patient experienced recurrence. CONCLUSION: Robotic nerve-sparing radical hysterectomy was found to be feasible and safe for LACC after NACT. A larger case series with longer follow-up data is needed to justify its widespread application.

[Preliminary study on clinical application of robotic sacral hysteropexy in treatment of uterine prolapse].

OBJECTIVE: To study the clinical efficacy of robotic sacral hysteropexy in treatment of uterine prolapse. METHODS: From January 2012 to December 2013, 3 patients undergoing robotic sacral hysteropexy in treatment of uterine prolapse in General Hospital of People's Liberation Army were studied retrospectively. Operation time, blood loss and postoperative recovery exhaust time and pelvic organ prolapse quantification (POP-Q) staging were evaluated. RESULTS: Three patients were treated by robotic sacral hysteropexy successfully. The mean operation time was 221 minutes (210-240 minutes), mean blood loss was 45 ml. One case with II degree perineal laceration patients simultaneously perineal repair, neither intra-nor post-operative complications occurred. The mean postoperative recovery exhaust time was 16 hours. At three months of follow-up, all 3 patients got satisfaction. Although one patient at the first six months of postoperation had leakage of urine when coughing, instruct exercise pelvic floor muscle function and acupuncture one month their symptoms disappear. CONCLUSION: Robotic sacral hysteropexy pave the way for an effective option in the management of uterine prolapse.

ARHI overexpression induces epithelial ovarian cancer cell apoptosis and excessive autophagy.

OBJECTIVE: ARHI is a maternally imprinted tumor suppressor gene that is responsible for initiating programmed cell death and inhibiting cancer cell growth. However, the influence of ARHI on epithelial ovarian cancer cell death and the underlying mechanisms behind how ARHI regulates cancer cells still require further studies. METHODS: Epithelial ovarian cancer cells TOV112D and ES-2 were used in this in vitro study. Cell proliferation, apoptosis, and autophagy activities were compared in TOV112D and ES-2 cells transfected with ARHI vectors or control vectors. Bcl-2 siRNA was transfected into TOV112D cells to investigate the roles of Bcl-2 played in regulating apoptosis and autophagy. RESULTS: ARHI expression was reduced in TOV112D and ES-2 cells compared with normal epithelial ovarian cells (NOE095 and HOSEpiC). Overexpressed ARHI inhibited cancer cell proliferation, whereas induced forced cell apoptosis and excessive formation of autophagosomes inhibited promoted cell death. Furthermore, we found that Bcl-2 expression moderately declined in response to ARHI overexpressing in ES-2 and TOV112D cells; meanwhile, more apoptotic cells and higher LC3 level presented after silence of Bcl-2 in TOV112D cells. Reduced Bcl-2-Beclin 1 complex were observed in ARHI overexpressing cells. Moreover, modulation of ARHI to Bcl-2 expression could be ascribed partially to the activation of PI3k/AKT pathway. The addition of LY294002 enabled to suppress Bcl-2 expression and cell proliferation. CONCLUSIONS: The silence of ARHI expression in vitro seems to accelerate the malignant transformation of healthy ovarian cells by restraining apoptosis and autophagy. The overexpressed ARHI in TOV112D cancer cells suppresses the activation of PI3K/AKT and reduces the expression of Bcl-2, leading to enhanced cell apoptosis and autophagic cancer cell death.