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With the postponement of female reproductive age and the higher incidence of cancer in young people, fertility preservation has become increasingly important in childbearing age. Chemotherapy during pregnancy is crucial for maternal cancer treatments and fetal outcomes. It is a need to further study ovarian damage caused by chemotherapy drug combinations and long-term effects on offspring development, and a detailed understanding of side effects of chemotherapy drugs. In this study, chemotherapy drug combinations significantly impacted on ovarian function, especially epirubicin/cyclophosphamide (EC) combination led to an unbalance in the development of the left and right ovary. Exposure to EC and cisplatin/paclitaxel (TP) increased the number of progenitor follicles while decreased the count of antral follicles and corpora luteum. As to the estrus cycle, EC exposure resulted in a longer estrus period and diestrus period, while TP exposure only extended the diestrus period. EC and TP affected steroid biosynthesis by reducing the expression of SF1 and P450arom.γ-H2AX was detected in both EC and TP exposure groups. As to the impact on the offspring from 4T1 tumor-bearing pregnant mice injected with EC, no significant difference was observed in the physical and neurological development compared to the control, but the ovarian weights, estrus cycles of the offspring were significantly different. Chemotherapy drug combinations exhibit ovarian toxicity, not only causing direct damage on the follicle cells but also disrupting steroid biosynthesis. The reproductive system of offspring from maternal tumor-bearing mice exposed to chemotherapy drugs was observed disorder, but the concrete mechanism still needs further exploration.
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The synergistic responses of O3 and PM2.5 to their common precursors remain unclear within industrial cities with complex emissions. In this study, hundreds of scenarios of jointly reduced local NOx and VOCs emissions were designed along with the source apportionment techniques embedded in the Comprehensive Air quality Model with extensions (CAMx) system to explore the locally formed O3 and PM2.5 sensitivities to the reduced emissions of NOx and VOCs. The results indicate that locally formed O3 and PM2.5 are more connected to local emissions, resulting in unique formation sensitivities. Local O3 formation is usually in a transitional regime and transferred to VOC-limited condition under O3-polluted conditions due to high VOC emissions. Locally formed O3 and PM2.5 vary largely in different functional regions due to different emission feature and meteorological condition. When reducing VOCs emissions alone, an increase in PM2.5 formation could be observed due to the increase in the formation of nitrate resulting from reduced competition of NOx in O3 formation. To reduce PM2.5 and O3 concentrations simultaneously, specific ratios of NOx reduction percentage to VOC reduction percentage should be considered to different functional regions under different pollution levels. This research highlights the importance to conduct targeted sensitivity tests for emission reduction in different functional zones with complex emission features for the coordinated control of O3 and PM2.5 pollution in typical industrialized cities.
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Peatland wildfires contribute significantly to the atmospheric release of light-absorbing organic carbon, often referred to as brown carbon. In this study, we examine the presence of nitrogen-containing organic compounds (NOCs) within marine aerosols across the Western Pacific Ocean, which are influenced by peatland fires from Southeast Asia. Employing ultrahigh-resolution Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS) in electrospray ionization (ESI) positive mode, we discovered that NOCs are predominantly composed of reduced nitrogenous bases, including CHN+ and CHON+ groups. Notably, the count of NOC formulas experiences a marked increase within plumes from peatland wildfires compared to those found in typical marine air masses. These NOCs, often identified as N-heterocyclic alkaloids, serve as potential light-absorbing chromophores. Furthermore, many NOCs demonstrate pyrolytic stability, engage in a variety of substitution reactions, and display enhanced hydrophilic properties, attributed to chemical processes such as methoxylation, hydroxylation, methylation, and hydrogenation that occur during emission and subsequent atmospheric aging. During the daytime atmospheric transport, aging of aromatic N-heterocyclic compounds, particularly in aliphatic amines prone to oxidation and reactions with amine, was observed. The findings underscore the critical role of peatland wildfires in augmenting nitrogen-containing organics in marine aerosols, underscoring the need for in-depth research into their effects on marine ecosystems and regional climatic conditions.
Subject(s)
Aerosols , Nitrogen/analysis , Organic Chemicals/analysis , Wildfires , Pacific OceanABSTRACT
Developing advanced underwater welding technology for titanium, which is the key structural material for underwater applications, is of great significance for the design, fabrication, and maintenance of submarine equipment. In this study, in order to investigate the underwater welding microstructure and mechanical properties of Ti-4Al-2V alloy, underwater wet laser welding was conducted on Ti-4Al-2V alloy using varying laser power. The microstructure and properties of the welding joints were characterized and analyzed. The microstructure of the heat-affected zone and fusion zone in the welding joints are not significantly different from those of welding in air, but a mixed oxide layer composed of Al2O3 and TiO2 is formed on the surface of the fusion zone. Due to internal stress, a large number of cracks initiate on the oxide layer and propagate to the joints. In the 4 kW and 5 kW joints, a penetrating crack formed due to the excessive accumulation of internal stress breaking up the α phase. The mechanical properties of the joints are significantly affected by the laser power. The tensile strength of the 3 kW and 4 kW joints is comparable to that of the base metal, which is about 600 MPa, while the 5 kW joint shows brittle fracture with no plastic deformation and 228 MPa strength. This research lays a solid foundation for understanding the underwater wet laser welding behavior of titanium alloys.
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OBJECTIVE: The study aimed to review the oncological characteristics and treatment of pregnancy-associated cancers and analyze the obstetric and neonatal outcomes to provide evidence-based recommendations for reproductive function preservation, oncological treatment, and obstetric management. METHODS: We conducted an observational retrospective cohort study among pregnant patients with cancer in 7 Chinese tertiary A hospitals from 2003 to 2021. We conducted multiple logistic regression to determine the influence of various factors on preterm birth and small-for-gestational-age infants, log-binomial regression to analyze temporal changes, and χ² tests to explore the effects of cancer type/treatment. RESULTS: Of 204 women, 17% terminated their pregnancies; 59% received pre-delivery treatment. Every 6 years, the rates of pregnancy termination (relative risk [RR]=0.48; 95% confidence interval [CI]=0.35-0.67) and iatrogenic preterm births (RR=0.73; 95% CI=0.54-0.98) reduced, and that of pre-delivery treatment increased, mainly due to increased rates of surgery (RR=1.87; 95% CI=1.31-2.67). Maternal systemic diseases were related to small-for-gestational-age infants (odds ratio [OR]=12.02; 95% CI=1.82-79.43). Chemotherapy with taxanes plus platinum-based agents was related to adverse obstetric outcomes (OR=1.87; 95% CI=1.42-2.46; p<0.05). Thyroid (OR=0.36; 95% CI=0.22-0.57) and ovarian cancer (OR=0.70; 95% CI=0.50-0.98) were associated with fewer cesarean sections. Thyroid cancer was associated with fetal growth restriction (OR=5.21; 95% CI=1.21-22.55). CONCLUSION: Rates of pregnancy termination in cancer declined. Taxane plus platinum-based chemotherapy was associated with adverse obstetric outcomes. Cancer type influenced outcomes. TRIAL REGISTRATION: Chinese Clinical Trial Register Identifier: ChiCTR2100044292.
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Objective: Urinary tract infection (UTI) is common in pregnant women. The selection of anti-infection plans during pregnancy must take into account the dual factors of patient pregnancy status and urinary tract infection anti-infection treatment, as well as the efficacy, cost, risk, and potential adverse reactions associated with each method applied to individual patients. Consequently, there are numerous drugs from which to choose; presently, there is no unified conclusion regarding the choice of drug therapy, and there is a lack of long-term drug treatment for UTI during pregnancy. Our objective is to investigate the actual drug treatment patterns of UTI patients during pregnancy in China over the past 5 years, with a particular emphasis on the trend and rationality of antibiotic use in these patients over the past 5 years. Method: We conducted a cross-sectional analysis of data from a China Medical Association-supervised hospital prescription analysis cooperation initiative. From January 2018 to December 2022, the information is extracted from prescriptions/medical orders of patients with UTI during pregnancy. Using a primary anatomical therapeutic chemistry (ATC) classification code and the US Food and Drug Administration (FDA) classification, we quantified the frequency of drug use and drug types. We also calculated the prevalence of the most frequently prescribed antibacterial medications and assessed the efficacy of anti-infection plans based on drug labels and guidelines. Results: Among the 563 patients included in this research, Chengdu (36.59%), Guangzhou (27.72%), and Shanghai (8.70%) were the top three cities. Over the course of 5 years, the average age was 29.60% ± 6.59 years, with approximately 60.21% of women between the ages of 25 and 34. Each patient's primary anti-infection medications were statistically analyzed. Cephalosporins (403, 71.58%), enzyme inhibitors (66, 11.72%), and penicillins (34, 6.04%) were the first few categories, followed by the most commonly used cephalosporins. Cefuroxime, ceftriaxone, and cefdinib, rounded out the top five. Cefoxitin and cefaclor. According to the 5-year change in dosage, cephalosporins have always ranked first. Three of the top five most expensive drugs are cephalosporins, carbapenems, and enzyme inhibitors. Teicoplanin, tigecycline, nifurtel, linezolid, and quinolones ranked among the top five in terms of per-patient drug costs for patients receiving comprehensive treatment drugs. Conclusion: In the 5 years of research, the average age of patients who visit a doctor has not increased substantially, but the opportunity cost of female fertility has increased, which has severely impeded the fulfillment of fertility desires. The selection of medications is generally reasonable, and the dosage of the first-line cephalosporins recommended by the guidelines is relatively high in this study. The dosage of furantoin and fosfomycin, which are more prevalent in urinary tract infections, is however relatively low. In addition, some expensive pharmaceuticals may increase patients' financial burden. On the premise of meeting clinical needs, future research will focus on how to further improve the level of rational drug use in outpatient clinics, attain economical, safe, and effective drug use, and thus reduce the economic burden on patients.
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Glucose detection with small and micro volume sampling has recently received increasing attention in monitoring personal health. Herein, a cauliflower-type cluster of Cu2O nanoparticles (NPs) was directly deposited on the tip surface of a stainless steel acupuncture needle electrode (ANE) by electrochemical deposition, and then this pre-formed cuprous basis was used to further prepare the neatly arranged CoCu-layered double hydroxide (CoCu-LDH) nanosheets that interconnected to form nano-sized pores in the range from 100 to 500 nm. The microstructure and spectral characteristics of the surface modification materials were comprehensively characterized by FE-SEM, EDS, XRD, FT-IR and TEM. Cu2O-based CoCu-LDH composites with special morphology had been proven to accelerate the rate of electron transport and provide more available active centers, and moreover, the mixed valence of Cu/Co induced an excellent synergism for the electrocatalytic oxidation of glucose. As a result, CoCu-LDH/Cu2O/ANE as a sensitive glucose probe exhibited two wider linear ranges of 0.03-0.40 mM and 0.40-6.00 mM, with sensitivities of 116.13 µA mM-1 and 52.08 µA mM-1, respectively, and the detection limit as low as 0.46 µM (S/N = 3). The response time only took 3 s and it kept working stably in the interference of ascorbic acid (AA), dopamine (DA), uric acid (UA), and Cl-. In the stability test, the CoCu-LDH/Cu2O/ANE sensor exhibited a stable monitoring sensitivity after 15 days. Finally, the CoCu-LDH/Cu2O/ANE sensor had been successfully applied to glucose analysis in human serum, proving that our design was an attractive strategy for developing a portable, minimally invasive, and low-cost non-enzymatic electrochemical glucose sensing platform.
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The relationship between single nucleotide polymorphisms (SNPs) at various loci and adverse drug reactions (ADRs) in patients with gynecologic cancer receiving platinum-based chemotherapy (PPCT) remains unexplored. This research aimed to investigate the correlation between SNPs at several loci (e.g., GSTP1 rs1695, MTHFR rs1801133, XPC rs2228001, TP53 rs1042522, and ERCC1 rs3212986) and ADRs in patients with gynecologic cancer receiving PPCT. A total of 244 patients with gynecologic cancer who received first-line PPCT were included in this retrospective study. Blood fluorescence quantitative polymerase chain reaction was used to detect genotypes. Logistic regression, Pearson's Chi-square test, and Fisher's exact test were used to explore the correlations between these SNPs and the occurrence of ADRs. The logistic regression results showed that different genotypes of the five genes had no statistical significance in the overall grade greater than or equal to 3 ADRs. The results of Pearson's Chi-square test showed the same results. On specific adverse reactions, we found that the rs1042522 GG genotype significantly increased the risk of grade greater than or equal to 3 leucopenia compared with the CG and the CC genotypes (p = 0.002). The rs1695 AG genotype showed higher correlation for grade greater than or equal to 3 neutropenia (p = 0.020). The rs2228001 CC genotype also had a higher risk for grade greater than or equal to 3 neutropenia (p = 0.003). This study found that whereas the overall grade greater than or equal to 3 adverse reactions in patients with gynecologic cancer receiving PPCT were not associated with SNPs, specific SNPs (rs1042522 GG, rs1695 AG, and rs2228001 CC) were linked to higher risks of leucopenia and neutropenia, indicating their potential as predictors of hematotoxicity in PPCT-treated patients with gynecologic cancer.
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Neoplasms , Neutropenia , Humans , Female , Platinum/adverse effects , Retrospective Studies , Genotype , Polymorphism, Single Nucleotide/geneticsABSTRACT
Objectives: The goal of our study is to analyze the effectiveness and role of clinical pharmacists in antibiotic management through retrospective research from 2011 to 2021, depending on the current scenario of the antibiotic application in China. Methods: We formed a team of pharmacists to carry out multifaceted intervention measures, such as forming a working group, developing a plan, establishing management rules via the pre-trial system, prescription comments, collaborating with the administrative department, implementing training and publicity, and so on. Antibiotic use was studied, bacterial drug resistance was determined, and antibiotic costs were computed. Results: The pharmacist intervention and rectification of inappropriate antibacterial drug orders considerably enhanced the rational use rate of antibiotics and reduced the cost of antibiotics. Antibiotic use in clean surgery decreased from 90.22% to 11.14%, the use rate of antibiotics decreased from 63.82% to 30.26%, and antibiotic use intensity decreased from 42.75DDDs to 30.04DDDs. The types, timing, and course of antibacterials used in wards were all improved to varying degrees. Bacterial drug resistance improved noticeably, with resistance of Escherichia coli to cephalosporins, ciprofloxacin and carbapenems decreased in varying degrees. The use of antibacterial drugs has decreased significantly. Conclusions: It is feasible and effective for pharmacists in gynecology and obstetrics to control antibiotic use, which plays a positive role in promoting the safe, effective, and cost-effective use of antibiotics and serves as a valuable reference for the antibiotic management.
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OBJECTIVES: Metformin is associated with osteoblastogenesis and osteoclastogenesis. This study aims to investigate the impacts of metformin therapy on bone mineral density (BMD) and bone turnover markers. DESIGN: Systematic review and meta-analysis of randomised controlled trials. METHODS: Searches were carried out in PubMed, EMBASE, Web of science, Cochrane library, ClinicalTrials.gov from database inception to 26 September 2022. Two review authors assessed trial eligibility in accordance with established inclusion criteria. The risk of bias was assessed using the Cochrane Risk of Bias tool (RoB V.2.0). Data analysis was conducted with Stata Statistical Software V.16.0 and Review Manager Software V.5.3. RESULTS: A total of 15 studies with 3394 participants were identified for the present meta-analysis. Our pooled results indicated that metformin had no statistically significant effects on BMD at lumbar spine (SMD=-0.05, 95% CI=-0.19 to 0.09, p=0.47, participants=810; studies=7), at femoral (MD=-0.01 g/cm2, 95% CI=-0.04 to 0.01 g/cm2, p=0.25, participants=601; studies=3) and at hip (MD=0.01 g/cm2, 95% CI=-0.02 to 0.03 g/cm2, p=0.56, participants=634; studies=4). Metformin did not lead to significant change in osteocalcin, osteoprotegerin and bone alkaline phosphatase. Metformin induced decreases in N-terminal propeptide of type I procollagen (MD=-6.09 µg/L, 95% CI=-9.38 to -2.81 µg/L, p=0.0003, participants=2316; studies=7) and C-terminal telopeptide of type I collagen (MD=-55.80 ng/L, 95% CI=-97.33 to -14.26 ng/L, p=0.008, participants=2325; studies=7). CONCLUSION: This meta-analysis indicated that metformin had no significant effect on BMD. Metformin decreased some bone turnover markers as N-terminal propeptide of type I procollagen and C-terminal telopeptide of type I collagen. But the outcomes should be interpreted with caution due to several limitations.
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Bone Density , Metformin , Humans , Metformin/pharmacology , Lumbar Vertebrae , Bone RemodelingABSTRACT
Previous studies have demonstrated that oxytocin was a viable therapy option for postpartum depression. However, the role remains controversial. To evaluate the efficacy of oxytocin on women postpartum depression, we searched PubMed, Web of Science, Cochrane Library, and EmBase for literatures from inception of the database to April 18th, 2022. Randomized controlled trials (RCTs) that investigated the effects of oxytocin on postpartum depression were selected for this study. Six RCTs (195 women) were gathered. The effects of oxytocin were roughly divided into emotion and cognition. The modulation of oxytocin to women's emotion was demonstrated in four of the trials. The results were conflicting: One trial showed that oxytocin alleviated the depressive mood; two trials showed that oxytocin had no effect (but reduce negative thoughts in healthy mothers, or decrease the narcissistic trait); another trial showed that oxytocin aggravated depression. Women's cognition was shown to be regulated by oxytocin in four of the trials. In general, oxytocin enhanced postpartum depressive women's perception of their relationship with the infants. This systematic review showed that the effect of oxytocin on postpartum depression is still uncertain. We partly support that exogenous oxytocin might improve the cognition of women with postpartum depression to their infants, while the effect on emotion is still controversial. Further RCTs with larger samples and more diversified evaluation criteria are needed to better reveal its efficacy on postpartum depression.
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PURPOSE: To investigate the prognostic value of N6-methyladenosine (m6A)-, 5-methylcytosine (m5C)-, and N1-methyladenosine (m1A)-related genes in cervical cancer (CESC) and predicting immunotherapy response. METHODS: We downloaded cervical cancer mRNA expression profiles, clinical data, and m6A, m5C, m1A-related genes from public databases, and subjected them to serial bioinformatics analysis and clinical sample validation. RESULTS: Differential analysis revealed 106 methylation-related differential genes (MEDs), including 44 differentially downregulated and 62 upregulated genes. We then obtained methylation models containing 10 genes by univariate and multifactorial COX analysis. High risk genes with HR > 1 include IQGAP3, PTBP1, STAC3, CUX1, SLC2A1, and CA2, and low risk genes with HR < 1 include IGBP1, DUOX1, CHAF1A, and STAC3. We verified the accuracy of the model from inside TCGA and outside GSE39001 (AUC = 0.729). K-M analysis showed shorter survival times in the High-risk group, and Immunocytic infiltration analysis showed model genes closely associated with six immune cells. The high-risk group may benefit more effectively from immunosuppressive therapy, especially anti-CTLA-4 therapy (p < .05). We also screened nine drugs for potential treatment and verified the expression of three key genes SLC2A1, CUX1, and CA2 using immunohistochemistry and RT-qPCR experiments with clinical samples. CONCLUSION: We identified a prognostic model using m6A/m5C/m1A-related genes in cervical cancer, which can predict survival time and correlate with immune cell infiltration. Additionally, anti-CTLA-4 may be used as an immunotherapeutic agent for cervical cancer.KEY MESSAGESCervical cancer still has a high mortality rate, we aim to establish a strong prognostic index and new treatment goals for improving patient survival.The role of three types of RNA methylation modifications, m6A, m5C, and m1A, in cervical cancer, remains unknown. Therefore, it is essential to explore the potential molecular mechanisms of m6A, m5C, and m1A methylation regulation in cervical cancer.We also screened nine drugs for potential treatment and anti-CTLA-4 may be used as an immunotherapeutic agent for cervical cancer. We verified the expression of three key genes SLC2A1, CUX1, and CA2.
Subject(s)
Uterine Cervical Neoplasms , Humans , Female , Methylation , Uterine Cervical Neoplasms/genetics , Uterine Cervical Neoplasms/therapy , Prognosis , Immunotherapy , RNA , Heterogeneous-Nuclear Ribonucleoproteins , Polypyrimidine Tract-Binding Protein , GTPase-Activating ProteinsABSTRACT
Background: Traditional medicine is a common treatment option for endometrioid-related symptoms. In the past few decades, Guixiong Xiaoyi formula has been widely used as a traditional medicine for the treatment of endometriosis. Purpose: This study aimed to prepare compound Angelica Ligusticum wallichii granule (CALG) by modern technological methods and to study its pharmacodynamics and mechanisms of treating endometriosis. Methods: The ingredients of CALG were determined by UPLC-Q-TOF/MS. Target prediction of compounds and diseases was performed using databases, and the mechanisms of CALG were predicted by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes and verified by molecular docking. Furthermore, a rat model of endometriosis was established to study the effects of CALG on endometriosis in vivo. Results: CALG with good specificity, durability, and stability was obtained following a detailed preparation process and quality control standard. Using network systems pharmacology, 109 chemical compositions and 104 core targets were identified for the treatment of endometriosis. The composition-target-channel-disease network topology analysis of the top 15 chemical compositions of CALG showed that the beneficial effect of CALG on endometriosis was attributed to phenolic compounds. In addition, CALG treatment reduced the volume of ectopic uterine lesions, promoted apoptosis, inhibited the secretion of inflammatory cytokines, and increased HIF-1 expression in rats with endometriosis. Conclusion: CALG induces apoptosis and inhibits inflammation and is a promising drug for the treatment of endometriosis.
Subject(s)
Angelica , Drugs, Chinese Herbal , Endometriosis , Ligusticum , Female , Humans , Animals , Rats , Molecular Docking Simulation , Endometriosis/drug therapy , Network Pharmacology , Anti-Inflammatory Agents/pharmacology , Drugs, Chinese Herbal/pharmacology , Medicine, Chinese TraditionalABSTRACT
Organic nitrogen (ON) is an important participant in the Earth's N cycle. Previous studies have shown that penguin feces add an abundance of nutrients including N to the soil, significantly changing the eco-environment in ice-free areas in Antarctica. To explore the molecular transformation of ON in penguin guano-affected soil, we collected guano-free weathered soil, modern guano-affected soil from penguin colonies, ancient guano-affected soil from abandoned penguin colonies, and penguin feces from the Ross Sea region, Antarctica, and Fourier transform ion cyclotron mass spectrometry (FT-ICR MS) was used to investigate the chemical composition of water-extractable ON. By comparing the molecular compositions of ON among different samples, we found that the number of ON compounds (>4,000) in weathered soil is minimal, while carboxylic-rich alicyclic-like molecules (CRAM-like) are dominant. Penguin feces adds ON into the soil with > 10,000 CHON, CHONS and CHN compounds, including CRAM-like, lipid-like, aliphatic/ peptide-like molecules and amines in the guano-affected soil. After the input of penguin feces, macromolecules continue to degrade, and other ON compounds tend to be oxidized into relatively stable CRAM-like molecules, this is an important transformation process of ON in guano-affected soils. We conclude the roles of various forms of ON in the N cycle are complex and diverse. Combined with previous studies, ON eventually turns into inorganic N and is lost from the soil. The lost N ultimately returns to the ocean and the food web, thus completing the N cycle. Our study preliminarily reveals the molecular transformation of ON in penguin guano-affected soil and is important for understanding the N cycle in Antarctica.
Subject(s)
Spheniscidae , Humans , Animals , Nitrogen , Antarctic Regions , Soil/chemistry , AminesABSTRACT
As a direct reflection of the interaction between the stirring tool and the base metal in the friction stir welding process, the force signal is an important means to characterize welding quality. In this paper, the variation mechanism of three-dimensional force and its relation with welding quality were explored. The acquired signals were subject to interference from high-frequency noise, so mean filtering and variational mode decomposition were applied to obtain the real signals. The denoised signals were analyzed and the results showed that the traverse force was ahead of the lateral force by a ratio of π /4, while the phase difference between the axial force and the other two forces changed with the process parameters. Through application of the least square method and polynomial fitting, the empirical formulas of three-dimensional force were obtained, and these were applicable regardless of tunnel defects. The minimum value of the lateral force increased several times more than that of traverse force when the welding speed increased from 80 mm/min to 240 mm/min. When the pole radiuses of most data points had a value greater than 4, tunnel defects were highly likely to generate. In order to predict welding quality more accurately, a prediction model based on long short-term memory was constructed. The model recognized the various modes of good welds and tunnel defects with 100% accuracy. The identification ability for large and small defects was relatively poor, and the average accuracy of classifying the three categories of welding quality was 84.67%.
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Background: Pharmacotherapy is one of the primary treatments for patients with Assisted reproductive technology (ART). Despite the publication of various research on ART treatment, there is no clear conclusion regarding the choice of drug treatment in China. Our research intends to examine the trend of widely prescribed medications for ART patients in China. For instance, the study examines the logic of drug indications, usage, and dose in patient prescriptions. Methods: We did a cross-sectional study of the data from the hospital prescription analysis cooperation project supervised by the China Medical Association. The information is extracted from the prescriptions of reproductive assistance outpatients from January 2016 to December 2020. We used the U.S. Food and Drug Administration (FDA) classification to quantify the frequency of drug use and the categories of drugs. We manually extract the information of patients who require ART treatment, divide the patients into various age groups and geographies, followed by study the indications, utilization, and rationale of the most important therapeutic medications. Results: Among the 225225 patients included in this study, Guangzhou (47.83%), Shanghai (19.84%), and Zhengzhou (9.36%) were the top three cities. In the past 5 years, the average age was 32.99, and 60.38% of women were between the age of 25 and 34. The main therapeutic medicines taken by each patient, primarily hormone therapies, were tallied. Eleven types of primary therapeutic medicines were employed. Different progesterone preparations (47472, 21.08%), chorionic gonadotrophin gondotrophin for injection (38932, 17.29%), dydrogesterone tables (33591, 14.91%), and triptorelin for injection (26959, 11.97%) rounded out the top five. According to the data on outpatient medications in major cities in China, the variety and proportion of injections are the highest, including the most frequent types of ovulation induction and urotropia, as well as triptorelin and progesterone. Even though the total dosage of urotropin was the highest in 5 years, it showed a declining trend. The dosages of progesterone and didroxyprogesterone increased, with progesterone showing the most rapid increase. The top five most expensive prescription medications are triptorelin, urotropin, progesterone, didroxyprogesterone, and leuprorelin, in that order. Goserelin, leuprorelin, triptorelin, growth hormone, and didroxyprogesterone are among the top five most expensive medications per capita. Conclusion: The average age of patients has not increased considerably over the past 5 years. However, the opportunity cost of childbirth for women has increased, which has significantly enhanced their willingness for childbearing intentions. The medication selection is reasonable overall. In this study, the recommended dosages of first-line medicines (urotropin and chorionic gonadotropin) are likewise high. In contrast, the dosage of oral first-line treatment for ovarian stimulation in unexplained infertility is modest, and the dosage of progesterone is steadily increasing. In addition, the price of certain medicines is high, which will increase the patients' financial burden. Future research will focus on enhancing the degree of rational drug use among outpatients and realizing the economical, safe, and effective use of pharmaceuticals to lessen the economic burden of patients.
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Postpartum Depression (PPD) is a serious psychiatric disorder of women within the first year after delivery. It grievously damages women's physical and mental health. Inflammatory reaction theory is well-established in depression, and also has been reported associated with PPD. This review summarized the inflammatory pathophysiological mechanisms implicated in PPD, including decreased T cell activation, increased proinflammatory cytokines secretion, active kynurenine pathway, and initiated NLRP3 inflammasome. Clinical and preclinical research are both gathered. Potential therapeutical alternatives targeting the inflammatory mechanisms of PPD were introduced. In addition, this review briefly discussed the differences of inflammatory mechanisms between PPD and depression. The research of inflammation in PPD is limited and seems just embarking, which indicates the direction we can further study. As a variety of risky factors contribute to PPD collectively, therapy for women with PPD should be comprehensive, and clinical heterogeneity should be taken into consideration. As PPD has a predictability, early clinical screening and interventions are also needed. This review aims to help readers better understand the inflammatory pathological mechanisms in PPD, so as to identify biomarkers and potential therapeutic targets in the future.
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Research on the mechanism and new targets of ovarian cancer is of great significance to reduce the high mortality and drug resistance of ovarian cancer. Human La protein has been found to be highly expressed in a variety of malignant tumors and plays a role in tumorigenesis and development through its RNA-binding function. However, its role and mechanism in ovarian cancer are not completely clear. The present study showed that La protein was highly expressed in serum and tissues of patients with ovarian cancer by ELISA and immunohistochemistry, and the high expression of La protein was associated with the increased degree of malignancy and poor prognosis by searching the KM plotter database. Interference of the La gene resulted in a significant decrease in the proliferation, migration, and invasion of ovarian cancer cells with growth block in the G1 phase and increasing apoptosis. By RNA binding protein immunoprecipitation, transcriptome sequencing, and proteomics, 14 downstream target genes were screened. The La protein might affect the protein expression of these 14 genes by binding with the mRNAs. Therefore, it played a role in the pathological process of ovarian cancer.
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Background: Circulating methionine components have been reported to be associated with Alzheimer's disease (AD) and mild cognitive impairment (MCI), although outcomes are not always consistent. Materials and methods: Database searching was conducted using PubMed, Embase, Cochrane Library, and Web of Science from inception to 26 December 2021. In this study, two reviewers independently identified eligible articles and extracted the data. We used Joanna Briggs Institute (JBI) Critical Appraisal tools to assess the overall quality of the included studies. STATA software was employed to perform meta-analysis evaluating the standardized mean difference (SMD) with its 95% confidence intervals (CIs) using random-effects models. Evidence quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Results: Totally, 30 observational studies were eligible for inclusion. Compared with cognitively normal controls, patients with AD had increased homocysteine (Hcy) levels in the blood [standardized mean difference (SMD) = 0.59, 95% confidence interval [CI]: 0.36-0.82, P = 0.000], plasma (SMD = 0.39, 95% CI: 0.23-0.55, P = 0.000), and serum (SMD = 1.56, 95% CI: 0.59-2.95, P = 0.002). Patients with MCI were not significantly different from controls (SMD = 0.26, 95% CI: -0.07-0.58, P = 0.127). Patients with AD or MCI did not significantly differ from controls of blood vitamin B12 levels, AD (SMD = -0.05, 95% CI: -0.19-0.08, P = 0.440), or MCI (SMD = 0.01, 95% CI: -0.16-0.17, P = 0.94). Some cohort studies have suggested that higher Hcy, methionine, and S-adenosylmethionine levels may accelerate cognitive decline in patients with MCI or AD, and vitamin B12 deficiency is a risk factor for the disease; however, the results of other studies were inconsistent. According to the GRADE system, all these outcomes scored very low to low quality, and no high-quality evidence was found. Conclusion: Only Hcy levels in the plasma and serum were found to be inversely related to the risk of AD. However, due to the low quality of supporting these results, high-quality studies are needed to verify these findings. Systematic Review Registration: http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022308961.