Effect of ultrasonic melt processing and Al-Ti-B on the microstructural refinement of recycled Al alloys.

Refining the α-Al grain size and controlling the morphology of intermetallic phases during solidification of Al alloys using ultrasonic melt processing (USMP) and Al-Ti-B have been extensively used in academic and industry. While, their synergy effect on the formation of these phases has not yet clearly demonstrated. In this paper, the influence of USMP and Al-Ti-B on the solidified microstructure of multicomponent Al-4.5Cu-0.5Mn-0.5Mg-0.2Si-xFe alloys (x = 0.7, and 1.2 wt%) has been comparatively studied. The results show that the USMP + Al-Ti-B method produce a more profound refinement effect than the individual methods. In addition, the area of single Fe-rich phases in both alloys with USMP + Al-Ti-B are also refined compared with conventional methods. A mechanism is proposed for the refinement, which are the deagglomerated TiB2 parties induced by USMP providing more effective nucleation sites for α-Al, and the refined interdendritic regions limited the growth of Fe-rich phases in the following eutectic reaction. Finally, the application of combined USMP + Al-Ti-B methods is feasible in microstructural refinement, resulting in the improving the casting soundness and mechanical properties of alloys.

Investigations on the Changes of Serum Proteins in Rabbits after Trimeresurus stejnegeri Venom Injection via Mass Spectrometry-Based Proteomics.

Purpose: There are few studies on protein phosphorylation in the process of snake poisoning. The purpose of this study was to investigate the toxic mechanism of Trimeresurus stejnegeri at the protein level by determining the differential expression of phosphorylated proteins in rabbits after poisoning using proteomics. Methods: The Trimeresurus stejnegeri venom model in rabbits was established by intramuscular injection of 20 mg/kg venom. The serum was collected and the differential expression of phosphorylated proteins in the serum was determined by the iTRAQ technology, TiO2 enriched phosphorylated peptides, and the mass spectrometry analysis. The functional analysis was conducted using ClueGO software and the related mechanism was evaluated by the network analysis of biological interaction. The expression level of related proteins was determined by the Western blotting assay. Results: Compared to the control group, 77 differentially expressed proteins were observed in the model group. These proteins were closely associated with the complement and agglomerate cascade signaling pathways, the HIF signaling pathway, the pentose phosphate pathway, and the cholesterol metabolism signaling pathway. According to the results of network analysis, TF and SCL16A1 were determined as the core proteins, which were identified by the Western blotting assay. Conclusion: The present study provided valuable phosphorylation signal transduction resources for investigating the toxic mechanism and the therapies for Trimeresurus stejnegeri poisoning.

Placental extracellular vesicles retain biological activity after short-term storage (14 days) at 4 °C or room temperature.

INTRODUCTION: To investigate the role of placental extracellular vesicles (EVs), especially in pathological pregnancy, the use of freshly isolated EVs is often limited due to the sporadic and unpredictable availability of placental samples. Therefore, it is important to understand and use optimised storage conditions for placental EVs. In this study, we investigated different conditions for the short-term storage of placental micro- and nano-EVs and examined their biological activity. METHODS: Placental EVs were collected from first trimester placentae. EVs were suspended in PBS and aliquoted, and then stored for up to 14 days at room temperature, 4 °C or -20 °C. Total protein and DNA levels were measured at various time points. The ability of stored placental EVs to alter endothelial cell activation was quantified by monocyte adhesion assays. RESULTS: There was no difference in the concentration of placental micro- or nano-EVs between each time point, when stored at either room temperature or 4 °C. However, there was a significant loss of placental EVs after storage at -20 °C. There was no difference in protein or DNA levels of placental EVs when stored at either room temperature or 4 °C. Biological activity of placental EVs was retained for up to 14 days at either room temperature or 4 °C measured by monocyte adhesion assays. DISCUSSION: We have shown that placental micro- and nano-EVs are stable and retain biological activities following storage in PBS or media for 14 days at either room temperature or 4 °C.

A Comparison of Treatment Options for Type 1 and Type 2 Caesarean Scar Pregnancy: A Retrospective Case Series Study.

Background: There is currently no agreement on the optimal management of caesarean scar pregnancy. Caesarean scar pregnancy is currently categorised into two subtypes according to the site of implantation. This may consequently result in the difference in treatment options. However, the comparison of the success rate of each treatment option according to the subtypes has not been fully investigated. Methods: 71 patients who were treated by uterine curettage (D and C), or uterine artery embolization with curettage (UAE) or hysteroscopy in conjunction with laparoscopy between January 2016 and March 2020 were included. Data on maternal age, gestational sac age, the sac diameter, the interval between two pregnancies, the number of previous caesarean sections, amount of bleeding and ß-hCG levels were collected and analysed dependent on the subtypes. Results: There was no difference in the clinical parameters of the cases who received different options of treatment, as well as no difference in the clinical parameters between type 1 and type 2 caesarean scar pregnancy. The primary success rate for type 1 caesarean scar pregnancy by D and C, or UAE, or hysteroscopy in conjunction with laparoscopy was 95, or 100 or 100%, respectively. The primary success rate for type 2 caesarean scar pregnancy by D and C, or UAE, or hysteroscopy in conjunction with laparoscopy was 27, or 67, or 95% respectively. Conclusion: Our data demonstrates that hysteroscopy in conjunction with laparoscopy for type 2 caesarean scar pregnancy was the most successful compared to other options, but for type 1 caesarean scar pregnancy, D and C could be the cost-effective option.

A pilot study on investigating the role of Salvia miltiorrhiza in fetal growth restriction.

To date there is no effective treatment for pregnancies complicated by fetal growth restriction (FGR). Salvia miltiorrhiza, a traditional Chinese herb has been shown to promote blood flow and improve microcirculatory disturbance. In this pilot study, we evaluated whether S. miltiorrhiza can potentially become a possible therapy for FGR. Nineteen pregnant women with FGR were treated with S. miltiorrhiza and ATP supplementation for an average of 7 days, and 17 cases received ATP supplementation as controls. The estimated fetal weights (EFWs) were measured by ultrasound after treatment, and the birthweights were recorded after birth. After treatment with S. miltiorrhiza, 7 (37%) FGR cases showed an increase in EFW to above the 10th percentile, compared with 4 (23%) FGR cases in controls (odds ratio: 1.896, 95% confidence limits (CLs): 0.44-8.144). At delivery, 10 (53%) FGR cases in the treatment group delivered babies with a birthweight above the 10th percentile, compared with 6 (35%) FGR cases in the control group (odds ratio: 2.037, 95% CL: 0.532-7.793); 80 or 64% FGR cases in the treatment group showed an increase in fetal abdominal circumference (AC) or biparietal diameter (BPD) above the 10th percentile before delivery. While 44 or 30% FGR cases in the control group showed an increase in AC or BPD. No improvement of head circumference (HC) or femur length (FL) was seen. These pilot data suggest the need for multicenter randomized clinical trials on the potential of S. miltiorrhiza to improve perinatal outcome in pregnant women complicated by FGR.

Association of benign gynaecological diseases and risk of endometrial and ovarian cancers.

Objective: Gynaecologic benign diseases such uterine fibroids share similar pathogeneses with endometrial and ovarian cancers. Whether a history of uterine fibroids increases the risk of developing endometrial or ovarian cancers is controversial, due to uterine fibroids was self-reported in those studies. Methods: In our current case-control study, 268 women with endometrial cancer and 108 women with ovarian cancer were included. In addition, 500 women without gynaecological cancers were randomly selected as a control group. Uterine fibroids in both groups were clinically diagnosed by pelvic examination and ultrasound. Data on age, parity, gravida, stages of cancers and history of uterine fibroids, endometriosis and adenomyosis were collected from hospital database. Results: After adjusted age and parity, the odds of women with history of uterine fibroids or endometriosis were lower in women with endometrial cancer than controls (odds ratio: 0.148, 95% CI: 0.097, 0.225, or 0.360, 95% CI: 0094, 1.381, respectively). The odds of women with a history of uterine fibroids or endometriosis were lower in women with ovarian cancer than controls (odds ratio: 0.141, 95% CI: 0.085, 0.235, or 1.057, 95% CI: 0.377, 2.963, respectively). However, the odds of women with a history of adenomyosis were higher in women with endometrial or ovarian cancers than controls (odd ratio: 3.757, 95% CI: 1.858, 7.599 or 2.341, 95% CI: 1.086, 5.045, respectively). Conclusion: Our observational data suggested that uterine fibroids or endometriosis may be not associated with the increased risk of developing endometrial or ovarian cancer. However, a history of adenomyosis may do.

Use of mifepristone to treat endometriosis: a review of clinical trials and trial-like studies conducted in China.

China was the first country in the world that approved mifepristone (RU-486) for abortion. A total of 6 years after the report published in the Western world indicated that mifepristone may also be effective in treating endometriosis, the first paper on the same topic was published in China in 1997. Since then, over 160 studies on this topic have been published in China. We retrieved 104 papers on clinical trials and trial-like studies conducted in China evaluating the use of mifepristone to treat endometriosis that were published in the last 11 years. We found that the quality of these studies is well below an acceptable level, making it difficult to judge whether mifepristone is truly efficacious. There are intriguing signs that these studies, as a whole, have serious anomalies. The areas that are glaringly deficient are informed consent, choice of outcome measures, the evaluation of outcome measures, data analysis and randomization. The uniformly low quality is disquieting, given the large quantity of studies, the enormous amount of resource and energy put into these studies and, above all, the weighty issue of treatment efficacy that concerns each and every patient with endometriosis. Equally disquieting are the low-quality repetition, the absence of a critical, systematic review on the subject, the lack of suggestions for multicenter clinical trials and the seemingly unnecessary duplication of clinical trials without due informed consent. In view of this, it may be time to institute changes in attitude and practice, and to change education and training programs in the methodology of clinical trials in obstetrics and gynecology research in China.

Increased immunoreactivity to SLIT/ROBO1 in ovarian endometriomas: a likely constituent biomarker for recurrence.

While surgery is currently the treatment of choice for endometriosis, recurrence remains a serious problem, and its prevention is an unmet clinical need. SLIT, a secreted protein that functions through the Roundabout (ROBO) receptor as a repellent for axon guidance and neuronal migration, has been recently found to induce tumor angiogenesis. We investigated the potential role of SLIT/ROBO1 in ovarian endometriomas and examined their predictive value in recurrence based on tissue samples from 43 patients with recurrence and 45 without recurrence. Microvascular density counts were evaluated by CD34 immunohistochemistry, and statistical analyses were performed to evaluate the effect of SLIT/Robo1 on recurrence risk after adjustment for other risk factors. We found that SLIT expression was positively correlated with microvascular density in ectopic endometrium and that its expression was higher in ectopic endometrium than control endometrium. Both SLIT and Robo1 expression were higher in recurrent cases than in non-recurrent cases. Higher immunoreactivity to SLIT, along with the presence of adhesion, PR-B, and nuclear factor-kappaB, was identified to be a risk factor for recurrence, with a sensitivity of 86% and a specificity of 87%. Therefore, increased SLIT immunoreactivity is likely an important constituent factor for recurrence of ovarian endometriomas, possibly through promoting angiogenesis in ectopic endometrium. Thus, the SLIT/ROBO1 system may be a potential target for reducing the risk of recurrence.

Cyclooxygenase-2 overexpression in ovarian endometriomas is associated with higher risk of recurrence.

Cyclooxegenase-2 expression was evaluated by immunohistochemistry in endometrioma tissue samples taken from 109 patients, of whom 53 had recurrence by 30 months after surgery and 56 did not. Cyclooxegenase-2 overexpression, along with previous medical treatment of endometriosis and the presence of adhesion, is predictive of recurrence of ovarian endometrioma within 30 months after surgery, with a resultant sensitivity of 72.5% and a specificity of 72.4%, suggesting that there are intrinsic and identifiable biomarkers that confer recurrence risk.

Immunoreactivity of progesterone receptor isoform B and nuclear factor kappa-B as biomarkers for recurrence of ovarian endometriomas.

OBJECTIVE: This study was undertaken to evaluate the immunoreactivity of progesterone receptor isoform B and nuclear factor kappa-B p65 subunit in ovarian endometrioma tissue samples harvested at the time of surgery and their relationship with the recurrence risk. STUDY DESIGN: One hundred nine patients were selected; 53 of them had recurrence within 30 months after surgery, whereas the other 56 had not had recurrence at least 32 months after surgery. For each patient, host and clinical information was also collected. The patients' archived, formalin-fixed, paraffin-embedded tissue blocks were retrieved, subjected to immunohistochemical staining of progesterone receptor isoform B and nuclear factor kappa-B p65 subunit, and were scored and compared. RESULTS: Increased nuclear factor kappa-B activation and decreased progesterone receptor isoform B immunoreactivity in ovarian endometriomas were 2 predominant factors in predicting recurrence. The classification tree method based on these 2 yielded a sensitivity of 86.6% and a specificity of 82.1%. CONCLUSION: Nuclear factor kappa-B activation/p65 and progesterone receptor isoform B immunoreactivity in ovarian endometrioma jointly constitutes a good biomarker for recurrence. The close relationship between nuclear factor kappa-B activation/p65 subunit and progesterone receptor isoform B immunoreactivity strongly suggests their roles involved in recurrence and may thus be excellent therapeutic targets to prevent recurrence. Our finding supports the notion that there are identifiable molecular genetic differences intrinsic to ovarian endometriomas that confer recurrence risk differential.

Risk factors for dysmenorrhea and its severity in women with ovarian endometriomas.

OBJECTIVE: To identify factors associated with the risk of developing dysmenorrhea or the severity of dysmenorrhea in women with surgically confirmed ovarian endometriomas. STUDY DESIGN: 710 patients with surgically diagnosed ovarian endometriomas were interviewed and their charts read. Fourteen factors were considered. Among the 710 patients, 376 patients had major complaint of dysmenorrhea and were evaluated to identify factors associated with the severity of dysmenorrhea. RESULTS: The logistic regression model identified younger age at surgery, previous medication use, presence of adhesion, and presence of adenomyosis as risk factors for dysmenorrhea. For the severity of dysmenorrhea, the presence of adenomyosis was consistently and robustly identified by several statistical models with rather different assumptions as the factor associated with severity. The rAFS stage was also associated with the severity, but the association may be explained by the presence of adenomyosis. CONCLUSION: The presence of adenomyosis has been consistently identified as a risk factor for both dysmenorrhea and its severity. Younger age at surgery, presence of adhesion, and previous use of endometriosis-related medication are additional risk factors for dysmenorrhea. For the severity of dysmenorrhea, there are other factors than the presence of adenomyosis that may influence the severity of dysmenorrhea.

Patterns of and factors potentially influencing the age at first surgery for women with ovarian endometriomas.

AIM: To investigate patterns of and factors that may influence age at the first surgery (AATFS) for ovarian endometrioma. METHODS: Five hundred and ninety-two consecutive patients with ovarian endometriomas who underwent surgery at the Shanghai OB/GYN Hospital from 2003 to 2004 were interviewed and their charts studied. Twelve variables were examined to assess their effect on AATFS using survival analysis methodology. All diagnoses were confirmed histologically. Twelve factors that potentially influence AATFS were recorded and subjected to univariate and multiple-variable statistical analyses. RESULTS: A Weibull distribution fitted the AATFS data very well. In addition, age at menarche, body mass index, parity, number of previous induced abortions, rAFS stage (revised classification of the American Fertility Society), presence of adhesions, myomas/adenomyosis, and dysmenorrhea were identified to be associated with AATFS. CONCLUSION: The AATFS may be determined by a myriad of independent factors, including age at menarche, body mass index, parity, number of pregnancies, rAFS stage, and presence of adhesions, myomas/adenomyosis, and dysmenorrhea. The identification of these and other factors that influence AATFS and delineation of their roles in the pathogenesis of endometriosis may help us devise strategies for better patient care and better allocate health care resources in the future.

Patterns of and risk factors for recurrence in women with ovarian endometriomas.

OBJECTIVE: To identify risk factors for and the patterns of recurrence of endometrioma and of dysmenorrhea in women with ovarian endometrioma. METHODS: We evaluated 710 consecutive patients operated on for ovarian endometriomas who were followed up for an average of 22.4 months. Twenty factors were examined to assess their effect on risk of recurrence of endometrioma and of dysmenorrhea using survival analysis. Hazard rate also was estimated to examine recurrence patterns. RESULTS: For recurrence of endometrioma, the revised American Fertility Society (rAFS) score, younger age at surgery, and previous medical treatment of endometriosis were identified to be risk factors. For recurrence of dysmenorrhea, rAFS score was the only risk factor. For both recurrences, there was a constant hazard rate in the first 28-30 months after surgery, indicating that the recurrence in that period is completely random. After that period, the hazard rate increased dramatically. CONCLUSION: The total rAFS score, but not rAFS stage, is a risk factor for recurrence of both endometrioma and dysmenorrhea, indicating that the rAFS stage has little prognostic value. The existence of a completely random recurrence period may be a universal phenomenon, with its duration and the magnitude of recurrence risk determined by patient characteristics and quality of care. The second phase of much higher recurrence risk may reflect successful reseeding, reimplantation, and regrowth of ectopic endometrium. Therefore, the identification of risk factors as well as patterns of recurrence should shed better light on possible causes for recurrence, which is now poorly understood.