Solid pseudopapillary neoplasm of pancreas in pregnancy treated with tumor enucleation: Case report and review of the literature.

Solid pseudopapillary neoplasm of pancreas (SPN) during pregnancy is rare and presents a threat both to the mother and the fetus. We report a case of SPN in a 26-year-old woman diagnosed at 21 weeks of gestation. Tumor enucleation was successfully performed by a general surgeon. A healthy female infant was delivered at 39 weeks and 5 days of gestation vaginally without complications. Our report provides an example that tumor enucleation of SPN during the second trimester could be successfully performed during pregnancy. A multidisciplinary approach with respect to the pregnant patient's diagnosis, indications, and timing of surgery is necessary in ensuring the best possible outcomes for both the mother and the child.

Regulation of CD4⁺FOXP3⁺ T cells by CCL20/CCR6 axis in early unexplained recurrent miscarriage patients.

Expression and function of CCR6/CCL20 in CD4(+)FOXP3(+) regulatory T cells (Tregs) was investigated in unexplained recurrent miscarriage (URM) patients. Flow cytometry, reverse transcription-polymerase chain reaction, enzyme-linked immunosorbent assay, western blots, and Transwell migration assays were used to analyze the expression and function of regulatory T cells in peripheral blood (PB) and decidual samples of women with URM and of healthy controls. Proportions of CD4(+)FOXP3(+) T cells and CCR6(+)CD4(+)FOXP3(+) T cells were lower in URM patients than in healthy controls for both PB lymphocytes and decidual samples (P < 0.05). Expression levels of FOXP3 and CCR6 mRNA were lower in URM patients than in control subjects for PB and decidual samples (P < 0.05). CCL20 protein levels were lower in URM patients than in controls (P < 0.05). An effect of Treg migration was significantly blocked (by 89.13%) using a neutralizing anti-CCL20 antibody in vitro. Furthermore, CCL20-stimulated Tregs exhibited a 3.21-fold increase in migration and this was blocked using a neutralizing anti-CCL20 antibody. IL-10 concentration in culture supernatants of CD4(+)CD25(+)CD127(dim/-) Tregs of URM patients was significantly lower than that in controls. Anti-CCL20 antibody inhibited IL-10 and IL-4 expression but increased IFN-r and IL-17 levels when there was cell-cell contact between PB CD4(+)CD25(+) T cells and CD4(+)CD25(-) T cells. No difference was detected when cell-cell contact was prevented by a semi-permeable Transwell membrane. CCL20-CCR6 could drive immune activity of CD4(+)FOXP3(+) Tregs, followed by their migration to the feto-maternal microenvironment. These results elucidated the mechanism by which Tregs exert this suppressive effect.

Caesarean scar pregnancy: treatment with bilateral uterine artery chemoembolization combined with dilation and curettage.

OBJECTIVE: This study investigated bilateral uterine artery chemoembolization (BUACE) combined with dilation and curettage (D&C) in caesarean scar pregnancy (CSP). METHODS: Nineteen women with CSP were referred for interventional radiology. In 13 patients, BUACE was performed before D&C, following a diagnosis of CSP. A further six patients received BUACE for massive vaginal bleeding after D&C for inevitable miscarriage; the diagnosis of CSP was subsequently confirmed ultrasonographically. BUACE of the uterine arteries was performed using gelfoam particles following intra-arterial infusion of 100 mg/m(2) methotrexate. RESULTS: BUACE was technically successful and immediate haemostasis was achieved in all patients. Blood loss was significantly greater during D&C undertaken before BUACE compared with D&C after BUACE, but this bleeding was controlled by BUACE. No patient required further surgical intervention and there were no severe complications. The gestational sac and placenta could no longer be detected ultrasonographically and the menstrual cycle returned to normal 2-3 months after treatment in all patients. CONCLUSIONS: BUACE followed by D&C seems to be a safe and effective treatment for CSP and should be considered as a treatment of choice.

Genetic diversity, population structure, and conservation of Sophora moorcroftiana (Fabaceae), a shrub endemic to the Tibetan Plateau.

Sophora moorcroftiana is a perennial leguminous low shrub endemic to the middle reaches of Yarlung Zangbo River in Tibet. It is an important species to fix sand dunes and to avoid the formation of shifting sands; therefore, its progressive over-exploitation may enhance land desertification. The levels and distribution of genetic variability of this species were evaluated from 10 natural populations at 24 loci encoding 13 enzymes, using allozyme analysis by starch gel electrophoresis. Data obtained revealed moderate levels of genetic variation within populations (Pp=27.5%, Ap=1.5, Hep=0.122) and a considerable divergence among populations (FST=0.199). Significant positive correlations (r2=0.49, p<0.05; r2=0.46, p<0.05) were found between elevation and both mean number of alleles per locus (A) and gene diversity (He) in the studied populations of S. moorcroftiana. Lower genetic diversity in lower elevation populations might be due to the negative effects of human pressures and habitat fragmentation, to adaptation to high altitudes as a consequence of a peripatric speciation process, or to directional gene flow along the river basin from the source populations located in the west at higher altitudes. The evaluation of the degree of threat has led to the inclusion of this species in the category of EN ("endangered"), and conservation strategies for this endemic species are discussed on the basis of these findings.

[Changes in T-lymphocyte subsets of peripheral blood in unexplained habitual abortion].

UNLABELLED: T-lymphocyte subsets of peripheral blood were examined by flow cytometry (FCM) in 20 cases of unexplained habitual abortion (UHA) before and after active immunization treatment, with 10 normal pregnant (NP) women and 20 normal nonpregnant (NNp) women as control. THE RESULTS: there was no difference in the percentage of CD3 cells between the UHA cases and NNP. Before immunization the percentage of CD8 cells was significantly lower (P < 0.001) and the ratio of CD4/CD8 was increased (P < 0.05) in UHA as compared with the NNP. However, after immunization, the percentage of CD8 cells greatly increased (P < 0.05) and CD4/CD8 ratio decreased significantly (P < 0.05) nearly to that of NP. These findings suggest that: (1) the increase of CD4/CD8 ratio due to the decreasing CD8 cells is the underlying immunomechanism of UHA; (2) immunization may induce the proliferation of CD8 cells and the lowering of CD4/CD8 ratio. Therefore, CD8 cells might play an important role in maintaining the balance of fetal-maternal immunological relationship; (3) the ratio of CD4/CD8 may served as parameter for observing the clinical efficacy of immunization therapy.

[Effects of sodium vanadate on action potentials of guinea pig papillary muscles].

Sodium vanadate (NaVO3, 800 mumol/L) diminished the plateau phase and the action potential duration of the action potentials in guinea pig ventricular fibers (VF). 200 mumol/L also reduced the maximal rate of depolarization of slow action potentials in the partial depolarized VF under high K superfusion and inhibited the delayed after depolarization induced by adrenalin. It is suggested that NaVO3 may inhibit the slow channel current and does not reduce the sodium pump activity in VF significantly when it was used extracellularly.