Application of elastography to diagnose adenomyosis and evaluate the degree of dysmenorrhea: a prospective observational study.

BACKGROUND: To determine whether there is a correlation between stiffness measured by strain elastography and the severity of dysmenorrhea and to determine the value of elastography in evaluating severe dysmenorrhea in patients with adenomyosis. METHODS: The correlation between tissue stiffness and dysmenorrhea was analyzed by performing elastography on premenopausal women diagnosed with adenomyosis. Expression levels of transforming growth factor-ß (TGF-ß), α-smooth muscle actin (α-SMA), and protein gene product 9.5 (PGP9.5) were detected by immunohistochemistry; the correlation of TGF-ß and α-SMA levels with the tissue stiffness and the degree of fibrosis was further analyzed. Also, the relationship of the PGP9.5 expression level with the tissue stiffness and degree of dysmenorrhea was determined. RESULTS: The degree of dysmenorrhea was significantly positively correlated with lesion stiffness in patients with adenomyosis but not with the uterine or lesion volume. The cutoff for the strain ratio was > 1.36 between the adenomyosis and control groups, with an area under the curve (AUC) of 0.987. For severe dysmenorrhea, the cutoff for the strain ratio was > 1.65 in patients with adenomyosis, with an AUC of 0.849. TGF-ß, α-SMA, and PGP9.5 expression levels were higher in adenomyotic lesions than in the endometrium of the adenomyosis and control groups. Both TGF-ß and α-SMA levels were positively correlated with the tissue stiffness and degree of fibrosis. Additionally, the expression level of PGP9.5 showed a positive correlation with the tissue stiffness and degree of dysmenorrhea. CONCLUSIONS: Elastography can be used to evaluate the degree of dysmenorrhea; the greater the tissue stiffness, the greater the degree of dysmenorrhea. In addition, elastography performed well in the diagnosis of adenomyosis and the evaluation of severe dysmenorrhea in patients with adenomyosis.

Association between serum IgG titers to periodontal pathogens and outcomes for ischemic stroke patients / 中华老年医学杂志

Objective:To explore the relationship between serum IgG titers to periodontal pathogens and the modified Rankin Score(mRS)after a 3-month follow-up of older patients with ischemic stroke.Methods:Data on 379 older patients diagnosed with ischemic stroke at the Third Affiliated Hospital of Soochow University from January 2019 to April 2020 were retrospectively analyzed.Basic patient data and laboratory test results were collected.Serum samples were collected within three days after the stroke, and serum IgG antibody titers to 9 periodontal pathogens were detected.Patients were followed up for 3 months and the m-RS was calculated.Results:Among the 379 patients, 104(27.4%)had an mRS score ≥ 3 at 3-months.Univariate analysis after adjusting for age and sex showed that atrial fibrillation, ischemic heart disease, ischemic stroke subtypes, the National Institutes of Health Stroke Scale(NIHSS)score, and C-reactive protein(CRP)levels were all risk factors for unfavorable 3-month outcomes(all P<0.05). After fully adjusting confounding factors including age, sex, atrial fibrillation, ischemic heart disease, ischemic stroke subtypes, NIHSS score and CRP level at hospital admission, only the serum IgG antibody titer to Fusobacterium nucleatum increased the risk of unfavorable 3-month outcomes out of titers to 9 periodontal pathogens, and the odds ratio( OR)per standard deviation increase in titer was 3.01(95% CI: 1.73-5.23, P<0.001). Curve fitting showed that the relationship between serum IgG antibody titers to Fusobacterium nucleatum and unfavorable 3-month outcomes was close to a positive linear correlation( χ2=15.333, P<0.001). Stratified analysis showed that there were no subgroup variables, including smoking and drinking habits, comorbidities(hypertension, diabetes, dyslipidemia, chronic kidney disease), and the history of stroke, significantly changed the association between serum IgG antibody titers to Fusobacterium nucleatum and poor prognosis( Pvalues for the interaction were: 0.985, 0.708, 0.388, 0.903, 0.613, 0.700, 0.611). Conclusions:Serum IgG antibody titers to Fusobacterium nucleatum are independently correlated with unfavorable 3-month outcomes in older ischemic stroke patients.The higher the antibody titer, the greater the risk of adverse outcomes.

Effects of recombinant human leukemia inhibitor on the preimplantation mouse embryo development in vitro / 中华妇产科杂志

Objective To assess the effect of recombinant human leukemia inhibitory factor (rhLIF) on mouse embryo development in vitro Methods Mice were randomly divided to three groups, one in vivo control (group Ⅰ) and two in vitro (group Ⅱ and Ⅲ) Mice were sacrificed at 116 120 hours (group Ⅰ) and 44-48 hours (group Ⅱ and Ⅲ) subsequent human chorionic gonadotropin (hCG) injection Two cell embryos (group Ⅱ and Ⅲ) and blastocysts (group Ⅰ) were obtained Embryos in group Ⅱwere cocultured with human tubal fluid (HTF) + 10% human serum and in group Ⅲ with HTF + 10% human serum+rhLIF (1 000 U/ml) The number of embryo in different stage was recorded and compared Results Embryo in four, eight cell and morula was noted in group Ⅱ and Ⅲ, 87 7% versus 91 2% and 75 0% versus 85 4% respectively There was no significant difference. However, further embryo development to the blastocyst, expanded blastocyst, and hatching blastocyst in group Ⅱ (48 1%, 32 1% and 18 4%) was lower than that in group Ⅲ (82 3%, 59 7% and 36 3%) There was no difference between blastocyst in group Ⅰ and group Ⅲ (86 0% vs 82 3%). Conclusion RhLIF does not provide obvious stimulation in early mouse embryo, however, rhLIF can promote the growth, differentiation, and hatching of preimplantion blastocyst