Diagnosis and management of non-communicating rudimentary horn pregnancy.

OBJECTIVES: Non-communicating rudimentary horn pregnancy is a rare condition associated with serious complications and consequences. MATERIAL AND METHODS: We reported a case of a 44-day non-communicating rudimentary horn pregnancy who was diagnosed by three-dimensional ultrasound (3D-US) and pelvic magnetic resonance imaging (MRI), followed by treatment via laparoscopic resection. RESULTS: The 3D-US and pelvic MRI scan showed a consistent result. Serious complications and consequences were avoided. Postoperative diagnosis showed that the malformation was classified as type IIc. CONCLUSIONS: For such diagnosis as a unicornuate uterus with a rudimentary horn, if there are no symptoms, it cannot be treated. Once pregnancy is in the rudimentary horn, 3D-US or MRI should be conducted to determine the implantation location of the pregnancy capsule and the operation should be performed as soon as possible to avoid uterine rupture. Laparoscopic surgery can be chosen in the early stage.

Factors associated with caesarean section in women referred for preinduction - a nested case-control study in dinoprostone and misoprostol groups.

OBJECTIVES: Induction of labour is a beneficial perinatal procedure, but may be associated with some risks. The aim of this study was to identify factors associated with the need for Caesarean section in women referred for preinduction with dinoprostone and misoprostol. MATERIAL AND METHODS: It was a retrospective cohort study of 560 pregnant women who underwent labour induction for medical reasons. Analyses were performed separately in the dinoprostone and misoprostol group. Above other characteristics, the diameters of the pelvis and abdominal circumference of pregnant women were analysed. RESULTS: There were some mothers' characteristics like age, weight, BMI, presence of hypothyroidism or diabetes, which were not associated with Caesarean section deliveries. Women in the misoprostol group with gestational age less than 38 weeks had an increased risk of Caesarean section (OR 2.189; p = 0.041). The analyses of combined effect of mothers age and parity history showed 6.7 (in dinoprostone group) and over 10 times (in misoprostol group) increased the risk of Caesarean section in nulliparous women over 35 years of age. CONCLUSIONS: The increased risk of Caesarean delivery in the dinoprostone group was combined with the intertrochanteric dimensions such as the mother's height measuring less than 165 cm, nulliparity and hypertension. In the misoprostol group, strong risk factors for Caesarean delivery were mothers aged 35 years or more, gestational age less than 38 weeks and nulliparity and hypertension as in dinoprostone group. The oxytocin infusion had increased the risk of Caesarean section only in the combined dinoprostone and misoprostol group. Further high-quality studies are warranted.

WJ­MSCs intervention may relieve intrauterine adhesions in female rats via TGF­β1­mediated Rho/ROCK signaling inhibition.

Estrogen is a commonly used hormone in the adjuvant treatment of intrauterine adhesion (IUA), which can promote endometrial growth. Stem cell transplantation has also been reported to promote endometrial regeneration in IUA due to its potential differentiative capacity. Human Wharton's jelly mesenchymal stem cells (WJ­MSCs) are isolated from the umbilical cord, possess strong self­renewal and proliferative abilities, and are hypo­immunogenic and non­tumorigenic. Therefore, the present study aimed to investigate the therapeutic effects and underlying mechanism of WJ­MSCs transplantation with estrogen treatment, separately or as a combined therapy, on IUA. The IUA model was established using the ethanol damage method. A total of 50 Sprague­Dawley female rats were randomly divided into the control, IUA model, WJ­MSCs treatment, estrogen treatment and WJ­MSCs+ estrogen treatment groups (n=10/group). WJ­MSCs were injected three times at 5­day intervals. IUA rats in the estrogen group received 0.2 mg/kg estrogen through intragastric administration, once every 2 days for 8 weeks. Morphological changes were evaluated by hematoxylin­eosin staining. Immunohistochemical evaluations of pan­keratin, vimentin, transforming growth factor (TGF)­ß1, RhoA, RhoB, RhoC, Rho­associated coiled­coil­containing protein kinase (ROCK)I, and ROCKII expression were performed in uterine tissue. After treatment, the uterine specimens were observed to have increased uterine thickness and gland numbers in all treatment groups compared with the IUA group; however, the degree of restoration in the independent WJ­MSCs and estrogen treatment groups was better than in the combined treatment group. Immunohistochemical analysis demonstrated that pan­keratin expression was increased, and RhoA, ROCKI and TGF­ß1 expression was significantly inhibited in the WJ­MSCs and WJ­MSCs + estrogen treatment groups compared with the IUA group; however, the expression levels of these proteins were similar among all treatment groups. No change in vimentin expression was detected in any treatment group. The expression levels of RhoB, RhoC and ROCKII were clearly not affected by WJ­MSCs intervention alone. In conclusion, transplantation of WJ­MSCs may repair endometrial damage in IUA rats via TGF­ß1­mediated inhibition of RhoA/ROCKI signaling.

Immunity and coagulation and fibrinolytic processes may reduce the risk of severe illness in pregnant women with coronavirus disease 2019.

BACKGROUND: There are specific physiological features regarding the immunity and coagulation among pregnant women, which may play important roles in the development of coronavirus disease 2019. OBJECTIVE: This study aimed to determine the key factors associated with the deterioration of patients with coronavirus disease 2019 and the differentiating clinical characteristics of pregnant women with coronavirus disease 2019 to interfere with the progression of coronavirus disease 2019. STUDY DESIGN: A retrospective study of 539 Chinese Han adult patients with coronavirus disease 2019 was conducted, of which 36 cases were pregnant women. In addition, 36 pregnant women without coronavirus disease 2019 were recruited as the control. The characteristics of severe and critical illnesses, which were differentiated from mild and moderate illnesses in patients with coronavirus disease 2019, were analyzed using a machine learning algorithm. In addition, major differences between pregnant women with coronavirus disease 2019 and age-matched nonpregnant women with severe or critical coronavirus disease 2019, paired with pregnant women without coronavirus disease 2019, were explored to identify specific physiological features of pregnant women with coronavirus disease 2019. RESULTS: For the total patient population, the lymphocyte, CD3+, CD4+, CD8+, CD19+, and CD16+CD56+ cell counts were significantly lower, and white blood cell count, neutrophil count, and neutrophil-to-lymphocyte ratio were higher in those with severe or critical illness than those with mild or moderate illness (P<.001). The plasma levels of interleukin-6, interleukin-10, and interleukin-6-to-interleukin-10 ratio were significantly increased in patients with critical illness compared with patients with mild, moderate, and severe illnesses (P<.001). The above immunologic coclusters achieved an area under the receiver operating characteristic curve of 0.801 (95% confidence interval, 0.764-0.838), and its combined model with the coagulation and fibrinolysis indices (prothrombin time, D-dimer) achieved an area under the receiver operating characteristic curve of 0.815 (95% confidence interval, 0.779-0.851) using the random forest regression model to predict severe or critical illness. For pregnant women with coronavirus disease 2019, none had preexisting diseases. Compared with nonpregnant women with mild or moderate coronavirus disease 2019, pregnant women with coronavirus disease 2019 displayed increased white blood cell count, neutrophil count, neutrophil-to-lymphocyte ratio, and levels of D-dimer and fibrinogen, along with decreased lymphocyte and interleukin-4 levels (P<.05). Although they presented similar changes of immunologic markers of lymphocyte; white blood cell count; neutrophil-to-lymphocyte ratio; CD3+, CD4+, CD8+, and CD16+CD56+ cell counts; and interleukin-6-to-interleukin-10 ratio, compared with nonpregnant women with severe or critical coronavirus disease 2019, none of the pregnant women with coronavirus disease 2019 deteriorated into severe or critical illness. There was no significant difference in white blood cell count, lymphocyte count, neutrophil count, neutrophil-to-lymphocyte ratio, immunologic markers, or coagulation and fibrinolysis markers between pregnant women with coronavirus disease 2019 and pregnant women without coronavirus disease 2019. As for the discrepancy of pathophysiological features between pregnant women with coronavirus disease 2019 and nonpregnant women with severe or critical coronavirus disease 2019, the immunologic markers achieved an area under the receiver operating characteristic curve of 0.875 (95% confidence interval, 0.773-0.977), and its combined model with coagulation and fibrinolysis indices achieved an area under the receiver operating characteristic curve of 0.931 (95% confidence interval, 0.850-1.000). CONCLUSION: Immune dysregulation was identified as a crucial feature of patients with coronavirus disease 2019, which developed severe or critical illness, and pregnant women with coronavirus disease 2019 presented with similar immune responses but rarer incidences of severe or critical illness. Immune dysregulation is related to the risks of deterioration into severe or critical illness. The specific coagulation and fibrinolysis systems of pregnancy may reduce the risk of pregnant women with coronavirus disease 2019 without preexisting disease from developing severe illness.

Rapid microwave synthesis of graphene directly on h-BN with excellent heat dissipation performance.

We report a new rapid household microwave method to successfully grow graphene on h-BN flakes without using any catalysts. We obtained a novel uniform multilevel matrix of vertical graphene sheets on h-BN flakes. The unique structure possessed outstanding electron conductivity and thermal properties (29.1 W m(-1) K(-1)).

[Effect on invasion ability of cervical cancer cells after silence heparanase gene expression in Hela cells].

OBJECTIVE: Design and synthesize short hairpin RNA (shRNA) expression vector of RNA for specific silencing of heparanase (HPA) gene, screened plasmid which silence effects is the best. Observe the function of cell invasion after inhibiting the expression of HPA in cervical carcinoma cell lines (HeLa). METHODS: The genomic sequence of HPA gene was retrieved from GenBank database. Designed four pairs of specific oligonucleotide sequences and a negative control according to the shRNA design principles. They were inserted into the vector pYr-1.1, vectors, and transfected into HeLa cells via lipofectamine. Reverse transcription(RT)-PCR and immunofluorescence were employed to detect the expression of HPA gene in the transfected cells at the mRNA and protein levels, respectively. The plasmid were screened and transfected into HeLa cells, then transwell small room stromal invasion experiment were employed to observe the cervical carcinoma cell invasion. RESULTS: RT-PCR results of transfected HeLa cells shown that the mRNA amplification multiples were 0.54 ± 0.05 in the HPA-592 group, 0.89 ± 0.18 in HPA-995 group, 0.82 ± 0.22 in the HPA-1351 group, 0.91 ± 0.47 in HPA-1658 group. While, they were 1.31 ± 0.72 and 1.09 ± 0.16 in negative control and blank control group, respectively. Green fluorescence was visible in the cytoplasm, which indicated that the HPA protein was expressed in the cytoplasm, of them the weakest green fluorescence in the HPA-592 group . The relative numbers of invasive cells among the HeLa cells were as follows: 182 ± 6 in the blank control group, 258 ± 17 in the negative control group, and 44 ± 4 in the HPA-592-specific interference group (P < 0.01) . CONCLUSION: Successfully screened shRNA vector targeting human HPA, efficiently inhibit expression of HPA gene when transfected into HeLa cells, and significantly reduced the invasion capacity of cervical carcinoma cells.

[Efficacy and safety of GnRH-a combine with laparoscope conservative surgery in the treatment of the moderate or severe endometriosis].

OBJECTIVE: To study the efficacy and safety of Gonadotropin-releasing hormone agonists (GnRH-a) combined with laparoscope conservative surgery in treatment of moderate or severe endometriosis. METHODS: From Jan. 2007 to Jan. 2010, 68 patients with moderate or severe undergoing treatment in Renmin Hospital of Wuhan University were enrolled in this retrospective study. Three groups were classified, which were 25 patients in GnRH-a group, subcutaneous injection Leuprorelin on the second day of menstruation, every 4 weeks for 3 months. Twenty-three patients in Marvelon group, orally one marvelon tablet on the second day of menstruation, continuous 21 days for one period of treatment for 3 courses. Twenty patients in surgery group, without any medicine used preoperatively. All patients were followed by 12 months and compare their surgery time, blood loss, recovery, visual analog scale (VAS), and recurrence and so on. RESULTS: The operating time were (68 ± 18) min in GnRH-a group, (80 ± 21) min in Marvelon group and (90 ± 24) min in surgery group. The amount of bleeding were (118 ± 15) ml in GnRh-a group, (161 ± 18) ml in Marvelon group and (193 ± 13) ml in surgery group. There was significant lower in the operating time and amount of bleeding in GnRH-a group than those in other two groups (P < 0.05). The activity time and the anus exhaust time were shorter in patients in GnRh-a group than those in the other two groups significantly (P < 0.05). When followed up in 12 months after treatment, visual analogue scale had dropped from 3.8 (1.9 - 6.8) to 1.9 (1.1 - 2.8) in GnRh-a group, from 2.7 (1.3 - 5.5) to 1.8 (1.2 - 3.2) in Marvelon group and from 1.9 (1.0 - 4.9) to 1.6 (1.0 - 3.6) in surgery group. It was showed the most remarkable decreased VAS in GnRHa group when compared with the other two groups (P < 0.05). The recurrence rates were 12% (3/25) in GnRH-a group, 22% (5/23)in Marvelon group and 25% (5/25) in surgery group. It was found that the most significant lower recurrence was in GnRH-a group when compared with the other two groups (P < 0.05). CONCLUSIONS: It was safe and efficacy that GnRH-a combined with laparoscopic conservative surgery were used in treatment of endometriosis. It could bring shorter operation time, less intraoperative blood loss, quick postoperative recover, the lower recurrence rate.

[Impact of quercetin on the expression of heparanase in cervical cancer cells].

OBJECTIVE: To detect the expression of heparanase (HPA) in cervical cancer cells and investigate the impact of quercetin on the expression of HPA, and the molecular mechanism that quercetin inhibits the growth of cervical cancer cells. METHODS: The experimental groups included cervical cancer cell lines (HeLa and Caski) exposed to different concentrations of quercetin (20, 40 and 80 µmol/L) in the culture medium. The control groups included a negative control group, which was cultured with RPMI 1640 only, and a positive control group, in which cervical cancer cells were transfected with HPA small interference RNA (siRNA) to silence HPA expression. The cellular expression levels of HPA were detected with fluorescence quantitative real-time PCR and western blot analysis at 24, 48 and 72 hours after treatment. RESULTS: (1) HPA was significantly expressed in both cervical cancer cell lines (HeLa and Caski), and it exists both nucleus and cytoplasm. (2) The real-time PCR shows as follows: as the quercetin concentration increased (20, 40 and 80 µmol/L), the mRNA expression level of HPA decreased (P < 0.01), in which the inhibition of HPA expression was concentration dependent. In addition, the inhibition of HPA expression was also time dependent. As time growth, the expression level of HPA mRNA (24, 48 and 72 hours) in HeLa and Caski cells decreased (P < 0.01). Compared with negative control group, the expression level of HPA mRNA decreased in different concentrations of quercetin (40 and 80 µmol/L) in both HeLa and Caski cells (all P < 0.05); Compared with positive control group, the expression level of HPA mRNA expressed no obvious difference in quercetin (80 µmol/L) group (P > 0.05) in HeLa cells, while it was opposite in Caski cells (P < 0.01). (3) The result of western blot shown that, as the quercetin concentration increased (20, 40 and 80 µmol/L) and time growth (24, 48 and 72 hours), the expression level of HPA protein decreased (P < 0.01), and the inhibition of HPA protein expression was concentration and time dependent. Compared with negative control group, the expression level of HPA protein decreased in different concentrations of quercetin (40 and 80 µmol/L) in both HeLa and Caski cells (all P < 0.05); Compared with positive control group, the expression level of HPA protein expressed no obvious difference in quercetin (80 µmol/L) group (all P > 0.05) in both HeLa cells and Caski cells (all P > 0.05). CONCLUSION: Quercetin could inhibits the expression of HPA in cervical carcinoma cell lines, which inhibition is concentration and time dependent.

Low-temperature aluminum reduction of graphene oxide, electrical properties, surface wettability, and energy storage applications.

Low-temperature aluminum (Al) reduction is first introduced to reduce graphene oxide (GO) at 100-200 °C in a two-zone furnace. The melted Al metal exhibits an excellent deoxygen ability to produce well-crystallized reduced graphene oxide (RGO) papers with a low O/C ratio of 0.058 (Al-RGO), compared with 0.201 in the thermally reduced one (T-RGO). The Al-RGO papers possess outstanding mechanical flexibility and extremely high electrical conductivities (sheet resistance R(s) ~ 1.75 Ω/sq), compared with 20.12 Ω/sq of T-RGO. More interestingly, very nice hydrophobic nature (90.5°) was observed, significantly superior to the reported chemically or thermally reduced papers. These enhanced properties are attributed to the low oxygen content in the RGO papers. During the aluminum reduction, highly active H atoms from H(2)O reacted with melted Al promise an efficient oxygen removal. This method was also applicable to reduce graphene oxide foams, which were used in the GO/SA (stearic acid) composite as a highly thermally conductive reservoir to hold the phase change material for thermal energy storage. The Al-reduced RGO/SnS(2) composites were further used in an anode material of lithium ion batteries possessing a higher specific capacity. Overall, low-temperature Al reduction is an effective method to prepare highly conductive RGO papers and related composites for flexible energy conversion and storage device applications.