Overexpression of ARHI increases the sensitivity of cervical cancer cells to paclitaxel through inducing apoptosis and autophagy.

Cervical cancer (CC) is a common malignant tumor of the female reproductive system. This study investigated the role of aplysia ras homolog I (ARHI) in resistance to CC in vitro and in patients' tissues. Hela cells were continuously treated with different concentrations of paclitaxel (1-10 nM) to construct paclitaxel-resistant cell model (Hela-TR). CC or CC-TR tissues were obtained from CC patients or CC patients who had developed paclitaxel resistance. The level of ARHI and multidrug resistance gene 1 (MDR1) in cells and tissues were detected by qRT-PCR and immunohistochemistry (IHC) staining. Cell viability, apoptosis and the number of colonies were assessed by MTT, flow cytometry and cell clone assay in Hela and Hela-TR cells after the ARHI plasmid or shARHI were transfected into cells. The autophagy and apoptosis signaling related proteins were analyzed by western blotting. The results revealed that the levels of ARHI mRNA and protein were down-regulated in CC tissues, and were further reduced in paclitaxel-resistant tissues and Hela cell model. High expression of ARHI inhibited the expression of MDR1 in Hela and Hela-TR cells. The cell viability and cell clone of Hela and Hela-TR cells were decreased by ARHI overexpression but increased by ARHI suppression. In addition, highly expressed ARHI promoted apoptosis and activated autophagy by increasing LC3-II/LC3-I through inactivating AKT/mTOR signaling pathway. In conclusion, overexpression of ARHI can increase the sensitivity of CC to paclitaxel through promoting apoptosis and autophagy in a AKT/mTOR inactivation dependent pathway.

Evaluation of cesarean delivery rates in different levels of hospitals in Jiangsu Province, China, using the 10-Group classification system.

OBJECTIVE: To compare cesarean delivery (CD) rates in referral and non-referral hospitals in Maternal Safety Collaboration in Jiangsu province, China. METHODS: Sixteen participants (4 referral hospitals, 12 non-referral hospitals) from Drum Tower Hospital Collaboration for Maternal Safety reported CD rates in 2019 using ten-group classification system and maternal/neonatal morbidity and mortality. RESULTS: A total of 22,676 CDs were performed among 52,499 deliveries and the average CD rate was 43.2% (range 34.8-69.6%). CD rate in non-referral hospitals (44.7%) was significantly higher than it was in referral hospitals (40.4%, p < .001). Term singleton cephalic nulliparous women with spontaneous labor (Group 1) or induced labor (Group 2a) had higher CD rates if they were cared in non-referral hospitals compared with those in referral hospitals (Group 1: 11.8% vs. 4.4%, p < .001; Group 2a: 29.1% vs. 21.3%, p < .001). In non-referral hospitals, CD rate in Group 5 and the proportion of Group 5 to the overall population were also significantly higher than those in referral hospitals (98.5% vs. 92.5%, p < .001; and 21.0% vs. 14.5%, p < .001). CONCLUSION: To decrease the CD rate, we need to take efforts in decreasing unnecessary operations for term singleton cephalic nulliparous women and increasing the rate of trial of labor after CD.

A retrospective study of maternal near miss in the Critical Maternal Care Center in Suqian City, Jiangsu Province, China: A single-center study.

BACKGROUND AND AIMS: Through a retrospective study of maternal near miss (MNM) cases treated by the Suqian Critical Maternal Care Center in Suqian City, Jiangsu Province, we summarized the most common diseases that caused MNM, treatment measures, and short-term prognosis in this region. The purpose of the research is to improve the clinical evidence of maternal health care in the region. METHODS: The study is a retrospective descriptive study. Among the pregnant women admitted to the Critical Maternal Care Center from 1 January 2015, to 31 December 2019, the pregnant women with severe pregnancy complications or comorbidities were identified as the research subjects. The study subjects were divided into an MNM group and a control group according to the MNM criteria recommended by the WHO.A retrospective analysis of the study subject data, including causes and clinical manifestations of MNM, treatment measures, and short-term prognosis, was conducted. RESULTS: The total number of deliveries was 27 619. There were 145 women in the control group and 65 women in the MNM group. The number of MNM cases accounted for 2.4% (65/27619) of the total number of deliveries. Placenta previa, postpartum hemorrhage, and hypertension accounted for 72.3% (47/65) of the causes of MNM cases observed. In the MNM group, the most common clinical manifestation was bleeding (80.0%, 52/65). Sixty-three patients underwent massive blood transfusion (96.9%, 63/65), and 36 underwent hysterectomy (55.4%,36/65). The prevalence of interventional procedures and unplanned secondary operations in the MNM group was higher than that in the control group. CONCLUSIONS: The top three causes of MNM were placenta previa, postpartum hemorrhage, and hypertension in pregnancy in Suqian area. Sufficient blood sources, convenient and fast blood transfusion procedures, and the use of large amounts of blood transfusion technology have an important impact on the success of treatment. Hysterectomy is still the main method of MNM treatment.