Genetic causality and metabolite pathway identifying the relationship of blood metabolites and psoriasis.

BACKGROUND: Psoriasis is a chronic inflammatory disease that causes significant disability. However, little is known about the underlying metabolic mechanisms of psoriasis. Our study aims to investigate the causality of 975 blood metabolites with the risk of psoriasis. MATERIALS AND METHODS: We mainly applied genetic analysis to explore the possible associations between 975 blood metabolites and psoriasis. The inverse variance weighted (IVW) method was used as the primary analysis to assess the possible association of blood metabolites with psoriasis. Moreover, generalized summary-data-based Mendelian randomization (GSMR) was used as a supplementary analysis. In addition, linkage disequilibrium score regression (LDSC) was used to investigate their genetic correction further. Metabolic pathway analysis of the most suggested metabolites was also performed using MetaboAnalyst 5.0. RESULTS: In our primary analysis, 17 metabolites, including unsaturated fatty acids, phospholipids, and triglycerides traits, were selected as potential factors in psoriasis, with odd ratios (OR) ranging from 0.986 to 1.01. The GSMR method confirmed the above results (ß = 0.001, p < 0.05). LDSC analysis mainly suggested the genetic correlation of psoriasis with genetic correlations (rg) from 0.088 to 0.155. Based on the selected metabolites, metabolic pathway analysis suggested seven metabolic pathways including ketone body that may be prominent pathways for metabolites in psoriasis. CONCLUSION: Our study supports the causal role of unsaturated fatty acid properties and lipid traits with psoriasis. These properties may be regulated by the ketone body metabolic pathway.

Dynamic changes in hs-CRP and risk of all-cause mortality among middle-aged and elderly adults: findings from a nationwide prospective cohort and mendelian randomization.

INTRODUCTION: The general population experiences mortality rates that are related to high levels of high-sensitivity C-reactive protein (hs-CRP). We aim to assess the linkage of longitudinal trajectories in hs-CRP levels with all-cause mortality in Chinese participants. METHODS: We utilized data from the China Health and Retirement Longitudinal Study (CHARLS). The exposures were dynamic changes in the hs-CRP and cumulative hs-CRP from 2012 to 2015, and the outcome was all-cause mortality. All participants were categorized into four trajectories according to hs-CRP levels. Multivariable logistic regression analysis, adjusted for potential confounders, was employed to evaluate the relationship of different trajectories of hs-CRP with mortality risk. A two-sample Mendelian randomization (TSMR) method and SHapley Additive exPlanations (SHAP) for identifying determinants of mortality risk were also employed. RESULTS: The study included 5,445 participants with 233 deaths observed, yielding a mortality proportion of 4.28%. Compared to individuals maintaining low, stable levels of hs-CRP (Class 1), individuals with sustained elevated levels of hs-CRP (Class 4), those experiencing a progressive rise in hs-CRP levels (Class 2), or those transitioning from elevated to reduced hs-CRP levels (Class 3) all faced a significantly heighted death risk, with adjusted Odds Ratios (ORs) ranging from 2.34 to 2.47 across models. Moreover, a non-linear relationship was found between them. Further TSMR analysis also supported these findings. SHAP showed that hs-CRP was the fifth most important determinant of mortality risk. CONCLUSIONS: Our study shows all-cause mortality increases with dynamic changes in hs-CRP levels among middle-aged and elderly adults in China, and cumulative hs-CRP shows an L-shaped relationship with all-cause mortality.

Choice of refractive surgery types for myopia assisted by machine learning based on doctors' surgical selection data.

In recent years, corneal refractive surgery has been widely used in clinics as an effective means to restore vision and improve the quality of life. When choosing myopia-refractive surgery, it is necessary to comprehensively consider the differences in equipment and technology as well as the specificity of individual patients, which heavily depend on the experience of ophthalmologists. In our study, we took advantage of machine learning to learn about the experience of ophthalmologists in decision-making and assist them in the choice of corneal refractive surgery in a new case. Our study was based on the clinical data of 7,081 patients who underwent corneal refractive surgery between 2000 and 2017 at the Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences. Due to the long data period, there were data losses and errors in this dataset. First, we cleaned the data and deleted the samples of key data loss. Then, patients were divided into three groups according to the type of surgery, after which we used SMOTE technology to eliminate imbalance between groups. Six statistical machine learning models, including NBM, RF, AdaBoost, XGBoost, BP neural network, and DBN were selected, and a ten-fold cross-validation and grid search were used to determine the optimal hyperparameters for better performance. When tested on the dataset, the multi-class RF model showed the best performance, with agreement with ophthalmologist decisions as high as 0.8775 and Macro F1 as high as 0.8019. Furthermore, the results of the feature importance analysis based on the SHAP technique were consistent with an ophthalmologist's practical experience. Our research will assist ophthalmologists in choosing appropriate types of refractive surgery and will have beneficial clinical effects.

Propofol induces hepatocellular carcinoma cell apoptosis via regulating miR-105/JAK2/STAT3 axis.

BACKGROUND: Hepatocellular carcinoma (HCC) is a type of malignancy with high mortality. It has been reported Propofol could modulate the tumorigenesis of liver cancer; however, the mechanism by which Propofol regulates the development of HCC is still not clear. METHODS: CCK8 assay was applied to test the cell viability. Flow cytometry and TUNEL staining were applied to detect the cell apoptosis. Meanwhile, dual luciferase reporter assay was performed to investigate the association between miR-105 and JAK2. In addition, RNA and protein levels were investigated by qRT-PCR and western blot, respectively. RESULTS: Propofol significantly suppressed the proliferation of HCC cells via inducing the apoptosis. Consistently, miR-105 upregulation inhibited the proliferation of HCC cells, while downregulation of miR-105 reversed Propofol-induced HCC cell apoptosis. Meanwhile, JAK2 was found to be the direct target of miR-105. Furthermore, Propofol could inactivate JAK2/STAT3 signaling via upregulation of miR-105. CONCLUSION: Propofol significantly attenuated HCC tumorigenesis via mediation of miR-105/JAK2/STAT3 axis. Thereby, Propofol might act as a new agent for the treatment of HCC.

Study of the Expression Transition of Cardiac Myosin Using Polarization-Dependent SHG Microscopy.

Detection of the transition between the two myosin isoforms α- and ß-myosin in living cardiomyocytes is essential for understanding cardiac physiology and pathology. In this study, the differences in symmetry of polarization spectra obtained from α- and ß-myosin in various mammalian ventricles and propylthiouracil-treated rats are explored through polarization-dependent second harmonic generation microscopy. Here, we report for the, to our knowledge, first time that α- and ß-myosin, as protein crystals, possess different symmetries: the former has C6 symmetry, and the latter has C3v. A single-sarcomere line scan further demonstrated that the differences in polarization-spectrum symmetry between α- and ß-myosin came from their head regions: the head and neck domains of α- and ß-myosin account for the differences in symmetry. In addition, the dynamic transition of the polarization spectrum from C6 to C3v line profile was observed in a cell culture in which norepinephrine induced an α- to ß-myosin transition.

Effects of excimer laser phototherapeutic keratectomy in limbal-conjunctival autograft transplantation for recurrent pterygium: a retrospective case control study.

BACKGROUND: Repeated surgery excisions could induce obvious irregular astigmatism in patients with recurrent pterygium. Our study is aimed to illustrate the effect of adjunct excimer laser phototherapeutic keratectomy (PTK) in limbal-conjunctival autograft transplantation on visual quality for patients with recurrent pterygium. METHODS: Retrospective case-control study. Eyes that underwent pterygium excision with (PTK group) or without (control group) PTK from 2006 to 2017 were retrospectively included. Recurrence rate, preoperative and postoperative surface regularity index (SRI), surface asymmetry index (SAI), cylinder and LogMAR vision were collected. Postoperative anterior segment optical coherence topography and in vivo confocal microscopy were performed to monitor the cornea epithelium healing and cellular recovery process respectively. RESULTS: A total of 99 eyes of 99 patients were collected, of which 39 were treated with PTK and 60 without PTK. The mean follow-up time was 50.4 ± 38.1 months. The recurrence rate was 10.3% (4 eyes) in the PTK group and 13.3% (8 eyes) in the control group (p = 0.759). The SRI decreased 0.53 (range: - 0.88, 2.81), SAI decreased 0.53 (range: - 0.64, 2.94), and the cylinder decreased 2.08 (range:-0.16, 9.40) D in the PTK group, and the corresponding values were 0.48 (range:-0.45, 2.27), 0.27 (range:-1.06, 2.21) and 0.71 (range:-1.75, 3.55) D in the control group, respectively (Z = 1.76, 2.15, and 3.97, p = 0.005, 0.016, and 0.000 respectively). LogMAR vision improved in both groups after surgery, with an improvement of 0.18 (range: 0.00, 0.70) in the PTK group and 0.06 (range: - 0.12, 0.50) in the control group (Z = 4.08, p = 0.000). Besides, the eyes treated with PTK showed faster re-epithelization and better cellular recovery. CONCLUSIONS: For recurrent pterygium, surgical excision with adjunct PTK might be a better option with improved corneal surface and vision outcomes.

Different Surgical Approaches to 313 Cesarean Scar Pregnancies.

STUDY OBJECTIVE: To evaluate the efficacy of different surgical treatments for cesarean scar pregnancy (CSP). DESIGN: Retrospective study (Canadian Task Force classification II-3). SETTING: Affiliated university hospitals. PATIENTS: Women (n = 313) with CSP. INTERVENTIONS: Dilation and curettage under ultrasound guidance (DCUS, n = 124), dilation and curettage with hysteroscopic guidance (DCH, n = 103), vaginal excision (n = 55), laparotomy (n = 12), and laparoscopy (n = 19). MEASUREMENTS AND MAIN RESULTS: Undetectable serum human chorionic gonadotropin (hCG) levels and thickness of the uterine scar were measured before and after surgery. Success rates of the 5 surgical treatments of CSP (DCUS, DCH, vaginal excision, laparotomy, and laparoscopy) ranged between 89% and 100%. Postoperative treatment was not needed in the vaginal and laparotomy groups, and vaginal treatment was associated with shorter operative time than laparotomy and laparoscopy and shorter time to undetectable hCG levels than DCUS and DCH. Serum hCG levels on day 3 after surgery were significantly lower than baseline levels in all groups of patients, but there was no significant difference between levels on days 3 and 5 postoperatively. Median scar thickness after surgery in the vaginal surgery, laparotomy, and laparoscopy groups was thicker than that in the DCUS and DCH groups. CONCLUSION: In certain circumstances, CSP can be treated simply by DCH or DCUS. However, time to undetectable hCG levels is prolonged compared with more invasive techniques.

Endoscopy-assisted inguinal lymphadenectomy in vulvar cancer.

OBJECTIVE: To explore the feasibility and efficiency of video endoscopic inguinal lymphadenectomy (VEIL) for vulvar cancer. METHODS: We evaluated 46 patients with vulvar cancer. Treatment included VEIL using the hypogastric subcutaneous approach (VEIL-H, 17 patients), VEIL with the limb subcutaneous surgical approach (VEIL-L, 8 patients), and open inguinal lymphadenectomy (OIL, 21 patients). All patients underwent radical vulvectomy; we evaluated operative time, the amount of bleeding, SF score, recurrence rate, etc. RESULTS: The durations of VEIL-H and VEIL-L were 170.79 ± 18.92 and 180.12 ± 17.88 min, respectively, which were longer than that of OIL (100.68 ± 11.37 min; P = 0.028). Bleeding volumes in the VEIL-H and VEIL-L groups were 15.23 ± 2.17 and 17.16 ± 2.35 ml, respectively; there were significantly lower than that of the OIL group (36.68 ± 3.48 ml; P = 0.021). The numbers of unilateral lymph nodes harvested were similar in all groups. The duration of hospitalization in VEIL group was shorter than that of the OIL group. There were less skin and lymphatic complications after VEIL than after OIL. Total SF-36 scores were significantly higher in the VEIL group than that in the OIL group (P = 0.032). There were no statistically significant differences in local recurrence, distant metastasis, and mortality among the three groups. CONCLUSION: VEIL for vulvar cancer treatment is effective, with the advantages of short hospitalization stay, less bleeding, and reduced postoperative complications comparing the OIL.

Microelectrode Array-evaluation of Neurotoxic Effects of Magnesium as an Implantable Biomaterial.

Magnesium (Mg)-based biomaterials have shown great potential in clinical applications. However, the cytotoxic effects of excessive Mg2+ and the corrosion products from Mg-based biomaterials, particularly their effects on neurons, have been little studied. Although viability tests are most commonly used, a functional evaluation is critically needed. Here, both methyl thiazolyl tetrazolium (MTT) and lactate dehydrogenase (LDH) assays were used to test the effect of Mg2+ and Mg-extract solution on neuronal viability. Microelectrode arrays (MEAs), which provide long-term, real-time recording of extracellular electrophysiological signals of in vitro neuronal networks, were used to test for toxic effects. The minimum effective concentrations (ECmin) of Mg2+ from the MTT and LDH assays were 3 mmol/L and 100 mmol/L, respectively, while the ECmin obtained from the MEA assay was 0.1 mmol/L. MEA data revealed significant loss of neuronal network activity when the culture was exposed to 25% Mg-extract solution, a concentration that did not affect neuronal viability. For evaluating the biocompatibility of Mg-based biomaterials with neurons, MEA electrophysiological testing is a more precise method than basic cell-viability testing.

Prolonging life in chick forebrain-neuron culture and acquiring spontaneous spiking activity on a microelectrode array.

Various types of animal neurons were cultured on a microelectrode array (MEA) platform to form biosensors to detect potential environmental neurotoxins. For a large-scale screening tool, rodent MEA-based cortical-neuron biosensors would be very costly but chick forebrain neurons (FBNs) are abundant, cost-effective, and easy to dissect. However, chick FBNs have a lifespan of ~14 days in vitro and their spontaneous spike activity (SSA) has been difficult to develop and detect. We used a high-density neuron-glia co-culture on an MEA to prolong chick FBN lifetime to 3 months with lifetime-long SSA. A remarkable embryonic age-dependency in the culture's morphology, lifespan, and most features of SSA signal was discovered. Our results show the feasibility of developing a chick FBN-MEA biosensor and also establish a new electrophysiological platform for functional study of an in vitro neuronal network.

[Comparison of corneal nerve regeneration and dry eye condition after conventional LASIK and femtosecond-assisted LASIK].

OBJECTIVE: To compare the regeneration of subbasal epithelial nerve plexus in the central cornea and dry eye condition between patients undergoing conventional LASIK surgery and femtosecond-assisted LASIK surgery. METHODS: It was across-sectional study. Thirty patients (60 eyes) who had LASIK at our hospital from October 2011 to September 2012 were included in this study. Patients were divided into conventional LASIK group and femtosecond-assisted LASIK group based on the method used for corneal flap creation. Subjective and objective dry eye tests were carried out at 1 year after surgery. HRT III confocal microscopy was used to observe the regeneration of subbasal epithelial nerve plexus, and the images were analyzed by ACCMetrics software using quantitative parameters to determine the density and morphology of corneal nerve fibers. The data of corneal nerve fibers and dry eye condition in the two groups undergoing different LASIK procedures was compared using an independent sample t test. RESULTS: During the one-year postoperative follow-up, the Schirmer test result, tear film break-up time value, and ocular surface disease index score in the F-LASIK group [(12.65 +/- 8.73) mm/5min, (7.85 +/- 2.81) s, (7.25 +/- 6.35) points] were not significantly different from that in the C-LASIK group [(6.73 +/- 10.55) mm/ 5 min, (8.77 +/- 3.04) s, (4.46 +/- 5.37) points] (t =1.399, -1.050, -1.613, P > 0.05). Regarding the nerve fiber measurements, which included corneal nerve fiber density, corneal nerve branch density, corneal nerve fiber length, corneal total branch node, corneal nerve fiber width, and corneal nerve fiber tortuosit, there was no statistically significant difference in their results between patients who had femtosecond-assisted LASIK surgery [(16.46 +/- 6.65 )/mm2, (19.27 +/- 9.56)/mm2, (10.88 +/- 4.70) mm/mm2, (65.10 +/- 38.43)/mm2, (4.76 +/- 0.34) microm, (2.30 +/- 0.34) grades] and those who had conventional LASIK surgery [(15.99 +/- 7.14)/mm2, (19.39 +/- 7.07)/mm2, (11.30 +/- 3.17) mm/mm2, (68.43 +/- 34.94)/mm2, (4.73 +/- 0.24) microm, (2.14 +/- 0.34) grades] (t = -0.229, 0.049, 0.365, 0.306, -0.394, -1.629, P > 0.05). CONCLUSION: The difference between conventionalLASIK and femtosecond-assisted LASIK does not significantly affect the dry eye test values and nerve fiber measurements in patients at 1 year after LASIK.

[Conjunctival Fas-FasL expression in chronic Stevens-Johnson syndrome].

OBJECTIVE: To investigate the expression level of Fas-FasL in conjunctiva tissue of chronic Stevens-Johnson syndrome (SJS) patients and to analyze the role of Fas-FasL pathway in the mechanism of ocular damage related to SJS. METHODS: Conjunctiva tissue was obtained during symblepharon release operation and cryostat sectioned at 5 µm. The tissue morphology was observed by electron microscopy. The expression of Fas-FasL (CD95/CD178) in conjunctiva was detected by immunohistochemistry (direct immunofluorescence). The conjunctiva tissue of normal people was also observed and tested as contrast group. RESULTS: The pathogenic changes included incrassation of epithelium and cavity of mucous glands in the sub-epithelium. The expression of Fas in SJS patients focusing in the basal layer of epithelium appeared a lower level compared to that in normal human conjunctiva, which distributed equally in all layers of epithelium. The expressions of FasL in SJS patients and normal people were both weak. CONCLUSIONS: The low level expression of Fas-FasL in conjunctiva of SJS patients has certain effect on the chronic ocular damage.

Transvaginal surgical treatment of cesarean scar ectopic pregnancy.

PURPOSE: To explore the feasibility of surgical management of cesarean scar ectopic pregnancy (CSEP) using a transvaginal approach. METHODS: Thirty-eight patients with CSEP presenting at the Shenzhen Nanshan People's hospital between January 2008 and May 2012 were reviewed in the study. Ten patients underwent uterine artery embolization, 13 patients underwent endoscopic CSEP removal in combination with chemotherapy and 15 received transvaginal surgical therapy (transvaginal group). Patients were followed up for between 3 and 48 months. RESULTS: Postoperative fever and irregular menstrual bleeding after healing were each observed in one of ten patients undergoing embolization. No pregnancies were reported in this group during follow-up. Endoscopy procedures included two patients undergoing laparoscopy and 11 undergoing hysteroscopy resection. There were six pregnancies during follow-up in this group. Transvaginal surgery was performed uneventfully in all cases. All patients recovered without complications. There were no reports of irregular menstrual bleeding or changes in menstrual blood volume. Serum HCG levels declined rapidly to within the normal range. The time to menstrual cycle recovery (29.2 ± 5.7 days) was significantly shorter than with endoscopic surgery (37.6 ± 8.2 days) or embolization (64.4 ± 9.2 days; P < 0.05). Three patients became pregnant after transvaginal surgery. CONCLUSION: Transvaginal removal of ectopic pregnancy tissue is a new surgical approach for the treatment of CSEP. The efficacy and safety of the approach needs further confirmation.

Anxiety disorder in menopausal women and the intervention efficacy of mindfulness-based stress reduction.

OBJECTIVES: The purpose of this study was to investigate the current situation of anxiety disorder in menopausal women and to analyze the intervention effect of Mindfulness-Based Stress Reduction (MBSR). METHODS: A total of 489 patients diagnosed with menopausal syndrome from July 2021 to June 2022 were selected as the study object. There were 120 patients with menopausal syndrome complicated with anxiety who were screened out by the Generalized Anxiety Disorder (GAD-7). The patients were divided into an experimental group (62 cases) and a control group (58 cases) according to the random number table method. The experimental group received MBSR intervention, and the control group received routine intervention. The present situation of menopausal women's anxiety disorder was analyzed. The Five Facet Mindfulness Questionaire (FFMQ) score, GAD-7 score, follicle stimulating hormone (FSH), estradiol (E2), and 5-hydroxytryptamine (5-HT) levels of the two groups were compared. RESULTS: After a statistical analysis, it was found that the incidence of anxiety in patients with menopausal syndrome was 24.54% (120/489). The severity of menopausal syndrome was positively correlated with the degree of anxiety (r = 0.621, P<0.001). After the intervention, in comparison with the control group, the FFMQ score was higher and the GAD-7 score was lower in the experimental group. The levels of FSH were decreased, and the levels of E2 and 5-HT were increased in both groups, with more significant alterations in the observation group (all P<0.05). CONCLUSIONS: The incidence of anxiety disorder in menopausal women was high and its severity was related to the severity of menopausal syndrome. MBSR intervention can alleviate anxiety symptoms and improve hormone levels in the patients.

Complement-mediated inflammation and mitochondrial energy metabolism in the proteomic profile of myopic human corneas.

Myopia is one of the most common causes of visual impairment worldwide. To identify proteins related to myopiagenesis, data-independent acquisition proteomic analysis was performed using corneal lenticules of myopic patients who underwent small incision lenticule extraction surgery. A total of 19 lenticules from 19 age and sex-matched patients were analyzed, 10 in high refractive error (HR, spherical equivalent over -6.00 D) group and 9 in low refractive error (LR, spherical equivalent between -3.00 and - 1.00 D) group. Differentially expressed proteins (DEPs) were identified by comparing the corneal proteome between the two groups. Functional analyses were performed to explore the biological pathways and interactions of the DEPs. 107 DEPs (67 upregulated and 40 downregulated in HR group, compared to LR) were identified from 2138 quantified proteins. Functional analyses indicated that upregulated proteins were primarily involved in the complement pathways and extracellular matrix (ECM) remodeling, while downregulated proteins were involved in mitochondrial energy metabolism. Western blot analysis confirmed increased complement C3a and apolipoprotein E in HR samples, further supporting the proteomics data. In conclusion, this proteomic study reveals that proteins associated with the complement system, ECM remodeling, and mitochondrial energy metabolism might be key effectors in myopiagenesis. SIGNIFICANCE: Myopia has become one of the most prevalent causes of visual impairment, especially in Asia. The underlying mechanism of myopia development is still up for debate. This study compares the proteomic profiles of high and low myopic corneas, identifying differentially expressed proteins associated with the complement system, ECM remodeling, and mitochondrial energy metabolism. The findings of this study could provide novel insights into the pathogenesis of myopia. The complement system and mitochondrial energy metabolism may provide potential therapeutic targets in the treatment and prevention of myopia.

Short-Term Impact of Different Corneal Incision Positions on Postoperative Astigmatism and Visual Quality After SMILE Surgery.

INTRODUCTION: This study aimed to evaluate the short-term impact of different incision positions on astigmatism and visual quality after small incision lenticule extraction (SMILE) surgery. METHODS: This prospective study enrolled patients who decided to have SMILE to correct myopia. Patients were randomly allocated into three groups of different incision positions (group A, B, and C with incision position at 90°, 120°, and 150° respectively). Preoperative and postoperative visual acuity, spherical equivalent, and high-order aberrations (HOAs) were measured and compared among groups. Astigmatism was analyzed with the ASSORT Group Analysis Calculator based on the Alpins method. RESULTS: A total of 148 eyes were included for analysis (48 eyes in group A, 50 eyes in group B, and 50 eyes in group C). At 1 month postoperatively, the mean uncorrected distance visual acuity (UDVA) logMAR in group A, B, and C was - 0.03, - 0.03, and - 0.04, respectively. The mean corrected distance visual acuity (CDVA) logMAR in group A, B, and C was - 0.03, - 0.04, and - 0.04, respectively (P > 0.05). The mean postoperative spherical equivalent (SE) values were - 0.01 ± 0.38, - 0.07 ± 0.39, and - 0.16 ± 0.49 (D) in group A, B, and C, respectively (P > 0.05). There was no statistically significant difference in preoperative and postoperative magnitude of astigmatism among different groups (P > 0.05). Significant differences were found in the distribution of astigmatism axis among the three groups at 1 day (P = 0.02) and 1 week (P = 0.02) postoperatively. However, such differences were no longer significant at 1 month after surgery (P > 0.05). No significant differences were found in HOAs among different groups 1 month after surgery (P > 0.05). CONCLUSION: Different incision positions have no effect on postoperative astigmatism and visual quality 1 month after SMILE surgery, though differences were found in the distribution of the astigmatism axis within 1 week after the surgery.

Assessment of transvaginal hysterotomy combined with medication for cesarean scar ectopic pregnancy.

The objective of this retrospective study was to explore a novel surgical technique, transvaginal hysterotomy combined with methotrexate injection, for treatment of cesarean scar ectopic pregnancy in 12 patients. All patients underwent the operation. Mean (SD; 95% CI) operative time was 21.6 (7.3; 17.0-26.2) minutes, and intraoperative blood loss was 90.8 (59.6; 52.9-128.7) mL. Postoperative ultrasonography confirmed removal of the pregnancy sac. The length of hospital stay was 7.4 (3.7; 5.0-9.8) days. The first normal postoperative menstrual period was at 28.3 (5.6; 24.7-31.9) days after surgery. The serum ß-human chorionic gonadotropin concentration returned to normal at 15.8 (6.3; 11.8-19.8) days. We conclude that surgical removal of the ectopic sac via transvaginal hysterotomy combined with methotrexate injection during the operation is a potentially good new approach to treatment of cesarean scar ectopic pregnancy. The efficacy and safety of the technique need further confirmation in future studies.

Case report of experience of misdiagnosis of Currarino syndrome as ovarian cyst.

The medical information was collected for Currarino syndrome. The patient had anal surgery for congenital anal stenosis when 2 years old. Clinical manifestations were pelvic cystic mass and low abdominal pain. The pelvic mass was found with a diameter of about 20 cm during the transabdominal exploration. At the second day after operation, the patient complained of neck pain. Neurosurgeon performed surgical treatment and diagnosed it as anterior sacral meningocoele. Currarino syndrome has female pelvic mass, sacral malformation, and congenital anorectal malformation, blindly puncture or drainage before operation should not be permitted.

In Situ Reduced Graphene Oxide and Polyvinyl Alcohol Nanocomposites With Enhanced Multiple Properties.

The nanocomposites formed by graphene oxide (GO) and carbazate-modified polyvinyl alcohol (PVA-N) were developed to investigate their multiple properties for wide applications. Their physicochemical characterizations confirmed that the in situ reduced GO (rGO) not only decreased the crystallization but also induced the porous structures inside the nanocomposites. Significantly, it revealed that the comprehensive performance of PVA-N2-2%GO consisted of PVA-N2 with the carbazate degree of substitution (DS) of 7% and the weight ratio (wt%) of 2% GO displayed 79% of tensile elongation and tensile strength of 5.96 N/mm2 (MPa) by tensile testing, glass transition temperature (Tg) of 60.8°C and decomposition temperature (Td) of 303.5°C by TGA and DSC, surface contact angle at 89.4 ± 2.1°, and electrical conductivity of 9.95 × 10-11 S/cm. The abovementioned comprehensive performance was enhanced with the increased amount of in situ rGO, contributed by the high DS of the carbazate group in PVA-N and high amount of GO. The rGO by in situ reduction was the main driving force for enhancing the multiple properties inside the nanocomposites.

Cetuximab Combined With Sonodynamic Therapy Achieves Dual-Modal Image Monitoring for the Treatment of EGFR-Sensitive Non-Small-Cell Lung Cancer.

BACKGROUND: Blocking signaling by epidermal growth factor receptor (EGFR), can effectively inhibit the proliferation and differentiation of non-small-cell lung cancer (NSCLC). Additionally, an increasing number of NSCLC patients have treatment limitations caused by EGFR overexpression or mutations. Therefore, we constructed a nanotherapy platform consisting of cetuximab (CTX) to target EGFR-sensitive NSCLC with an iron tetroxide core loading the sound-sensitive agent IR780 for dual-mode imaging diagnosis by combining targeting and sonodynamic therapy (SDT) to reshape the tumor microenvironment (TME), enhance the SDT antitumor effects and improve the therapeutic effects of EGFR sensitivity. METHODS: IR780@INPs were prepared by reverse rotary evaporation, CTX was adsorbed/coupled to obtain IR780@INPs-CTX, and the morphology and structure were characterized. Intracellular ROS levels and cell apoptosis first verified its killing effects against tumor cells. Then, a nude mouse lung cancer subcutaneous xenograft model was established with HCC827 cells. A real-time fluorescence IVIS imaging system determined the targeting and live distribution of IR780@INPs-CTX in the transplanted tumors and the imaging effects of the T2 sequence of the INPs by magnetic resonance imaging (MRI) 0 h, 2 h, 4 h and 6 h after administration to confirm drug efficacy. RESULTS: In vitro, US+IR780@INPs-CTX produced a large amount of ROS after SDT to induce cell apoptosis, and significant cell death after live/dead staining was observed. In vivo fluorescence imaging showed the IR780@INPs-CTX was mainly concentrated in the tumor with a small amount in the liver. MRI displayed rapid enrichment of the IR780@INPs into tumor tissue 0h after injection and the T2 signal intensity gradually decreases with time without obvious drug enrichment in the surrounding tissues. In vivo, at the end of treatment, the US+IR780@INPs-CTX group showed disappearance or a continued decrease in tumor volume, indicating strong SDT killing effects. CONCLUSION: The combination of CTX and SDT is expected to become a novel treatment for EGFR-sensitive NSCLC.