The strategy of frozen-thawed blastocyst transfer in women over 40 years / 中国医师杂志

Objective:To explore the selection strategy of blastocyst transfer number in freeze-thaw cycle for women over 40 years old, so as to provide reference for reducing twin rate and improving perinatal clinical outcome.Methods:A retrospective analysis was made of 377 patients who underwent freeze-thaw blastocyst transplantation in the reproductive center of Guangdong Maternal and Child Health Hospital from January 2017 to December 2019. They were divided into single blastocyst and double blastocyst transplantatio groups according to the number of blastocyst transplantation. The clinical pregnancy rate, implantation rate, abortion rate, live birth rate, premature delivery rate, twin rate and singleton delivery rate were compared between the two groups.Results:⑴There was no significant difference between two groups regarding the majority of baseline characteristics, including age at retrieval, age at transfer, body mass index (BMI), antral follicle count (AFC), basal follicle stimulating hormone (FSH), anti Mullerian hormone (AMH), endometrial thickness at transfer day, number of oocytes retrieved, Gn starting dose, Gn days, Gn dosage, embryos at cleavage stage and top-quality embryos ( P>0.05). ⑵ There was no significant difference in the rate of implantation, early pregnancy loss, late pregnancy loss and live birth between two groups ( P>0.05). ⑶ The preterm birth rate was higher in the double blastocyst transplantation group compared with the single blastocyst transplantation group, albeit not reaching significant difference (31.7% vs 12.5%, P=0.083). ⑷ The clinical pregnancy rate and the twin pregnancy rate was significantly higher in the double blastocyst transplantation group compared with the single blastocyst transplantation group ( P<0.05). ⑸ The singleton birth rate was significantly lower in the double blastocyst transplantation group compared with the single blastocyst transplantation group (75.61% vs 95.83%, P<0.05). Conclusions:In women ≥40 years old, transferring a single blastocyst can result in live birth rate that is similar as transferring two blastocysts while dramatically reducing the risk of twin pregnancy rate and increasing singleton birth rate.

Recurrence risk stratification of esophageal squamous cell carcinoma after neoadjuvant chemoradiotherapy / 中华放射肿瘤学杂志

Objective To analyze the pattern of recurrence risk and investigate the association between pathological staging and recurrence risk in patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (CRT). Methods Clinical data of 174 patients with advanced thoracic ESCC treated with neoadjuvant CRT between 2002 and 2015 were retrospectively analyzed. All patients received preoperative concurrent platinum-based chemotherapy with conformal radiotherapy (40-50. 4 Gy,conventional fractionation) combined with surgery. Kaplan-Meier method was utilized to analyze the survival,the log-rank test was conducted to compare the differences between groups,and the Cox regression model was used for multivariate analysis. Results The median follow-up time was 53. 9 months. A total of 44. 8% of patients achieved pathological complete response, and 59 patients ( 33. 9%) recurred after neoadjuvent CRT.The postoperative recurrence rate was 22. 2% for patients with pathological stage 0/I,38. 7% for stageⅡand 68. 2% for stageⅢ(P=0. 000).The 5-year recurrence-free survival (RFS) rates were 74. 7%, 61. 4% and 20. 9% for patients with pathological stage 0/Ⅰ,ⅡandⅢ,respectively (P=0. 000).In total,20. 5% of patients with pathological stage 0/I orⅡrecurred after postoperative 3 years, whereas all patients with pathological stageⅢrecurred within postoperative 2 years. Multivariate analysis demonstrated that age,clinical TNM staging,chemotherapy regimen,and pathological response after CRT were independent prognostic factors affecting the RFS ( P= 0. 027, 0. 047, 0. 010, 0. 005). Conclusions Pathological stage is significantly correlated with the recurrence risk in ESCC patients after neoadjuvant CRT.Risk-based surveillance strategies can be defined according to different pathologial staging.

Analysis of outcomes and prognostic factors in patients with esophageal cancer after concurrent chemoradiotherapy / 中华放射肿瘤学杂志

Objective To analyze the outcomes and prognostic factors in patients with esophageal cancer after concurrent chemoradiotherapy.Methods A total of 135 patients with esophageal squamous cell carcinoma were enrolled in the clinical study from January 2008 to June 2015.The patients were treated with two-dimensional radiotherapy (56 patients) or three-dimensional radiotherapy (79 patients).The radiotherapy was delivered at a total dose of 60-64 Gy (1.8-2.0 Gy per fraction).The concurrent chemotherapy regimen consisted of fluorouracil plus cisplatin or paclitaxel plus cisplatin and was performed on days 1 and day 29 of radiotherapy.The Kaplan-Meier method was used to calculate overall survival (OS)and progression-free survival (PFS) rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis,and the Cox model was used for multivariate prognostic analysis.Results The 1-,3-,and 5-year sample sizes were 96,31,16,respectively.The 1-,3-,and 5-year OS rates were 74.0％,39.0％,and 28.6％,respectively;the median OS time was 25 months.The 1-,3-,and 5-year PFS rates were 57.3％,27.3％,and 16.6％,respectively;the median PFS time was 15 months.The univariate analysis indicated that clinical stage,radiotherapy method,and M stage were prognostic factors for OS and PFS (P =0.006,0.000,and 0.032;P=0.017,0.004,and O.000).The multivariate analysis showed that clinical stage and radiotherapy method were independent prognostic factors for OS and PFS (P=0.006 and 0.000;P =0.033 and 0.023).Conclusions For non-surgical treatment of patients with esophageal cancer,concurrent chemoradiotherapy is a preferred strategy and has proven to be effective and tolerable.

Effect of the hydrophobin HFBI-fusion tag on exogenous protein accumulation in tobacco plant / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the mechanisms by which HFBI fusions increase recombinant fusion protein accumulation in plants.</p><p><b>METHODS</b>The HFBI sequence from Trichoderma reesei was synthesized and two plant expression vectors for expression of green fluorescence protein (GFP) and GFP-HFBI were constructed. The vectors were inoculated in Nicotiana benthamiana plants through agroinfiltration, and the expression levels and mRNA accumulation levels of GFP in Nicotiana leaves were examined by Western blotting, ELISA and RT-PCR.</p><p><b>RESULTS</b>The HFBI fusion tag significantly enhanced the accumulation of GFP in the leaves of N. benthamiana without causing toxic effects. Endoplasmic reticulum-targeted GFP-HFBI fusion induced the formation of spherical protein particles in the plant cells.</p><p><b>CONCLUSION</b>HFBI fusions can increase the accumulation of its fusion partner in plants by forming stable protein particles, which probably shields the target protein from endogenous protease-induced degadation. HFBI fusion technology provides an alternative to improving recombinant protein expression in plants from agroinfection-compatible expression vectors.</p>

Regulation of invasion behavior of ERK-mediated trophoblast by focal adhesion kinase / 中南大学学报(医学版)

OBJECTIVE@#To investigate the role of focal adhesion kinase (FAK) in extracellular signal-regulated kinase (ERK) signaling pathway mediated invadsion of trophoblasts.@*METHODS@#We established a human extravillous cytotrophoblasts in vitro invasion model. Different concentrations of herbimycin A(FAK inhibitor)and PD98059 (ERK inhibitor) were given to observe the influence on the growth of trophoblast cells, FAK, ERK phosphorylation, and trophoblast invasion abilities.@*RESULTS@#The expression of phosphorylated FAK in the extravillous cytotrophoblasts (EVCT) was inhibited by herbimycin A in a concentration-dependent manner and expression of phosphorylated ERK1/2 was also partially reduced. PD98059 had no effect on the expression of phosphorylated FAK. Herbimycin A and PD98059 suppressed the in vitro invasion of EVCT to various degrees.@*CONCLUSION@#ERK signaling pathway may be the common pathway for many invasive signals,and play a key role in the regulation of trophoblast invasion.