The long-term outcomes of vaginoplasty using acellular porcine small intestinal submucosa grafts in patients with Mayer-Rokitansky-Küster-Hauser syndrome: A case series.

OBJECTIVE: To investigate the long-term outcomes for Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) patients undergoing vaginoplasty using acellular porcine small intestinal submucosa grafts (SIS). DESIGN: A case series. POPULATION: Seventy-eight MRKH syndrome patients and a post-SIS patient who delivered a baby following the world's first robot-assisted uterus transplantation. METHODS: Mayer-Rokitansky-Küster-Hauser syndrome patients were grouped based on the postoperative time and the diagnosis-surgery interval. Outcomes of sexual function and psychological status were assessed using the female sexual function index (FSFI), self-rating scale of body image (SSBI) and self-acceptance questionnaire (SAQ). Anatomical outcomes were measured by clinicians. MAIN OUTCOME MEASURES: The primary outcome was restoration of sexual function, defined by an FSFI score in the 'good' range. Anatomical and psychological outcomes were also analysed. RESULTS: Sexual function was restored in 42.3% (33/78) of patients and the total FSFI score was 23.44 ± 4.43. Three factors (body defect, recognition of physical appearance and willingness to change physical appearance scores) in the SSBI and two in the SAQ decreased as the postoperative time increased. Based on the interval between diagnosis and surgery, the total SSBI score was lower in the short-interval group than in the long-interval group (7.25 ± 5.55 versus 12.04 ± 10.21, p = 0.038). CONCLUSIONS: Nearly half of MRKH patients in our study had good long-term sexual function after SIS vaginoplasty. Sexual function and psychological status improved as postoperative time increased. In addition, reducing the diagnosis to surgery interval was associated with improved psychological function.

Cohort Profile: Chinese Cervical Cancer Clinical Study.

Cervical cancer is the fourth most common cancer worldwide, but its incidence varies greatly in different countries. Regardless of incidence or mortality, the burden of cervical cancer in China accounts for approximately 18% of the global burden. The Chinese Cervical Cancer Clinical Study is a hospital-based multicenter open cohort. The major aims of this study include (i) to explore the associations of therapeutic strategies with complications as well as mid- and long-term clinical outcomes; (ii) to widely assess the factors which may have an influence on the prognosis of cervical cancer and then guide the treatment options, and to estimate prognosis using a prediction model for precise post-treatment care and follow-up; (iii) to develop a knowledge base of cervical clinical auxiliary diagnosis and prognosis prediction using artificial intelligence and machine learning approaches; and (iv) to roughly map the burden of cervical cancer in different districts and monitoring the trend in incidence of cervical cancer to potentially inform prevention and control strategies. Patients eligible for inclusion were those diagnosed with cervical cancer, whether during an outpatient visit or hospital admission, at 47 different types of medical institutions in 19 cities of 11 provinces across mainland China between 2004 and 2018. In a total, 63 926 patients with cervical cancer were enrolled in the cohort. Since the project inception, a large number of standardized variables have been collected, including epidemiological characteristics, cervical cancer-related symptoms, physical examination results, laboratory testing results, imaging reports, tumor biomarkers, tumor staging, tumor characteristics, comorbidities, co-infections, treatment and short-term complications. Follow-up was performed at least once every 6 months within the first 5 years after receiving treatment and then annually thereafter. At present, we are developing a cervical cancer imaging database containing Dicom files with data of computed tomography/magnetic resonance imaging examination. Additionally, we are also collecting original pathological specimens of patients with cervical cancer. Potential collaborators are welcomed to contact the corresponding authors, and anyone can submit at least one specific study proposal describing the background, objectives and methods of the study.

CDK4/6 inhibition promotes immune infiltration in ovarian cancer and synergizes with PD-1 blockade in a B cell-dependent manner.

Great progress has been made in the field of tumor immunotherapy in the past decade. However, the therapeutic effects of immune checkpoint blockade (ICB) against ovarian cancer are still limited. Recently, an inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6i) has been reported to enhance antitumor immunity in preclinical models. The combined use of CDK4/6i and ICB may be beneficial, but the effects of CDK4/6is on the tumor immune microenvironment and whether they can synergize with ICB in treating ovarian cancer remain unknown. Methods: In this study, we first assessed the antitumor efficacy of abemaciclib, an FDA-approved CDK4/6i, in a syngeneic murine ovarian cancer model. Then, immunohistochemistry, immunofluorescence and flow cytometry were performed to evaluate the number, proportion, and activity of tumor-infiltrating lymphocytes. Cytokine and chemokine production was detected both in vivo and in vitro by PCR array analysis and cytokine antibody arrays. The treatment efficacy of combined abemaciclib and anti-PD-1 therapy was evaluated in vivo, and CD8+ and CD4+ T cell activities were analyzed using flow cytometry. Lastly, the requirement for both CD8+ T cells and B cells in combination treatment was evaluated in vivo, and potential cellular mechanisms were further analyzed by flow cytometry. Results: We observed that abemaciclib monotherapy could enhance immune infiltration, especially CD8+ T cell and B cell infiltration, in the ID8 murine ovarian cancer model. Immunophenotyping analysis showed that abemaciclib induced a proinflammatory immune response in the tumor microenvironment. PCR array analysis suggested the presence of a Th1-polarized cytokine profile in abemaciclib-treated ID8 tumors. In vitro studies showed that abemaciclib-treated ID8 cells secreted more CXCL10 and CXCL13, thus recruiting more lymphocytes than control groups. Combination treatment achieved better tumor control than monotherapy, and the activities of CD8+ and CD4+ T cells were further enhanced when compared with monotherapy. The synergistic antitumor effects of combined abemaciclib and anti-PD-1 therapy depended on both CD8+ T cells and B cells. Conclusion: These findings suggest that combined treatment with CDK4/6i and anti-PD-1 antibody could improve the efficacy of anti-PD-1 therapy and hold great promise for the treatment of poorly immune-infiltrated ovarian cancer.

A novel FoxM1-PSMB4 axis contributes to proliferation and progression of cervical cancer.

The abnormally high activity of the proteasome system is closely related to the occurrence and development of various tumors. PSMB4 is a non-catalytic subunit for the proteasome assembly. Although the reports from genetic screening have demonstrated it's a driver gene for cell growth in several types of solid tumor, its expression pattern and regulatory mechanisms in malignant diseases are still elusive. Here, we found that PSMB4 is overexpressed in cervical cancer tissues. And knockdown of PSMB4 significantly inhibited cervical cancer cell proliferation. The mechanistic study revealed that FoxM1, a master regulator of cell division, binds directly to the promoter region of PSMB4 and regulates the PSMB4 expression in the mRNA level. In addition, the data analysis from TCGA showed a positive correlation between FxoM1 and PSMB4 in cervical cancer. Furthermore, the loss of functional and rescue experiments confirmed that PSMB4 is required for FoxM1-driven cervical cancer cell proliferation. Collectively, our study explains the phenomenon of dysregulated expression of PSMB4 in cervical cancer tissues and verifies its driver effect on cancer cell proliferation. More importantly, it highlights a FoxM1-PSMB4 axis could be a potential target for the treatment of cervical cancer.

Gender differences in functional connectivities between insular subdivisions and selective pain-related brain structures.

BACKGROUND: The incidence of pain disorders in women is higher than in men, making gender differences in pain a research focus. The human insular cortex is an important brain hub structure for pain processing and is divided into several subdivisions, serving different functions in pain perception. Here we aimed to examine the gender differences of the functional connectivities (FCs) between the twelve insular subdivisions and selected pain-related brain structures in healthy adults. METHODS: Twenty-six healthy males and 11 age-matched healthy females were recruited in this cross-sectional study. FCs between the 12 insular subdivisions (as 12 regions of interest (ROIs)) and the whole brain (ROI-whole brain level) or 64 selected pain-related brain regions (64 ROIs, ROI-ROI level) were measured between the males and females. RESULTS: Significant gender differences in the FCs of the insular subdivisions were revealed: (1) The FCs between the dorsal dysgranular insula (dId) and other brain regions were significantly increased in males using two different techniques (ROI-whole brain and ROI-ROI analyses); (2) Based on the ROI-whole brain analysis, the FC increases in 4 FC-pairs were observed in males, including the left dId - the right median cingulate and paracingulate/ right posterior cingulate gyrus/ right precuneus, the left dId - the right median cingulate and paracingulate, the left dId - the left angular as well as the left dId - the left middle frontal gyrus; (3) According to the ROI-ROI analysis, increased FC between the left dId and the right rostral anterior cingulate cortex was investigated in males. CONCLUSION: In summary, the gender differences in the FCs of the insular subdivisions with pain-related brain regions were revealed in the current study, offering neuroimaging evidence for gender differences in pain processing. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02820974 . Registered 28 June 2016.

Modified human uterus transplantation using ovarian veins for venous drainage: the first report of surgically successful robotic-assisted uterus procurement and follow-up for 12 months.

OBJECTIVE: To report the 12-month results of the first human uterus transplantation case using robot-assisted uterine retrieval. This type of transplantation may become a treatment for permanent uterine factor infertility. DESIGN: Case study. SETTING: University hospital. PATIENT(S): A 22-year-old woman with complete müllerian agenesis who underwent a previous surgery for vaginal reconstruction. The live uterine donor was her mother. INTERVENTION(S): The uterus transplantation procedure consisted of robot-assisted uterine procurement, orthotopic replacement and fixation of the retrieved uterus, revascularization, and end-to-side anastomoses of bilateral hypogastric arteries and ovarian-uterine vein to the bilateral external iliac arteries and veins. MAIN OUTCOME MEASURE(S): Data from preoperative investigations, surgery, and follow-up (12 months). RESULT(S): The duration of the donor and recipient surgeries were 6 and 8 hours, 50 minutes, respectively. No immediate perioperative complications occurred in the recipient or donor. The recipient experienced menarche 40 days after transplant surgery, and she has had 12 menstrual cycles since the surgery. No rejection episodes occurred in the recipient. CONCLUSION(S): These results demonstrate the feasibility of live-donor uterine transplantation with a low-dose immunosuppressive protocol and the role of DaVinci robotic assistance during human uterine procurement. CLINICAL TRIAL REGISTRATION NUMBER: XJZT12Z06.

Deregulation of WNT2/FZD3/ß-catenin pathway compromises the estrogen synthesis in cumulus cells from patients with polycystic ovary syndrome.

Mechanistic insight into estrogen deficiency by polycystic ovary syndrome (PCOS) remains a longstanding challenge in reproductive medicine. Recent advance suggest that Wingless-type MMTV integration site family members (WNTs), in concert with its Frizzled (FZD) receptors, regulate normal folliculogenesis, luteogenesis and ovarian steroidogenesis. However, no studies have so far investigated any causality between WNT-FZDs interactions and disrupted estrogen synthesis under certain pathological conditions. Here, we show that (i) FZD3 expression was significantly up-regulated in the cumulus cells (CCs) from PCOS patients. This up-regulation, along with the activation of WNT2/ß-Catenin pathway, was tightly associated with insulin resistance and estrogen deficiency, two hallmarks of PCOS. (ii) Overexpression of exogenous FZD3 in human granulosa cell COV434 impaired long-term FSH incubation-induced CYP19A1 transactivation and the recruitment of ß-Catenin onto CYP19A1 promoter, and subsequently compromised FSH-stimulated estrogen production. (iii) Conversely, inhibition of FZD3 expression exhibited a therapeutic effect on estrogen synthesis in PCOS CCs. Thus, excessive FZD3 expression in CCs may act as a brake on steroidogenic activation that is normally overcome by FSH stimulation. Future endeavor in this field should help to elucidate the complicated crosstalk between energy metabolism and endocrine cells through WNT/FZD signaling molecules.

High expression of Kruppel-like factor 4 as a predictor of poor prognosis for cervical cancer patient response to radiotherapy.

PURPOSE: The aim of this study was to explore the associations of Kruppel-like factor 4 expression with sensitivity to radiation therapy in locally advanced cervical squamous cell carcinoma patients. METHODS: The records of 117 locally advanced cervical squamous cell carcinoma patients were retrospectively reviewed, and Kruppel-like factor 4 expression in cervical carcinoma tissues was examined by immunohistochemical staining. The associations of Kruppel-like factor 4 expression with clinicopathological parameters were analyzed. Survival time was analyzed using Kaplan-Meier analysis and a Cox regression model. RESULTS: Patients being resistant to radiation therapy were associated with advanced International Federation of Gynecology and Obstetrics stage, tumor diameter (>4 cm), and poor differentiation grade. The high Kruppel-like factor 4 expression level was significantly related to resistance to radiation therapy, including radiation therapy non-response, local recurrence, and distant metastasis. The high Kruppel-like factor 4 expression level was also significantly related to the advanced International Federation of Gynecology and Obstetrics stage and poor differentiation grade. Kaplan-Meier analysis indicates that locally advanced cervical squamous cell carcinoma patients with high Kruppel-like factor 4 expression showed worse progression-free survival and overall survival. Univariate and multivariate Cox regression model analyses suggest that the high Kruppel-like factor 4 expression was one of the high-risk factors associated with poor prognosis in locally advanced cervical squamous cell carcinoma patients after radiation therapy. CONCLUSION: Our results suggest that the high Kruppel-like factor 4 expression can be used as a novel biomarker to predict radiation therapy resistance and poor prognosis for locally advanced cervical squamous cell carcinoma.

Elevated growth differentiation factor 15 expression predicts poor prognosis in epithelial ovarian cancer patients.

The purpose of this study was to determine the expression of growth differentiation factor 15 (GDF15) and explore its clinical significance in epithelial ovarian cancer (EOC) patients. The expression of GDF15 in EOC tissues and serum samples was evaluated using immunohistochemistry and enzyme-linked immunosorbent assay (ELISA), respectively. The association of GDF15 expression with clinicopathologic parameters was analyzed. Survival time was assessed using the Kaplan-Meier technique and Cox regression model. Both in EOC tissues and serum, high GDF15 levels were obviously related with advanced International Federation of Gynecology and Obstetrics (FIGO) stage, lymph node metastasis, ascites, and chemoresistance. Kaplan-Meier analysis indicated that EOC patients with high GDF15 expression showed poorer progression-free survival (PFS) and overall survival (OS). Multivariate analysis demonstrated that GDF15 expression was an independent predictor of PFS in EOC patients. Our study shows that elevated GDF15 expression was associated with poor prognosis in EOC patients. We suggest that GDF15 is a novel biomarker for the early detection of EOC, prediction of the response to chemotherapy, and screening for recurrence in EOC patients.

Modified uterine allotransplantation and immunosuppression procedure in the sheep model.

OBJECTIVE: To develop an orthotopic, allogeneic, uterine transplantation technique and an effective immunosuppressive protocol in the sheep model. METHODS: In this pilot study, 10 sexually mature ewes were subjected to laparotomy and total abdominal hysterectomy with oophorectomy to procure uterus allografts. The cold ischemic time was 60 min. End-to-end vascular anastomosis was performed using continuous, non-interlocking sutures. Complete tissue reperfusion was achieved in all animals within 30 s after the vascular re-anastomosis, without any evidence of arterial or venous thrombosis. The immunosuppressive protocol consisted of tacrolimus, mycophenolate mofetil and methylprednisolone tablets. Graft viability was assessed by transrectal ultrasonography and second-look laparotomy at 2 and 4 weeks, respectively. RESULTS: Viable uterine tissue and vascular patency were observed on transrectal ultrasonography and second-look laparotomy. Histological analysis of the graft tissue (performed in one ewe) revealed normal tissue architecture with a very subtle inflammatory reaction but no edema or stasis. CONCLUSION: We have developed a modified procedure that allowed us to successfully perform orthotopic, allogeneic, uterine transplantation in sheep, whose uterine and vascular anatomy (apart from the bicornuate uterus) is similar to the human anatomy, making the ovine model excellent for human uterine transplant research.

Basigin-2 is the predominant basigin isoform that promotes tumor cell migration and invasion and correlates with poor prognosis in epithelial ovarian cancer.

BACKGROUND: Basigin, which has four isoforms, has been demonstrated to be involved in progression of various human cancers. The aim of this study was to examine the prognostic value of basigin-2 protein expression in epithelial ovarian cancer. Furthermore, the function of basigin-2 in ovarian cancer was further investigated in cell culture models. METHODS: Immunohistochemistry staining was performed to investigate basigin-2 expression in a total of 146 ovarian tissue specimens. Kaplan Meier analysis and Cox proportional hazards model were applied to assess the relationship between basigin-2 and progression-free survival (PFS) and overall survival (OS). Real-time PCR, RT-PCR and western blot were used to explore basigin-2, basigin-3 and basigin-4 expression in ovarian cancer cell lines and tissues. To evaluate possible contributions of basigin-2 to MMP secretion and cell migration and invasion, the overexpression vectors pcDNA3.1-basigin-2 and basigin-2 siRNA were transfected into HO-8910 and HO-8910 PM cells respectively. RESULTS: High basigin-2 expression was associated with lymph-vascular space involvement, lymph node metastasis and poor prognosis of epithelial ovarian cancer. Multivariate analyses indicated that basigin-2 positivity was an independent prognostic factor for PFS (P = 0.006) and OS (P = 0.019), respectively. Overexpression of basigin-2 increased the secretion of MMP-2/9 and cancer cell migration and invasion of HO-8910 cells, whereas knockdown of basigin-2 reduced active MMP-2/9 production, migration and invasion of HO-8910 PM cells. CONCLUSIONS: The expression of basigin-2 might be an independent prognostic marker and basigin-2 inhibition would be a potential strategy for epithelial ovarian cancer patients, especially in inhibiting and preventing cancer cell invasion and metastasis.

[Relationship between the inhibition of NF-kappaB and insulin resistance in uterrus of rats with gestational diabetes mellitus].

AIM: To observe the expression of nuclear factor-kappaB (NF-kappaB) and glucose transporter-4 (GLUT-4) in uteru of rats with gestational diabetes mellitus (GDM) and to explore the relationship between inhibition of NF-kappaB and insulin resistance. METHODS: Thirty Sprague-Dawley rats were randomly divided into 3 groups: normal pregnant control (NC) group, GDM group and PDTC group, 10 rats each group. GDM rat model was established by intraperitoneal (ip) injection of streptozotocin (STZ). PDTC (40 mg/kg) was ip injected in PDTC group.The rats were sacrificed on the 20-day of pregnancy before delivery. The uterus were taken to observe the pathological changes. The expressions of GLUT-4 and NF-kappaB in uteru tissue were detected by immunohistochemical staining and Western blot. RESULTS: The renal NF-kappaB activity in GDM group was higher significantly than that in NC group (P<0.01); and NF-kappaB activity in PDTC group was lower than that in GDM group (P<0.01). The expression of GLUT-4 in GDM group was significantly lower than that in NC group (P<0.01). However, compared with GDM group, the expression of GLUT-4 in PDTC group was increased (P<0.01). CONCLUSION: The inhibition of NF-kappaB activity can increase the expression of GLUT-4 in uterus of GDM rats, indicating that the occurrence of GDM in rats with uteru insulin resistance may be related with the intervention of NF-kappaB activity on the down regulation of the expression of GLUT-4.

XIAP gene downregulation by small interfering RNA inhibits proliferation, induces apoptosis, and reverses the cisplatin resistance of ovarian carcinoma.

OBJECTIVE: XIAP is one of the most important members of the inhibitors of apoptosis family. It is upregulated in various malignancies, including human ovarian carcinomas, it promotes invasion, metastasis, growth, and survival of malignant cells, and it also confers resistance to some chemotherapeutic drugs. We observed the effect of XIAP gene RNA interference (RNAi) on the proliferation, apoptosis, tumorigenicity, and chemosensitivity of the human ovarian carcinoma cells A2780/cp70. STUDY DESIGN: We used a human U6 promoter-driven DNA template approach to induce short hairpin RNA-triggered RNAi to block XIAP gene expression in the human ovarian cancer cell line A2780/cp70. A corresponding site-mutated vector was constructed as a negative control (pSilencer 2.1-NC). The expression of XIAP mRNA and protein among the stable transfected cells and the untransfected ones was detected by RT-PCR and Western blotting. The cell growth was examined and drug sensitivity was assayed using the MTT assay. Cell apoptosis was measured by flow cytometry and the tumorigenicity by using nude mice. RESULTS: Three stable transfected cell lines: A2780/cp70-s2, A2780/cp70-NC, and A2780/cp70-neo were established. The expression levels of XIAP gene mRNA and protein in A2780/cp70-s2 were 63.3% and 60.8%, lower than in A2780/cp70-NC, A2780/cp70-neo, and untransfected A2780/cp70 cells. The cell proliferation of A2780/cp70-s2 was reduced by up to 62.2+/-1.9%. Compared with the other cell lines, the changes in apoptotic rate in A2780/cp70-s2 was 31.1+/-1.3%, obviously increasing (P<0.05). The knockdown of XIAP retards tumorigenicity in nude mice and after 21 days the average tumor weight of the A2780/cp70-s2 group was lower by 1.62+/-0.11g (P<0.05). And the survival index in A2780/cp70-s2 cells was markedly reduced with the addition of 1 microM and 10 microM cisplatinum, respectively (P<0.05). CONCLUSIONS: XIAP gene RNAi inhibited the proliferation of ovarian carcinoma cells and caused cells to be more sensitive to cisplatin through the reduction of its mRNA and protein. These results suggest that XIAP is an ovarian cancer-related gene and that XIAP is a potential target for therapeutic anti-cancer drugs.

[Differentially expressed genes in diabetes-induced embryopathy].

To determine molecular mechanism in hyperglycemia induced congenital neural tube defects, yolk sac cells were harvested at gestational day 12 from streptozotocin (STZ) -induced diabetic rats with congenital neural tube defects in offspring, STZ-induced diabetic rats without neural tube defects and normal control group. We analyzed gene expression profiles in yolk sac cells using a DNA microarray technique. Changes in apoptotic and MAP Kinase signaling pathways were detected by Western blotting analyses. Comparison of genes in yolk sac cells with a total of 1 200 genes in the control cells, 79 genes differently expressed between the two groups were detected. Forty-two of them were up-regulated and 37 were down-regulated. There was strong characteristic apoptotic DNA ladder in yolk sac cells in embryopathic offspring from experimentally-induced diabetic rats. The activity of ERK1/2 was dramatically decreased and the activity of JNK1/2 was significantly increased. Differentially expressed genes, MAP Kinase, and apoptotic signal pathways play very important roles in hyperglycemia induced neural tube defects. We hope that these could provide useful hallmark to rapid identification of early diabetic embryopathy.

Carbapenem resistance mechanism and risk factors of Pseudomonas aeruginosa clinical isolates from a University Hospital in Xi'an, China.

PURPOSE: Carbapenems are important agents for the therapy of Gram-negative bacillus infections, and the development of their resistance hampers effective therapeutic options. The purpose of this study was to assess the major mechanisms and risk factors leading to carbapenem resistance in clinical Pseudomonas aeruginosa isolates. METHODS: Thirty-four clinical isolates with differing degrees of carbapenem susceptibility were analyzed for carbapenemase, porin, and efflux systems. Risk factor analysis was performed using a case-control study. RESULTS: Eighteen of 24 carbapenem-resistant isolates were producers of carbapenemase. Diminished expression of oprD and overexpression of effluxes were present in five and seven carbapenem-resistant isolates, respectively. The number of days from admission to the day of positive culture and days of antibiotic apply were identified as the independent predictors of infection with carbapenem-resistant P. aeruginosa. CONCLUSIONS: Carbapenemase production is a major mechanism of P. aeruginosa isolates involved in this study. Increased length of hospital stay and days of antibiotic application were the most important risk factors identified for carbapenem resistance.

Inhibition of multi-drug resistance of ovarian carcinoma by small interfering RNA targeting to MRP2 gene.

AIMS: To investigate the inhibiting mechanism of multi-drug resistance (MDR) using expression vectors of short hairpin RNA (shRNA) in a MDR human ovarian cancer cell line (A2780/cp70). METHODS: Two shRNA expression vectors were constructed and introduced into A2780/cp70 cells. Expression of MRP2 mRNA was assessed by RT-PCR, and Mrp2 expression was determined by Western blot and immunocytochemistry. Apoptosis and sensitization of the cells to cisplatinum were quantified by flow cytometry and methyl-thiazol-tetrazolium (MTT) assays. Cellular cisplatinum accumulation was assayed by laser scanning confocal microscopy (LSCM). RESULTS: In A2780/cp70 cells transfected with MRP2-A and MRP2-B shRNA expression vectors, RT-PCR showed that MRP2 mRNA expression was reduced by 41.8% (P < 0.05), 30.9% (P < 0.01) (transient transfection) and 39.6% (P < 0.05), 29.4% (P < 0.01) (stable transfection), respectively. Western blot and immunocytochemistry showed that Mrp2 expression was significantly and specifically inhibited. Resistance against cisplatinum was decreased from 173- to 119-fold (P < 0.05), 64-fold (P < 0.01) (transient transfection) and to 117-fold (P < 0.05), 60-fold (P < 0.01) (stable transfection). Furthermore, shRNA vectors significantly enhanced the cellular cisplatinum accumulation. The combination of shRNA vectors and cisplatinum significantly induced the apoptosis of cells. CONCLUSIONS: shRNA expression vectors effectively reduce MRP2 expression and can restore the sensitivity of drug-resistant cancer cells to conventional chemotherapeutic agents.

Three- and 4-dimensional ultrasonography in the prenatal evaluation of fetal anomalies associated with trisomy 18.

OBJECTIVE: The purpose of this study was to assess the usefulness of 3- and 4-dimensional ultrasonography (3D/4DUS) for the description of anomalies associated with trisomy 18 and to determine whether 3D/4DUS adds diagnostic information over what is provided by conventional 2-dimensional ultrasonography (2DUS) alone. METHODS: Twenty-six fetuses subsequently proven to have trisomy 18 underwent prenatal ultrasonographic evaluations by both 2DUS and 3D/4DUS. Volume data sets were acquired by the same sonographers after the conventional 2DUS examinations and were explored with 4-dimensional imaging software by another independent examiner blinded to the indications of 2DUS. The findings detected by 2DUS and 3D/4DUS were compared with those acquired at autopsy. The sensitivity of each modality for detecting anomalies was calculated and compared by the McNemar test. RESULTS: Excluding polyhydramnios, there were 131 anomalies confirmed postnatally in 26 fetuses with trisomy 18. There was a statistically significant difference in the sensitivity for detecting anomalies between 3D/4DUS and 2DUS (93.89% versus 73.28%; McNemar value = 23.31; P < .05), especially in anomalies of the face/neck (96.15% versus 65.38%; McNemar value = 6.13; P < .05) and extremities (96.3% versus 48.15%; McNemar value = 11.07; P < .05). Three- and 4-dimensional ultrasonography provided additional diagnostic information for 83.97% of the anomalies related to trisomy 18 and influenced the obstetric management of 4 fetuses. CONCLUSIONS: Three- and 4-dimensional ultrasonography offered diagnostic advantages for many anomalies associated with trisomy 18, especially for anomalies of the extremities and face. This modality could be a powerful adjunct to 2DUS in the prenatal anatomic evaluation of fetuses with trisomy 18.

[Inhibition of ovarian cancer growth by small interfering RNA targeting X-linked inhibitor of apoptosis gene].

OBJECTIVE: To construct an RNA interference vector to down-regulate X-linked inhibitor of apoptosis (XIAP) gene and study the RNA interference effect on the cell cycle and growth of ovarian cancer. METHODS: Oligonucleotides of 64 base pairs for hairpin RNA targeting XIAP were designed, chemically synthesized, annealed, and cloned into the pSUPER vector. After identification by restriction digestion, the correct vectors were transiently transfected into SKOV3 cells, a human ovarian cancer cell line. The XIAP mRNA was detected by RT-PCR. The proteins were detected by western blot and indirect immunofluorescence staining. Flow cytometry (FCM) analysis and methyl thiazolyl tetrazolium (MTT) assay method were applied to measure cell cycle, cell growth and sensitiveness to cisplatin. RESULTS: SKOV3 cells had a high level expression of XIAP. The vector of RNA interference, which can interfere with XIAP gene was successfully constructed. After transient transfection, the expression of XIAP protein was significantly decreased in SKOV3 cells and the value of relative density was 3584 +/- 124, 2138 +/- 65, 1973 +/- 80 and 110 +/- 12, respectively (P = 0.0334). At the same time, the expression of XIAP mRNA was decreased accordingly and the value of relative density was 6674 +/- 274, 4532 +/- 107, 2322 +/- 57 and 1864 +/- 78, respectively (P = 0.0127). The FCM results showed that, the vector could increase the number of cells in G(1) phase compared with parent cells and compared with the cells transfected with pSUPER (P < 0.05); the number in S phase decreased compared with parent cells and compared with the cells transfected with pSUPER (P < 0.05). MTT results showed that pSUPER-siXIAP could inhibit the growth and proliferation of SKOV3 cells in a time-dependent manner, and inhibit the tumor cell growth. CONCLUSIONS: We successfully constructed an expressing hairpin RNA against the XIAP vector. The vector can effectively silence XIAP gene, increase the number of cells in G(1) phase, and slow down the growth of tumor cells. This may be a useful therapeutic strategy for XIAP over-expressing ovarian carcinomas.

Knockdown of RAB25 expression by RNAi inhibits growth of human epithelial ovarian cancer cells in vitro and in vivo.

AIMS: Ovarian cancer is the leading cause of cancer death among gynaecological malignancies. Elevated expression of Rab25 has been seen in this malignancy. To better understand its role in maintaining the malignant phenotype, we used RNA interference (RNAi) directed against Rab25 in our study. RNAi provides a new, reliable method to investigate gene function and has the potential for gene therapy. The aim of the study was to examine the anti-tumour effects elicited by a decrease in the level of Rab25 by RNAi and its possible mechanism of action. METHODS: According to the Rab25 mRNA sequence in Genbank, a pair of 64 nt oligonucleotides were designed and synthesised, each containing the sites of restriction endonuclease at both ends. Oligonucleotides were annealed and ligated with linearised pSUPER by ligase. The recombinants (named pSUPER/Rab25 siRNA) were finally sequenced and identified by enzyme cutting and sequencing. The human ovarian cell line A2780 was grown without transfection, transfection with empty vector and with pSUPER/Rab25 siRNA with electroporation. The inhibitory effect was examined by RT-PCR, MTT, FCM and tumour growth of athymic nude mice. RESULTS: Rab25 siRNA expression vector was successfully constructed and identified by double endonuclease digestion. Sequence analysis of inserted fragment revealed the same sequence as synthesised siRNA oligonucleotides. Cells transfected with Rab25 siRNA can specifically knock down the transcription of Rab25, exhibiting cells with slower proliferation, increased apoptosis, and decreased tumour growth. CONCLUSIONS: Rab25 siRNA expression vector has been successfully constructed, and it could inhibit the tumour growth both in vitro and in vivo. Our data suggest that the Rab25 signalling pathway plays a role in the regulation of cell proliferation and apoptosis in ovarian cancer cells, which indicates that the Rab25 gene plays a definite role in the development and aggressiveness of human ovarian cancer and should be further elucidated as a possible therapeutic target of ovarian cancer.