Gap-free X and Y chromosome assemblies of Salix arbutifolia reveal an evolutionary change from male to female heterogamety in willows, without a change in the position of the sex-determining locus.

In the Vetrix clade of Salix, a genus of woody flowering plants, sex determination involves chromosome 15, but an XY system has changed to a ZW system. We studied the detailed genetic changes involved. We used genome sequencing, with chromosome conformation capture (Hi-C) and PacBio HiFi reads to assemble chromosome level gap-free X and Y of Salix arbutifolia, and distinguished the haplotypes in the 15X- and 15Y-linked regions, to study the evolutionary history of the sex-linked regions (SLRs). Our sequencing revealed heteromorphism of the X and Y haplotypes of the SLR, with the X-linked region being considerably larger than the corresponding Y region, mainly due to accumulated repetitive sequences and gene duplications. The phylogenies of single-copy orthogroups within the SLRs indicate that S. arbutifolia and Salix purpurea share an ancestral SLR within a repeat-rich region near the chromosome 15 centromere. During the change in heterogamety, the X-linked region changed to a W-linked one, while the Z was derived from the Y.

Impaired immune response against SARS-CoV-2 infection is the major factor indirectly altering reproductive function in COVID-19 patients: a narrative review.

Coronavirus disease 2019 (COVID-19) is an infectious disease affecting multiple systems and organs, including the reproductive system. SARS-CoV-2, the virus that causes COVID-19, can damage reproductive organs through direct (angiotensin converting enzyme-2, ACE-2) and indirect mechanisms. The immune system plays an essential role in the homeostasis and function of the male and female reproductive systems. Therefore, an altered immune response related to infectious and inflammatory diseases can affect reproductive function and fertility in both males and females. This narrative review discussed the dysregulation of innate and adaptive systems induced by SARS-CoV-2 infection. We reviewed the evidence showing that this altered immune response in COVID-19 patients is the major indirect mechanism leading to adverse reproduction outcomes in these patients. We summarized studies reporting the long-term effect of SARS-CoV-2 infection on women's reproductive function and proposed the chronic inflammation and chronic autoimmunity characterizing long COVID as potential underlying mechanisms. Further studies are needed to clarify the role of autoimmunity and chronic inflammation (long COVID) in altered female reproduction function in COVID-19.

Flip a coin: cell senescence at the maternal-fetal interface†.

During pregnancy, cell senescence at the maternal-fetal interface is required for maternal well-being, placental development, and fetal growth. However, recent reports have shown that aberrant cell senescence is associated with multiple pregnancy-associated abnormalities, such as preeclampsia, fetal growth restrictions, recurrent pregnancy loss, and preterm birth. Therefore, the role and impact of cell senescence during pregnancy requires further comprehension. In this review, we discuss the principal role of cell senescence at the maternal-fetal interface, emphasizing its "bright side" during decidualization, placentation, and parturition. In addition, we highlight the impact of its deregulation and how this "dark side" promotes pregnancy-associated abnormalities. Furthermore, we discuss novel and less invasive therapeutic practices associated with the modulation of cell senescence during pregnancy.

HLA-DR+ CD45RA- Tregs and CD28- Treg-like cells: Potential immunologic biomarkers for reproductive aging.

PROBLEM: This study aimed to identify subsets of regulatory T cells (Tregs) associated with ovarian aging and determine whether they can be used as markers of reproductive aging. METHOD: This prospective cohort study was conducted among women of reproductive age. Basic physiological characteristics, reproductive hormones, Treg cell subsets, and correlations between these parameters were assessed. The POSEIDON criteria was used to identify women with low reproductive potential. RESULTS: The percentages of HLA-DR+ CD45RA- Tregs and CD28- Treg-like cells significantly increased with age. Women between 40 and 49 years had significantly higher percentages of HLA-DR+ CD45RA- Tregs and CD28- Treg-like cells than those at 20-29, 30-34, and 35-39 years old. Age positively correlated with FSH levels and the percentages of HLA-DR+ CD45RA- Tregs and CD28- Treg-like cells, but inversely correlated with antral follicle count (AFC) and AMH levels. Interestingly, a positive correlation was found between the percentages of HLA-DR+ CD45RA- Tregs and FSH levels, whereas an inverse correlation was found between those of HLA-DR+ CD45RA- Tregs and AFC or AMH levels. Furthermore, a significant positive correlation was observed between the percentages of CD28- Treg-like cells and AFC. Based on POSEIDON criteria, women with the percentages of HLA-DR+ CD45RA- Tregs and CD28- Treg-like cells above reference value ranges were assigned to the low prognosis groups. CONCLUSION: These findings suggest that HLA-DR+ CD45RA- Tregs and CD28- Treg-like cells can be used as immunologic markers of reproductive aging, which helps clinicians identify women with low reproductive potential and establish individualized therapeutic strategies.

Correction to: Medical expenditure for patients with hemophilia in urban China: data from medical insurance information system from 2013 to 2015.

An amendment to this paper has been published and can be accessed via the original article.

Medical expenditure for patients with hemophilia in urban China: data from medical insurance information system from 2013 to 2015.

BACKGROUND: Hemophilia, a high-cost disease, is the only rare disease covered by basic medical insurance in all province of China. However, very few studies have estimated the medical expenditure of patients with this rare disease Therefore, this study is aimed at evaluating the medical expenditure of patients with hemophilia and identifying its determinants. METHODS: The study population included 450 patients with hemophilia who were extracted from the national insurance database between 2014 and 2016. An independent-sample Kolmogorov-Smirnov test was performed to compare the medical expenditure of patients with hemophilia covered under urban employee basic medical insurance (UEBMI) and urban residence basic medical insurance (URBMI). Quantile regression analysis was conducted to explore the factors that affect the medical expenditure of patients with hemophilia. RESULTS: The total annual medical expenditure of patients with hemophilia in 2013, 2014, and 2015 had median of ¥7167 (US$ 1156), ¥3522 (US$ 577), and ¥4197 (US$ 677), respectively. The median medical expenditures of patients with hemophilia covered by UEBMI were ¥10,991 (US$ 1773), ¥2301 (US$ 377) and ¥8074 (US$ 1302), those of patients covered by URBMI were ¥4000 (US$ 645), ¥5717 (US$ 937) and ¥3141 (US$ 507) from 2013 to 2015. The differences in the medical expenditure of patients with hemophilia between UEBMI and URBMI from 2013 to 2015 were statistically significant. The number of admissions and the number of hospital days were statistically significant and positive for all quantiles. The types of medical service were statistically significant and negative for 50th quantile, and the reimbursement ratio was statistically significant and positive for 50th and 75th quantiles. (p < 0.05). CONCLUSION: The medical expenditure of patients with hemophilia was lower than that of patients with other common rare diseases that were not included in the scope of basic medical insurance reimbursement. It was also observed that the medical expenditure was mainly influenced by the severity of disease, and partly affected by the reimbursement rate.

Agaricus section Arvenses: three new species in highland subtropical Southwest China.

Agaricus is a genus of saprobic basidiomycetes with more than 400 species recognized worldwide, with about 50 species known in China. Our objective was to investigate three new species of section Arvenses in highland subtropical Southwest China. Agaricus guizhouensis is a new species characterized by a white pileus with yellowish squamules, small ellipsoid spores and cheilocystidia with yellowish-brown pigments; another new species, Agaricus longistipes is recognized by its slender stipe, and its elongate-ellipsoid basidiospores; the third new one, Agaricus megalocarpus is remarkable by its large size and its pileus surface covered with fine brown squamules. It is firstly reported for Guizhou Province that Agaricus abruptibulbus, Agaricus flocculosipes, and Agaricus subrufescens are illustrated. Two probable new species require further studying. A phylogenetic analyses of rDNA-ITS sequence data belonging to section Arvenses showed that the section Arvenses is monophyletic and can be subdivided in five branches, the branch of A. subrufescens and four clades (A-D). The eight species from highland subtropical Southwest China were distributed in all five branches, indicating that this highland is at the climatic crossroads. The white pileus trait and the potential interest are discussed. These data suggest a potential species richness that remains to be discovered.

Reduced leaflet stress in the stentless quadrileaflet mitral valve: a finite element model.

BACKGROUND: Failure of bioprosthetics is usually caused by calcification of the leaflets as a consequence of high tensile stresses. The stentless valve resembles native mitral valve anatomy, has a flexible leaflet attachment and a suspension at the papillary muscles, and preserves annuloventricular continuity. In this study, the effects of the stentless valve design on leaflet stress were investigated with a finite element model. METHODS: Finite element models of the stentless quadrileaflet mitral valve were created in the close and open configurations. The geometry of the stented trileaflet mitral valve was also analyzed for comparative purposes. Under the designated pressures, the regional stresses were evaluated, and the distributions of stresses were assessed. RESULTS: Regardless of whether the valve is in the open or close configuration, the maximum first principal stress was significantly lower in the stentless valve than in the stented valve. For the stentless valves, limited stress concentration was discretely distributed in the papillary flaps under both close and open conditions. In contrast, in the stented valve, increased stress concentration was evident at the central belly under the open condition and at the commissural attachment under close condition. In either configuration, the maximum second principal stress was markedly lower in the stentless valve than in the stented valve. CONCLUSIONS: The stentless valve was associated with a significant reduction in leaflet stress and a more homogeneous stress distribution compared to the stented valve. These findings are consistent with recent reports of the clinical effectiveness of the stentless quadrileaflet mitral valve.

Outcome of laparoscopic splenectomy with sandwich treatment including pericardial devascularization and limited portacaval shunt for portal hypertension due to liver cirrhosis.

AIM: To investigate the feasibility, effectiveness, and safety of a combination therapy of laparoscopic splenectomy (LS) with pericardial devascularization (PD) (laparoscopic Hassab's procedure) with or without limited portacaval shunt (LPS) for patients with portal hypertension due to liver cirrhosis. SUBJECTS AND METHODS: During September 2008 to April 2012, 42 patients underwent a combined treatment of LS with PD in our hospital. Of these subjects, 16 patients had an assessment of free portal vein pressure of more than 3.92-4.4 kPa and underwent a further limited LPS. Information on patients' demographics, diagnosis, and indication of splenectomy and perioperative variables was collected and analyzed. RESULTS: All patients successfully survived the operation, and 2 patients required an intraoperative conversion to open splenectomy because of intraoperative bleeding. For patients with LS plus PD, the mean operating time was 145 minutes, and the estimated blood loss was 146.2 mL. For patients who received an additional LPS, the total operating time was 232 minutes, and the established blood loss was 338.1 mL. The mean postoperative hospital stay was 11.7 and 12.3 days, respectively. Postoperative complications occurred in 1 patient who suffered gastric leakage, who received a re-operation and recovered later, and in 5 patients who experienced ascites, who received conserved medical treatment. During the follow-up, 2 patients had esophageal variceal bleeding 3 months and 1 year, respectively, after surgery. One patient had an encephalopathy 1 year after surgery, and 2 patients suffered a portal vein thrombosis without any clinical symptom. All of them were treated with conservation therapy. Two patients died 24-36 months and more than 36 months after surgery, because of liver failure. The other patients recovered well. CONCLUSIONS: We concluded that being only slightly invasive, the sandwich strategy treatment of LS with PD and LPS is feasible, effective, and safe for patients with portal hypertension due to liver cirrhosis.

[Porous polyethylene channel implants in reconstruction of orbital blowout fractures].

OBJECTIVE: To evaluate the efficacy of porous polyethylene channel implants in reconstruction of orbital blowout fractures. METHODS: Twenty-three patients with orbital blowout fractures were admitted in our eye center from June 2003 to January 2006. Porous polyethylene channel implants were used to repair the defects of orbital wall and to correct the enophthalmos. The visual acuity, the degree of enophthalmos, diplopia and position were recorded preoperatively and postoperatively. RESULT: No patients presented loss or apparent descent of visual acuity after surgery. Postoperative mean enophthalmos (1.7+/-0.5)mm was smaller significantly than that of preoperation [(3.9 +/-1.2)mm (P<0.05)]. Diplopia disappeared in 10 patients 1 month after surgery. Diplopia disappeared in 11 patients in primary position, but it remained in other positions. Diplopia remained in primary position in 2 patients. Ocular movement in 22 patients was normal postoperatively. While primary position upward occurred in 1 patient postoperatively and 2 weeks later it became normal. CONCLUSION: Porous polyethylene channel implants are effective in reconstruction of orbital blowout fractures.

[Evaluation of living donor liver transplantation for patients with hepatocellular carcinoma].

OBJECTIVE: To evaluate the donor risks and potential recipient benefits of living donor liver transplantation (LDLT) for adult patients with hepatocellular carcinoma (HCC). METHODS: From January 2002 to December 2006, a total of 27 LDLT for HCC patients were performed in our center, of which 25 received right lobe grafts and 2 received dual grafts. The clinical and follow-up data of these 27 recipients and 29 donors were analyzed retrospectively. RESULTS: Of the 29 donors, the overall complication rate was 17.24% (5 cases). Two cases (6.90%) experienced major complications (one with intra-abdominal bleeding and one with portal vein thrombosis) and three cases (10.34%) experienced minor ones (fat necrosis and infection of the surgical skin wound in one, pleural effusion in another and transient chyle leakage in the third). All donors were fully recovered and returned to their previous work. No recipients developed small-for-size syndrome. The overall HCC patients survival rate at 1- and 3-years was 84.01% and 71.40%, respectively, similar to that of patients undergoing LDLT for various nonmalignant diseases during the same period (P > 0.05). CONCLUSION: Although further study is needed to fully assess the risks and benefits of LDLT for the HCC patients and donors, our present results preliminarily suggest that LDLT offers an acceptable chance and duration of survival in patients with HCC, and it is a relatively safe procedure.

Porous polyethylene channel implants in reconstruction of orbital blowout fractures / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the efficacy of porous polyethylene channel implants in reconstruction of orbital blowout fractures.</p><p><b>METHODS</b>Twenty-three patients with orbital blowout fractures were admitted in our eye center from June 2003 to January 2006. Porous polyethylene channel implants were used to repair the defects of orbital wall and to correct the enophthalmos. The visual acuity, the degree of enophthalmos, diplopia and position were recorded preoperatively and postoperatively.</p><p><b>RESULT</b>No patients presented loss or apparent descent of visual acuity after surgery. Postoperative mean enophthalmos (1.7+/-0.5)mm was smaller significantly than that of preoperation [(3.9 +/-1.2)mm (P<0.05)]. Diplopia disappeared in 10 patients 1 month after surgery. Diplopia disappeared in 11 patients in primary position, but it remained in other positions. Diplopia remained in primary position in 2 patients. Ocular movement in 22 patients was normal postoperatively. While primary position upward occurred in 1 patient postoperatively and 2 weeks later it became normal.</p><p><b>CONCLUSION</b>Porous polyethylene channel implants are effective in reconstruction of orbital blowout fractures.</p>

[Experiment on the sexual virility of immature mice immunized with LHRH fusion protein vaccine].

OBJECTIVE: To observe the sexual virility of immature immature male mice were divided into a pre-ablactation group (n 10). The first two groups were immunized with the LHRH fusion proportion of pregnant female mice, the morphological and histological examined to conform the emasculating effect of the vaccine. When ted with testosterone (1.0 ml each) , the post-ablactation ones were rameters. RESULTS: The sexual virility of the immature mice immunized in 3 -4 months. CONCLUSION: The LHRH fusion protein vaccine mice after ablactation, and the sexual virility can recover in the pre-ablactation decrease.

[Treatment of benign bone tumor in extremities of children by subperiosteal free fibula graft].

OBJECTIVE: To investigate the way to reconstruct bone scaffold after removal of giant benign bone tumor in extremities of children. METHODS: From June 1995 to October 2000, 6 cases of benign bone tumor were treated, aged 6-14 years. Of 6 cases, there were 4 cases of fibrous hyperplasia of bone, 1 case of aneurysmal bone cyst and 1 case of bone cyst; these tumors were located in humerus (2 cases), in radius (1 case), in femur (2 cases) and in tibia (1 case), respectively. All patients were given excision of subperiosteal affected bone fragment, autograft of subperiosteal free fibula(4-14 cm in length) and continuous suture of in situ periosteum; only in 2 cases, humerus was fixed with single Kirschner wire and external fixation of plaster. RESULTS: After followed up 18-78 months, all patients achieved bony union without tumor relapse. Fibula defect was repaired, and the function of ankle joint returned normal. CONCLUSION: Autograft of subperiosteal free fibula is an optimal method to reconstruct bone scaffold after excision of giant benign bone tumor in extremities of children.