Global, regional, and national burdens of nutritional deficiencies, from 1990 to 2019.

The epidemiological and burden characteristics of nutritional deficiencies (NDs) have been evolving, and it is crucial to identify geographical disparities and emerging trends. This study aimed to analyze the global, regional, and national trends in the burden of NDs over the past 30 years. Data were obtained from the Global Burden of Disease (GBD) 2019 database for the period 1990-2019. The study examined the incidence rates and disability-adjusted life years (DALYs) of NDs at various levels. Globally, the incidence rate of NDs decreased from 2226.2 per 100,000 in 2019 to 2096.3 per 100,000 in the same year, indicating a decline of 5.8%. The average annual percentage change (AAPC) was -0.21 (-0.31 to -0.11). Similarly, DALYs, prevalence, and mortality rates of NDs exhibited significant declines (AAPC = -3.21 [-3.45 to -2.96], AAPC = -0.53 [-0.55 to -0.51], and AAPC = -4.97 [-5.75 to -4.19], respectively). The incidence rate of NDs varied based on age group, gender, cause, and geographical area. Moreover, a negative association was observed between incidence and the sociodemographic index. At the regional level, the South Asia and Sub-Saharan Africa regions had the highest incidence rates of NDs. In conclusion, the global incidence rate of NDs showed a mixed pattern, while the DALY rate consistently declined. Additionally, prevalence and mortality rates of NDs decreased between 1990 and 2019.

Treasure to the mother and threat to the fetus: case report of warfarin-associated fetal intracranial hemorrhage and review of literature.

In patients with mechanical heart valve protheses, warfarin is usually recommended because of its exceptional anticoagulation effects. However, warfarin can cross the placenta, leading to teratogenicity and even catastrophic hemorrhage in the fetus. The present article describes a case of warfarin-associated fetal intracranial hemorrhage. The patient was a woman in her early 30s. At the age of 11 years, she had undergone aortic valve replacement (mechanical) for aortic regurgitation. Since then, she had been taking oral warfarin. During her pregnancy, her prothrombin time-international normalized ratio was maintained between 1.5 and 2.5. At 35 weeks of gestation, fetal ultrasonography revealed an intracranial mass in the left hemisphere. An emergency cesarean section was performed because fetal intracranial hemorrhage was suspected. A male infant was delivered with a 1- 5-, and 10-minute Apgar score of 1, 5, and 7, respectively. Cranial computed tomography revealed multiple hemorrhage sites with newly emerged bleeding spots. In patients with mechanical heart valve protheses, obstetricians face the dilemma of individual-patient differences and the difficulty of intensive monitoring of the coagulation parameters in the fetus. Tailor-made anticoagulation therapy and a more intensive ultrasonic monitoring strategy, even that involving regular magnetic resonance imaging, are necessary in these patients.

Tanshinone IIA inhibits endometrial carcinoma growth through the MAPK/ERK/TRIB3 pathway.

Endometrial carcinoma is the most common gynecological tumor in developed countries. Tanshinone IIA is a traditional herbal medicine which is to treat cardiovascular disease and has been shown to have various biological effects, such as anti-inflammatory, antioxidative and antitumor activities. However, there has been no study about the effect of tanshinone IIA on endometrial carcinoma. Thus, the aim of this study was to determine the antitumor activity of tanshinone IIA against endometrial carcinoma and investigate the associated molecular mechanism. We demonstrated that tanshinone IIA induced cell apoptosis and inhibited migration. We further demonstrated that tanshinone IIA activated the intrinsic (mitochondrial) apoptotic pathway. Mechanistically, tanshinone IIA induced apoptosis by upregulating TRIB3 expression and inhibiting the MAPK/ERK signaling pathway. In addition, knockdown of TRIB3 with an shRNA lentivirus accelerated proliferation and attenuated inhibition mediated by tanshinone IIA. Finally, we further demonstrated that tanshinone IIA inhibited tumor growth by inducing TRIB3 expression in vivo. In conclusion, these findings suggest that tanshinone IIA has a significant antitumor effect by inducing apoptosis and may be used as a drug for the treatment of endometrial carcinoma.

Molecular Features, Prognostic Value, and Cancer Immune Interactions of Angiogenesis-Related Genes in Ovarian Cancer.

Angiogenesis is crucial to tumor growth and metastasis; it plays a key role in various cancers development and progression. However, the potential effects of angiogenesis-related genes (ARGs) in ovarian cancer (OC) remain to be further investigated. We discussed the characteristics changes of ARGs in 784 OC samples from genomic and transcriptional levels, as well as their expression patterns based on four distinct datasets. First, 784 OC patients were divided into three molecular subtypes, and the findings indicated that ARG changes were correlated with clinicopathological parameters, prognosis, and immune cell-infiltrating tumor microenvironment (TME). OC patients were subsequently divided into two gene subtypes depending on differentially expressed genes (DEGs) of the abovementioned molecular subtypes. We also established an ARGs-related score (ARGs score) model for evaluating overall survival (OS) and determining the immunological landscape of OC patients, therefore predicting patients' prognosis and therapeutic responses. A lower ARGs' score accompanied by a high mutation frequency implies a higher probability of survival. Furthermore, the ARG score was correlated with the cancer stem cell (CSC) index and chemotherapeutic sensitivity. The significant involvement of ARGs in the tumor-immune-stromal microenvironment, clinicopathological characteristics, and prognosis were established in our systematic investigation of ARGs for OC patients. These discoveries might help us to better understand the role of ARGs in OC, as well as give new insight for predicting the prognosis and providing promising immunotherapy.

Anlotinib Exerts Inhibitory Effects against Cisplatin-Resistant Ovarian Cancer In Vitro and In Vivo.

Background: Anlotinib is a highly potent multi-target tyrosine kinase inhibitor. Accumulating evidence suggests that anlotinib exhibits effective anti-tumor activity against various cancer subtypes. However, the effects of anlotinib against cisplatin-resistant (CIS) ovarian cancer (OC) are yet to be elucidated. The objective of this study was to investigate the inhibitory effect of anlotinib on the pathogenesis of cisplatin-resistant OC. Materials and Methods: Human OC cell lines (A2780 and A2780 CIS) were cultured and treated with or without anlotinib. The effects of anlotinib on cell proliferation were determined using cell-counting kit-8 and colony-formation assays. To evaluate the invasion and metastasis of OC cells, we performed wound-healing and transwell assays. The cell cycle was analyzed via flow cytometry. A xenograft mouse model was used to conduct in vivo studies to verify the effects of anlotinib. The expression of Ki-67 in the tumor tissue was detected via immunohistochemistry. Quantitative real-time polymerase chain reaction and Western blotting were used to measure the mRNA and protein levels. Results: Our study revealed that anlotinib significantly inhibited the proliferation, migration, and invasion of A2780 and A2780 CIS in a dose-dependent way in vitro (p < 0.05). Through R software 'limma' package analysis of GSE15372, it was found that, in comparison with A2780, PLK2 was expressed in significantly low levels in the corresponding cisplatin-resistant strains. The ERK1/2/Plk2 signaling axis mediates the inhibitory effect of anlotinib on the proliferation and migration of ovarian cancer cell lines. Moreover, our research found that anlotinib effectively inhibited the growth of tumor cells in an OC xenograft mouse model. Conclusions: In this study, anlotinib showed excellent inhibitory effects against cisplatin-resistant OC both in vitro and in vivo. These results add to the growing body of evidence supporting anlotinib as a potential anticancer agent against OC.

The effectiveness of cold-knife conization (CKC) for post-menopausal women with cervical high-grade squamous intraepithelial lesion: a retrospective study.

BACKGROUND: The effectiveness of surgery of high-grade squamous intraepithelial lesion in post-menopausal women needs to be investigated. This study evaluated the clinical significance of cold-knife conization in the diagnosis and surgery of cervical high-grade squamous intraepithelial lesions in post-menopausal women. METHODS: We conducted a retrospective analysis of post- and pre-menopausal patients with high-grade squamous intraepithelial lesion. All patients received cold-knife conization as the primary therapy. RESULTS: The satisfactory rate of colposcopy was significantly lower in the post-menopausal group than in the pre-menopausal group (38.33 vs. 71.25%; χ2 = 36.202, P < 0.001). The overall positive margin rate of cold-knife conization (25.83 vs 12.50%; χ2 = 10.106, P = 0.001) and rate of positive endocervical cone margins (16.67 vs. 4.58%; χ2 = 14.843, P < 0.001) were significantly higher in the post-menopausal group. Moreover, 49 post- and 60 pre-menopausal women underwent subsequent surgical treatment (40.83 vs. 25.00%). Residual rate of positive and negative margins in patients before and after menopause was significantly different (χ2 = 5.711, P = 0.017; χ2 = 12.726, P < 0.001, respectively). The recurrence rate in post-menopausal women remained 3.85%. CONCLUSIONS: Cold-knife conization can be performed as a primary procedure for diagnosis and surgery of post-menopausal patients with high-grade squamous intraepithelial lesions. Sufficient deep excisions are necessary to avoid positive endocervical margins, which can reduce the residual and recurrence of postoperative lesions.