Group B Streptococcus infection-induced ovarian vein thrombosis identified during cesarean section: A case report and a literature review.

RATIONALE: Ovarian vein thrombosis (OVT) is a rare yet potentially life-threatening condition associated with thromboembolic events. Group B Streptococcus (GBS) is a type of ß-hemolytic Gram-positive bacterium known for asymptomatic colonization in the lower genital and gastrointestinal tracts. Here we reported a 35-year-old multiparous woman with gestational diabetes who suffered from placental abruption, stillbirth, OVT, septic shock, and renal failure due to severe GBS infection. PATIENT CONCERNS: A 35-year-old woman with gestational diabetes presented with acute and sustained lower abdominal cramping, vaginal bleeding, and fever at 35 gestational weeks. DIAGNOSES: Based on preoperative ultrasound and intraoperative findings, the patient was diagnosed with placental abruption, intrauterine fetal demise, and right OVT. GBS was cultured from the amniotic fluid obtained during cesarean section. INTERVENTIONS: The patient underwent a right adnexectomy during a cesarean section and received intravenous antibiotics. Subsequently, an ultrasound-guided uterine curettage was performed due to recurrent fever. OUTCOMES: After a prolonged course of intravenous antibiotics for over a month, the patient recovered and was discharged from the hospital. LESSONS: This case underscores the need for early initiation of anticoagulant protocols in cases of OVT, particularly when GBS infection is identified as a predisposing factor. Further research and awareness are warranted to better understand the relationship between GBS infection and OVT and to optimize management strategies in such cases.

De Novo Synthesis of Poly(3-hydroxybutyrate-co-3-hydroxypropionate) from Oil by Engineered Cupriavidus necator.

Poly(3-hydroxybutyrate-co-3-hydroxypropionate) [P(3HB-co-3HP)] is a biodegradable and biocompatible polyester with improved and expanded material properties compared with poly(3-hydroxybutyrate) (PHB). This study engineered a robust malonyl-CoA pathway in Cupriavidus necator for the efficient supply of a 3HP monomer, and could achieve the production of [P(3HB-co-3HP)] from variable oil substrates. Flask level experiments followed by product purification and characterization found the optimal fermentation condition (soybean oil as carbon source, 0.5 g/L arabinose as induction level) in general consideration of the PHA content, PHA titer and 3HP molar fraction. A 5 L fed-batch fermentation (72 h) further increased the dry cell weight (DCW) to 6.08 g/L, the titer of [P(3HB-co-3HP)] to 3.11 g/L and the 3HP molar fraction to 32.25%. Further improving the 3HP molar fraction by increasing arabinose induction failed as the engineered malonyl-CoA pathway was not properly expressed under the high-level induction condition. With several promising advantages (broader range of economic oil substrates, no need for expensive supplementations such as alanine and VB12), this study indicated a candidate route for the industrial level production of [P(3HB-co-3HP)]. For future prospects, further studies are needed to further improve the strain and the fermentation process and expand the range of relative products.

Cesarean delivery was associated with low morbidity in very low birth weight infants: A retrospective cohort study.

To estimate the relationship among the cesarean delivery (CD), mortality and morbidity in very low birth weight (VLBW) infants weighing less than 1500 g. This retrospective cohort study enrolled 242 VLBW infants delivered between the 24 to 31week of gestation from 2015 to 2021. We compared CD with vaginal delivery (VD). The primary outcome was a composite neonatal morbidity including bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, necrotizing enterocolitis, late-onset sepsis and retinopathy of prematurity. The secondary outcome included mortality within 28 days. A multivariate logistic regression was used and adjusted for birthweight, twin pregnancy and antenatal steroids intake. The overall CD rate was 80.6%. Compared with VD, a significantly lower composite neonatal morbidity was associated with CD (adjusted odds ratio, 0.33, 95% confidence interval, 0.12-0.90, P = .031). The relationship between CD and neonatal morbidity disappeared when the VLBW infants were stratified according to the gestational age. No significant difference was observed between the VD and CD cohorts regarding mortality. Compared with VD, CD was associated with a lower morbidity in VLBW infants. Further studies are required to clarify how this association is influenced by gestational age.

Production and waste treatment of polyesters: application of bioresources and biotechniques.

Chemical resources and techniques have long been used in the history of bulk polyester production and still dominate today's chemical industry. The sustainable development of the polyester industry demands more renewable resources and environmentally benign polyester products. Accordingly, the rapid development of biotechnology has enabled the production of an extensive range of aliphatic and aromatic polyesters from renewable bio-feedstocks. This review addresses the production of representative commercial polyesters (polyhydroxyalkanoates, polylactic acid, poly ε-caprolactone, polybutylene succinate, polyethylene terephthalate, polybutylene terephthalate, polypropylene terephthalate, polyethylene furandicarboxylate, polypropylene furandicarboxylate, and polybutylene furandicarboxylate) or their monomers (lactic acid, succinic acid, 1,4-butanediol, ethylene glycol, terephthalic acid, 1,3-propanediol, and 2,5-furandicarboxylic acid) from renewable bioresources. In addition, this review summarizes advanced biotechniques in the treatment of polyester wastes, representing the near-term trends and future opportunities for waste-to-value recycling and the remediation of polyester wastes under sustainable models. For future prospects, it is essential to further expand: non-food bioresources, optimize bioprocesses and biotechniques in the preparation of bioderived or biodegradable polyesters with promising: material performance, biodegradability, and low production cost.

Analysis of the impact of noninvasive prenatal testing for trisomies 21 and 18 in twin pregnancies undergoing artificial reproductive technology.

PURPOSE: The purpose of this study was to evaluate the performance and impact of noninvasive prenatal screening (NIPS) on twin pregnancies. PATIENTS AND METHODS: Twin pregnancies after artificial reproductive technology(ART) were tested by NIPS for screening trisomy 21, 18, and 13 in a single medical center in Hangzhou. Positive NIPS results were confirmed by karyotyping, while negative results were interviewed after delivery. RESULTS: From January 2019 to December 2020, 474 twin pregnancies were tested by NIPS for screening trisomy 21, 18, and 13 in a single medical center in Hangzhou. The performance of NIPS had been evaluated compared to the invasive diagnostic results. The positive predictive value (PPV) of NIPS for chromosome 21 and 18 aneuploidies is 80% (95CI, 36.09-96.59) and 100%, respectively. The incidence of trisomy 21, and 18 chromosome aneuploidies among the twin pregnancies undergoing ART was 0.84% and 0.21%, respectively. CONCLUSION: The performance of NIPS was substantially accurate among the twin pregnancies after ART in this study, and NIPS potentially avoided a considerable part of aneuploidies liveborn in twin pregnancies in Hangzhou.

Co-Production of Isoprene and Lactate by Engineered Escherichia coli in Microaerobic Conditions.

Lactate and isoprene are two common monomers for the industrial production of polyesters and synthetic rubbers. The present study tested the co-production of D-lactate and isoprene by engineered Escherichia coli in microaerobic conditions. The deletion of alcohol dehydrogenase (adhE) and acetate kinase (ackA) genes, along with the supplementation with betaine, improved the co-production of lactate and isoprene from the substrates of glucose and mevalonate. In fed-batch studies, microaerobic fermentation significantly improved the isoprene concentration in fermentation outlet gas (average 0.021 g/L), compared with fermentation under aerobic conditions (average 0.0009 g/L). The final production of D-lactate and isoprene can reach 44.0 g/L and 3.2 g/L, respectively, through fed-batch microaerobic fermentation. Our study demonstrated a dual-phase production strategy in the co-production of isoprene (gas phase) and lactate (liquid phase). The increased concentration of gas-phase isoprene could benefit the downstream process and decrease the production cost to collect and purify the bio-isoprene from the fermentation outlet gas. The proposed microaerobic process can potentially be applied in the production of other volatile bioproducts to benefit the downstream purification process.

Diagnostic and Prognostic Value of Long Noncoding RNAs as Potential Novel Biomarkers in Intrahepatic Cholestasis of Pregnancy.

Long noncoding RNAs (lncRNAs) are a class of important regulators participating in various pathological processes. Until now, the role of lncRNAs in the occurrence and development of intrahepatic cholestasis of pregnancy (ICP) has rarely been investigated. The data from microarray screening revealed 58 upregulated and 85 downregulated lncRNAs and 47 upregulated and 71 downregulated mRNAs in ICP patients compared to healthy controls. Bioinformatics analysis revealed biological processes focused on lipid metabolism, apoptosis, cell cycle, cell differentiation, and oxidative stress. Furthermore, the expressions of three lncRNAs (ENST00000505175.1, ASO3480, and ENST00000449605.1) chosen for verification were significantly decreased and showed the diagnostic and prognostic value for ICP based on ROC analysis. This is the first study to report the specific role of lncRNAs in ICP, which may be helpful for the diagnosis and prognosis of ICP clinically.

Use of data-independent acquisition mass spectrometry for comparative proteomics analyses of sera from pregnant women with intrahepatic cholestasis of pregnancy.

We used data-independent acquisition (DIA) proteomics technology followed by ELISAs and automated biochemical analyses to identify and validate protein expression levels in Intrahepatic Cholestasis of Pregnancy (ICP) and healthy pregnant controls. We employed bioinformatics to identify metabolic processes associated with differentially expressed proteins.The expression levels of two proteins (S100-A9 and the L-lactate dehydrogenase A chain) were significantly higher in ICP patients than in controls; the areas under the receiver operating characteristic (ROC) curves (AUCs) were 0.774 and 0.828, respectively. The expression levels of two other proteins (apolipoprotein A-I and cholinesterase) were significantly lower in patients, with values of 0.900 and 0.842, respectively. Multiple logistic regression showed that a combination of the levels of the four proteins optimized the AUC (0.962), thus more reliably diagnosing ICP. The levels of all four proteins were positively associated with that of total bile acids. Bioinformatics analyses indicated that the four proteins principally affected neutrophil activation involved in the immune response, cell adhesion, lipoprotein metabolism, and the PPAR signaling pathway. SIGNIFICANCE: This preliminary work improves our understanding of changes in serum levels of protein in pregnant women with ICP. The four proteins may serve as novel noninvasive biomarkers for ICP.

One-Pot Synthesis of 5-Hydroxymethylfurfural from Glucose by Brønsted Acid-Free Bifunctional Porous Coordination Polymers in Water.

Efficient synthesis of 5-hydroxymethylfurfural (HMF) using glucose (Glc) as a starting material represents an important process in biomass transformation. In this study, novel bifunctional porous coordination polymer (PCP) catalysts [PCP(Cr)-NH2-x (CH3) x ; x = 0, 1, or 2] containing Lewis acidic and Lewis basic sites have been synthesized and utilized as solid-phase catalysts for HMF synthesis starting from a Glc-in-water system. PCP(Cr)-NH2 was found as the optimal catalyst, with an HMF yield of 65.9% and Glc conversion of 99.9% in a water/tetrahydrofuran (THF) system. Compared with PCP(Cr), amino groups in PCP(Cr)-NH2 catalysts play a vital role in Glc isomerization and subsequent dehydration-cyclization process to obtain the highly selective and effective fructose-to-HMF conversion. High yield and chemoselectivity are ascribed to concurrent extraction of HMF into the THF layer just upon its formation in water. The mechanism of Lewis acid-base synergistic catalysis was deduced by means of infrared spectroscopy, and catalysts could be reused after simple washing procedure with high reproducibility.

Effects of electro-acupuncture on labor pain management.

PURPOSE: To evaluate the effects of a non-pharmacologic electro-acupuncture method at different acupoints on labor pain management. METHODS: Nulliparous women under the maternity care of the Department of Obstetrics and Gynecology of Sir Run Run Shaw Hospital were recruited and allocated into two experimental groups (EX-B2 group and SP6 group) and one control group, each with 60 eligible participants. Visual analog scale (VAS) was used to assess the pain during active phase of labor before and 30, 60, 120 min after intervention. The duration of active phase, the duration of second stage of labor, the duration of third stage of labor, use of oxytocin, neonatal birth weight, neonatal Apgar score at 1 and 5 min were considered as secondary outcomes of this study. RESULTS: After 30 min intervention, the mean VAS scores of both EX-B2 group and SP6 group were significantly decreased compared with the control group (P < 0.01); however, no significant difference was observed between the two experimental groups (P > 0.05). After 60 and 120 min intervention, the mean VAS scores of EX-B2 group were significantly lower than SP-6 group (P < 0.05). Both EX-B2 group and SP6 group had significant lower VAS scores after interventions and shorter time used in active phase of labor than the control group (P < 0.05). CONCLUSIONS: The study revealed that the application of electro-acupuncture at EX-B2 and SP6 acupoints could be used as a non-pharmacologic method to reduce labor pain and shorten the duration of active phase of labor.

Fertility-preserving treatment and pregnancy outcomes in the early stage of endometrial carcinoma.

OBJECTIVE: This study aimed to review the available literature on fertility-preserving treatment and pregnancy outcomes in patients with early-stage endometrial carcinoma who desired to preserve their fertility. DATA SOURCES: The PubMed database (1992-2012) was searched for the words "conservative "OR" fertility sparing "OR" fertility preserving" AND "endometrial neoplasms" (MeSH). All relevant articles in English and the relevant references were collected. STUDY SELECTION: Data from published articles about fertility-preserving treatment of endometrial cancer, including the response and recurrence rate of conservative treatment, strategies of infertility treatment, pregnancy, and obstetric outcomes, were selected. Data were mainly extracted from 41 studies, which are listed in the reference section of this review. RESULTS: Hormone therapy was the most common method used for early-stage endometrial carcinoma in patients who wished to preserve fertility. Sixty percent of the patients became pregnant after remission of the carcinoma. The percentage of patients who conceived in the assisted reproductive technology group was higher than that of the natural pregnancy group (80.0% vs. 43.2%, P < 0.01). A higher rate of preterm labor and multiple pregnancies was observed in the assisted reproductive technology group than that in the natural pregnancy group. The majority of pregnancies (71.4%) in the assisted reproductive technology group were achieved by in vitro fertilization-embryo transfer. The clinical pregnancy rate of transfer cycles in patients with endometrial carcinoma was 34.1%. CONCLUSIONS: Assisted reproductive technology is a good option in well-selected patients with early-stage endometrial carcinoma who have completed conservative treatment. In vitro fertilization-embryo transfer offers an opportunity to achieve an immediate pregnancy.

[Clinical application of protein-to-creatinine ratio in spot urine samples for preeclampsia].

OBJECTIVE: To evaluate the clinical application of protein-to-creatinine ratio (P/Cr) in spot urine samples so as to check whether it can replace urine protein excretion in 24 h collections for the diagnosis and screening of preeclampsia. METHODS: The investigators selected 100 cases of pregnant women with preeclampsia and 36 cases of normal pregnant women examined at Sir Run Run Shaw Hospital over the last two years. The correlations between P/Cr in first morning urine samples and urinary protein excretion in 24 h collections were analyzed. The cutoff values of P/Cr in first morning urine samples for screening preeclampsia of 0.3 g and 5 g in urinary protein excretion in 24 h collections were determined by a receiver operating characteristics (ROC) curve. RESULTS: A highly significant correlation existed between P/Cr in first morning urine samples and urinary protein excretion in 24 h collections. By the ROC curve analysis, the P/Cr of 0.34 g/g and 2.08 g/g in first morning urine samples represented the most appropriate threshold for detecting the urinary protein excretion of 0.3 g and 5 g in 24 h collections. CONCLUSION: The P/Cr in spot urine samples can replace urinary protein excretion in 24 h collections. It is a simple and reliable tool of diagnosis and follow-up for preeclampsia.

[Clinical curative effects of preoperative neoadjuvant chemotherapy on cervical cancer: analysis of 62 patients].

OBJECTIVE: To explore the clinical curative effects of preoperative neoadjuvant chemotherapy (NACT) on locally advanced cervical cancer. METHODS: A total of 62 patients of stage Ib2-IIb cervical cancer received neoadjuvant chemotherapy of paclitaxel plus cisplatin for 2 - 3 courses. The clinical curative effects were evaluated according to the changes of lesion size, intraoperative conditions and postoperative pathological reactions. RESULTS: The overall response rate was 90.32% (56/62) and the complete response rate 30.65% (19/62). The tumor volumes decreased after NACT. The differences were significant (P < 0.05). After NACT, 56 patients undergoing radical hysterectomy recovered smoothly. The surgical resection rate was 90.32%. Chemotherapeutic reactions of cancerous tissue and a large number of infiltrated lymphocytes were seen in 50 cases. Lymph nodes were positive in 3 cases. There were parametrial invasion (n = 2) and vascular tumor emboli (n = 2). CONCLUSION: Preoperative neoadjuvant chemotherapy is efficacious in cervical cancer. The parametrium becomes softer and the tumor staging decreases.

Methotrexate-based bilateral uterine arterial chemoembolization for treatment of cesarean scar pregnancy.

We have evaluated the efficacy of methotrexate-based bilateral uterine arterial chemoembolization for treating cesarean scar pregnancy (CSP) in 52 women between January 2005 and December 2009. Ten patients experienced massive vaginal hemorrhage after a misdiagnosis and subsequent curettage. Bleeding in these patients was reduced after chemoembolization. Dilation and curettage was not done in five of these patients because ultrasound scanning showed sparse or no blood flow in the previous gestational sac area. The five remaining patients, along with additional 42 patients who were diagnosed with CSP, underwent ultrasound-guided dilation and curettage within 24-48 hours following chemoembolization. Patients tolerated the procedure well and only mild bleeding occurred. The positive clinical outcomes in these patients support the use of bilateral uterine artery chemoembolization for the treatment of CSP.

[A pilot study on relationship of periodontal status, serum level of interleukin-1beta and delivery outcomes in pregnant women].

OBJECTIVE: To evaluate the associations between periodontal conditions, serum level of interleukin-1beta (IL-1beta) and delivery outcomes in pregnant women with a diagnosis of threatened premature labor(TPL). METHODS: Eighty systemically healthy pregnant women were enrolled in the study. The case group was composed of 40 pregnant women hospitalized with the diagnosis of TPL (TPL group) and the control group was composed of 40 normal pregnant women (Non-TPL group). Periodontal examinations included assessments of plaque index (PLI), clinical attachment loss (CAL), probing depth (PD), bleeding index (BI) and the percent of periodontitis sites (PD >3 mm, CAL > or =2 mm). The serum level of IL-1beta was determined using commercially available enzyme-linked immunoassays. RESULTS: (1) Fourteen of forty subjects of TPL group delivered premature labor infants (TPL-TB group), and twenty-six subjects delivered natural labor infants (TPL-PB group). No infants were delivered as premature labor infants in non-TPL group. There were significant differences in gestational age at delivery, birth weight, PLI, percentage of periodontitis sites and IL-1beta levels between the non-TPL group and TPL group or between the TPL-TB group and TPL-PB group (P < 0.05). (Significant negative correlation were observed between the gestational age at delivery and percentage of periodontitis sites as well as serum IL-1beta levels (P < 0.05). And significant positive correlation were observed between percentage of periodontitis site and serum IL-1beta levels (P < 0.05). CONCLUSION: Periodontal inflammation might be one of the pathogenesis of preterm birth.

[Associations between periodontal status and delivery outcomes in pregnant women with a diagnosis of threatened premature labor].

OBJECTIVE: To evaluate the association between periodontal conditions and delivery outcomes in pregnant women with a diagnosis of threatened premature labor (TPL). METHODS: Eighty systemically healthy pregnant women were enrolled in the study. Forty of these were pregnant women hospitalized with the diagnosis of TPL, and 40 normal pregnant women served. TPL was control clarified as TPL-PB (14 women) and TPL-TB (26 women) based on the delivery outcomes. No infants were delivered as PB in the control with non-TPL. Periodontal examinations included assessments of plaque index (PLI), clinical attachment loss (CAL), probing depth (PD), bleeding index (BI) and the percentage of periodontitis sites (PD > 3 mm, CAL >or= 2 mm). The serum level of TNF-alpha was determined using commercially available enzyme-linked immunoassays (ELISA). RESULTS: The mean PLI (0.94 +/- 0.05), percentage of periodontitis sites (2.93%) and TNF-alpha levels [14.81 ng/L (13.40 - 15.64 ng/L)] were significantly higher in the TPL group than in the non-TPL group [0.59 +/- 0.03, 1.32% and 11.47 ng/L (10.82 - 12.86) ng/L] (P < 0.001). The mean PLI (0.96 +/- 0.06), BI (2.99 +/- 0.14), percentage of periodontitis sites (3.61%) and TNF-alpha levels [18.35 ng/L (15.47 - 31.94) ng/L] were significantly higher in the TPL-PB group than in the TPL-TB group [0.66 +/- 0.04, 2.76 +/- 0.12, 2.25% and 13.70 ng/L (12.64 - 14.80 ng/L)]. Significant negative correlations were observed between the gestational age at delivery and percentage of periodontitis sites as well as serum TNF-alpha levels (P < 0.05). And significant positive correlations were observed between percentage of periodontitis site and serum TNF-alpha levels (P < 0.05). CONCLUSIONS: Periodontal inflammation might be involved in the pathogenesis of preterm birth.

[Analysis of periodontal status in pregnant women with a diagnosis of threatened premature labor].

PURPOSE: To evaluate the associations between periodontal conditions and delivery outcomes in pregnant women with a diagnosis of threatened premature labor (TPL). METHODS: Eighty systemically healthy pregnant women were enrolled in the study. The case group was composed of 40 pregnant women hospitalized with the diagnosis of TPL and the control group was composed of 40 normal pregnant women. Periodontal examinations included assessments of plaque index (PLI), clinical attachment loss (CAL), probing depth (PD), bleeding index (BI) and the percentage of periodontitis sites (PD > 3 mm, CAL > or = 2mm). The serum level of IL-6 was determined using commercially available enzyme-linked immunoassays (ELISA). The data were analyzed with SPSS11.0 software package for chi2 test, Student's t test and Pearson correlation analysis. RESULTS: 40 subjects were clarified as TPL and 14 as TPL-PB. 26 TPL women subsequently delivered TB infants. No infants were delivered as PB in 40 subjects clarified as non-TPL. There were no significant differences in the mean ages and gestational age at examination between the non-TPL and TPL groups or between the TPL-TB, and TPL-PB groups. There were significant differences in gestational age at delivery and birth weight between the non-TPL and TPL groups or between the TPL-TB, and TPL-PB groups (P < 0.05). The mean PLI, percentage of periodontitis sites and IL-6 levels were significantly higher in the TPL group than those of the non-TPL group. The mean PLI, BI, and percentage of periodontitis sites were significantly higher in the TPL-PB group than those of the TPL-TB group. Significant negative correlations were observed between the gestational age at delivery and percentage of periodontitis sites as well as BI (P < 0.05). CONCLUSION: Periodontal inflammation might be involved in the pathogenesis of preterm birth.

[Study on clinical significance of fetal posterior fossa fluid].

OBJECTIVE: To discuss the clinical significance of accumulated fluid in fetal posterior fossa. METHODS: Prenatal ultrasonography examination was performed on 5 400 woman at more than 20 weeks gestation, 110 women with fetus accumulated fluid in the posterior fossa more than 5mm were included in this study. The changes of accumulated fluid in fetal posterior fossa and the associated intracranial and extracranial anomalies were observed regularly every 2 or 3 weeks until delivery. The infants were also followed up. RESULTS: The incidence of the fetal posterior fossa fluid was 2.0%. Generally, the accumulated fluid in fetal posterior fossa was diagnosed at first time at 22 approximately 41 gestation weeks, median was (31 +/- 4) weeks. Most of them were be found between 29 approximately 32 weeks (42 cases, 38.2%), and the maximum amount of accumulated fluid in fetal posterior fossa was also in 29 approximately 32 gestation weeks (39 cases, 35.5%). The amount of accumulated fluid was from 6 mm to 26 mm, mean (11 +/- 3) mm, mostly between 10 approximately 14 mm (79 cases, 71.8%). The incidence of defected infants was 4.0%, 7.6% and 83.3% respectively, when the posterior fossa fluid was less than 10 mm, 10 approximately 14 mm and more than 15 mm. CONCLUSION: Most of cases could be diagnosed between 29 approximately 32 weeks gestation. The more fluid in the posterior fossa found, the more defected fetal or infant would be observed. In cases of more than 10 mm, especially more than 15 mm, anomales should be observed carefully.