Dynein axonemal intermediate chain 2 plays a role in gametogenesis by activation of Stat3.

We previously identified the mouse dynein axonemal intermediate chain 2 (Dnaic2) gene. This gene expresses a component of the axonemal dynein complex that functions in cilia or flagella. We found that overexpression of Dnaic2 results in female subfertility and male infertility. In this study, we generated Dnaic2 knockdown (KD) mice and identified the potential regulatory mechanisms involved in Dnaic2 function. For phenotype analysis, we found that body weight was lighter and size was smaller in Dnaic2 KD mice than in wild-type mice. A total of 45% of these Dnaic2 KD mice were infertile due to sperm abnormalities in males, or had oocyte abnormalities and pathological changes in the tunica mucosa in the oviduct of females. Moreover, Dnaic2 overexpression enhanced the expression of proliferating cell nuclear antigen (PCNA) in the ovaries, which suggested that Dnaic2 stimulated proliferation of cells in the ovaries. However, PCNA expression in the testis of Dnaic2-overexpressed mice was lower than that in controls. Additionally, the ratio of Bax/B-cell lymphoma-2(Bcl-2) in the testis of Dnaic2-overexpressed mice was higher than that in controls, which suggested that Dnaic2 inhibited cellular proliferation in the testis. To examine the molecular action of Dnaic2, immunoprecipitation analysis was used and showed that Dnaic2 protein interacted with signal transducer and activator of transcription 3 (Stat3). Molecular modelling analysis showed that Dnaic2 bound with the linker and SH2 domains of Stat3. Furthermore, overexpression of Dnaic2 promoted phosphorylation of Stat3. In conclusion, our study suggests that Dnaic2 plays a role in oogenesis and spermatogenesis by activation of Stat3.

Risk Factors for Unsuccessful Office-Based Endometrial Biopsy: A Comparative Study of Office-Based Endometrial Biopsy (Pipelle) and Diagnostic Dilation and Curettage.

STUDY OBJECTIVE: To determine the risk factors for Pipelle diagnostic failure, which might help healthcare providers choose the appropriate protocol for endometrial evaluation individually. DESIGN: A single-center prospective study (Canadian Task Force classification II). SETTING: The Obstetrics and Gynecology Hospital of Fudan University. PATIENTS: Patients (n = 466) with an indication for endometrial biopsy. INTERVENTIONS: All patients received Pipelle and then diagnostic dilation and curettage. The samples were sent for histopathologic diagnosis separately. MEASUREMENTS AND MAIN RESULTS: The Pipelle procedure failed in 10 of 466 patients (2.146%). The general sample inadequacy and histopathologic diagnosis inconsistency of Pipelle was 5.921% (27/456) and 14.254% (65/456), respectively. Upon multivariate analysis, history of cervical operation(s) (odds ratio [OR], 26.510; 95% coefficient interval [CI], 2.932-239.784; p = .004), prior intrauterine procedure(s) (OR, .096; 95% CI, .017-.554; p = .009), and pinpoint cervical os (OR, 5.939; 95% CI, 1.134-31.108; p = .035) were significantly associated with Pipelle procedure failure. Meanwhile, uterine volume < 43 cm3 (OR, 8.229; 95% CI, 1.902-35.601; p = .005) and uneven endometrium detected by ultrasound (OR, .176; 95% CI, .042-.734; p = .017) had significant correlation with sample inadequacy. Pipelle detected all endometrial cancer cases, whereas only 50.000% (7/14) of endometrial hyperplasia with atypia, 26.471% (9/34) of polyps, and 18.182% (2/11) of polyps with endometrial hyperplasia without atypia cases were detected by Pipelle. CONCLUSION: Although Pipelle is the first-line method for endometrial biopsy, it might fail in women with risk factors identified in this study. More considerations should be taken when choosing Pipelle.

Quantitative risk assessment to guide the treatment of cesarean scar pregnancy.

OBJECTIVE: To develop a risk-factor scoring system for the prediction of bleeding during ultrasound-guided dilation and curettage (D&C) for cesarean scar pregnancy (CSP). METHODS: The retrospective study included patients with a CSP of 31-67 days who underwent transabdominal ultrasonography-guided D&C in 2010-2014. Binary logistic regression analysis was used to identify risk factors for the need of Foley catheter hemostasis. The predictive accuracy of a risk-scoring system based on significant factors was evaluated by receiver operating curve analysis. RESULTS: Among 82 included patients, 66 (80%) were successfully treated without any complications, whereas 16 (20%) required Foley catheter compression hemostasis. Four patients who received the Foley catheter needed further treatment. A longer pregnancy duration (odds ratio 1.171, 95% confidence interval 1.050-1.305; P=0.004) and a rich blood supply on ultrasonography (odds ratio 3.282, 95% confidence interval 1.441-4.742; P=0.005) were significant risk factors for the need of compression hemostasis. A scoring system based on these two risk factors would have identified 93.8% of patients requiring compression hemostasis if the optimum cutoff score was used. CONCLUSION: Heavy bleeding during transabdominal ultrasound-guided D&C for CSP is associated with a longer pregnancy duration and a rich blood supply on ultrasonography. The new risk-scoring system can be used to predict bleeding during surgery.