LncRNA ROR promotes proliferation of endometrial cancer cells via regulating Notch1 pathway.

OBJECTIVE: The aim of this study was to investigate the effects of long non-coding ribonucleic acid regulator of reprogramming (lncRNA ROR) on the proliferation and apoptosis of endometrial cancer (EC) cells, and to explore its possible underlying mechanism. PATIENTS AND METHODS: The expression levels of lncRNA ROR and Notch1 in EC tissues were detected via quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The changes in Notch1 protein were detected via Western blotting. Subsequently, the regulatory mechanism of lncRNA ROR on Notch1 was analyzed using Luciferase reporter gene assay. Moreover, the changes in cell proliferation and apoptosis were determined through cell counting kit-8 (CCK-8) assay and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay, respectively. RESULTS: Both lncRNA ROR and Notch1 were highly expressed in EC tissues (p<0.05). After overexpression of lncRNA ROR, HEC-1A cells had significantly enhanced proliferation (p<0.05) and weakened apoptosis (p<0.05). Meanwhile, the mRNA and protein levels of Notch1 rose remarkably compared with those in control group (p<0.05). Luciferase reporter gene assay revealed that lncRNA ROR could bind to the Notch1 regulatory factor miR-34a and inhibit its activity. CONCLUSIONS: LncRNA ROR regulates the proliferation and apoptosis of EC cells via promoting the expression of Notch1 protein.

Comparison of pegylated liposomal doxorubicin and paclitaxel plus carboplatin-based chemotherapy as first line treatment for patients with ovarian cancer: a systematic review and meta-analysis of randomized controlled trials.

We reviewed studies comparing survival outcomes such as overall survival (OS), progression free survival (PFS), and toxicity profile between patients treated with Pegylated Liposomal Doxorubicin (PLD) combination and those treated with paclitaxel combination for ovarian cancer. We conducted systematic searches in various databases including Medline, Cochrane Controlled Register of Trials (CENTRAL), ScienceDirect, and Google Scholar from inception until August 2019. We used the Cochrane risk of bias tool to assess the quality of published trials. We carried out a meta-analysis with random-effects model and reported pooled Hazard ratios (HR) or Risk ratios (RR) with 95% confidence intervals (CIs). In total, we analysed 7 studies including 3,676 participants. All the studies were randomized controlled trials, while majority of studies had low bias risks. We did not find significant evidence for any of these outcomes except progression free survival (favoured PLD combination therapy pooled HR=0.87; 95% CI: 0.77-0.98). Worst grade toxicities like allergy (pooled RR: 1.86; 95% CI: 1.06-3.24) and neurotoxicity (pooled RR: 5.59; 95% CI: 1.43-21.84) were significantly higher among patients receiving paclitaxel combination therapy when compared to patients receiving PLD combination therapy. To summarize, PLD combination therapy is non-inferior to paclitaxel combination therapy in the management of ovarian cancer with respect to survival outcomes and worst grade toxicity profile. However, clinical recommendations cannot be made, as the evidence is not conclusive or significant enough.

Integrated network analysis to identify the key genes, transcription factors, and microRNAs involved in hepatocellular carcinoma.

HCC (hepatocellular carcinoma), which can be induced by cirrhosis and viral hepatitis infection, is the most frequent form of liver cancer. This study is performed to investigate the mechanisms of HCC. GSE57957 was obtained from Gene Expression Omnibus database, including 39 HCC samples and 39 adjacent non-tumorous samples. The DEGs (differentially expressed genes) were screened using the limma package in R, and then were conducted with enrichment analysis using "BioCloud" platform. Using STRING database, WebGestalt tool, as well as ITFP and TRANSFAC databases, PPI (protein-protein interaction) pairs, miRNA (microRNA)-target pairs, and TF (transcription factor)-target pairs separately were predicted. Followed by integrated network was constructed by Cytoscape software and module analysis was performed using the MCODE plugin of Cytoscape software. There were 518 DEGs identified from the HCC samples, among which 17 up-regulated genes (including MCM2, MCM6, and CDC20) and 5 down-regulated genes could also function as TFs. In the integrated network for the down-regulated genes, FOS and ESR1 had higher degrees, and both of them were targeted by miR-221 and miR-222. Additionally, MCM2 had interaction with MCM6 in the up-regulated module with the highest score. MCM2, MCM6, CDC20, FOS, ESR1, miR-221 and miR-222 might affect the pathogenesis of HCC.

Molecular analyses of circadian gene variants reveal sex-dependent links between depression and clocks.

An extensive literature links circadian irregularities and/or sleep abnormalities to mood disorders. Despite the strong genetic component underlying many mood disorders, however, previous genetic associations between circadian clock gene variants and major depressive disorder (MDD) have been weak. We applied a combined molecular/functional and genetic association approach to circadian gene polymorphisms in sex-stratified populations of control subjects and case subjects suffering from MDD. This approach identified significant sex-dependent associations of common variants of the circadian clock genes hClock, hPer3 and hNpas2 with major depression and demonstrated functional effects of these polymorphisms on the expression or activity of the hCLOCK and hPER3 proteins, respectively. In addition, hCLOCK expression is affected by glucocorticoids, consistent with the sex-dependency of the genetic associations and the modulation of glucocorticoid-mediated stress response, providing a mechanism by which the circadian clock controls outputs that may affect psychiatric disorders. We conclude that genetic polymorphisms in circadian genes (especially hClock and hPer3, where functional assays could be tested) influence risk of developing depression in a sex- and stress-dependent manner. These studies support a genetic connection between circadian disruption and mood disorders, and confirm a key connection between circadian gene variation and major depression.

Tensile strains give rise to strong size effects for thermal conductivities of silicene, germanene and stanene.

Based on first principles calculations and self-consistent solution of the linearized Boltzmann-Peierls equation for phonon transport approach within a three-phonon scattering framework, we characterize lattice thermal conductivities k of freestanding silicene, germanene and stanene under different isotropic tensile strains and temperatures. We find a strong size dependence of k for silicene with tensile strain, i.e., divergent k with increasing system size; however, the intrinsic room temperature k for unstrained silicene converges with system size to 19.34 W m(-1) K(-1) at 178 nm. The room temperature k of strained silicene becomes as large as that of bulk silicon at 84 µm, indicating the possibility of using strain in silicene to manipulate k for thermal management. The relative contribution to the intrinsic k from out-of-plane acoustic modes is largest for unstrained silicene, ∼39% at room temperature. The single mode relaxation time approximation, which works reasonably well for bulk silicon, fails to appropriately describe phonon thermal transport in silicene, germanene and stanene within the temperature range considered. For large samples of silicene, k increases with tensile strain, peaks at ∼7% strain and then decreases with further strain. In germanene and stanene, increasing strain hardens and stabilizes long wavelength out-of-plane acoustic phonons, and leads to similar k behaviors to those of silicene. These findings further our understanding of phonon dynamics in group-IV buckled monolayers and may guide transfer and fabrication techniques for these freestanding samples and engineering of k by size and strain for applications of thermal management and thermoelectricity.

Use of progesterone and progestin analogs for inhibition of preterm birth and other uterine contractility disorders.

In this paper we focus on preterm birth as a uterine contractility disorder caused by hypercontractility of the -myometrium. We describe changes in uterine function during term and preterm labor and delivery. We also examine the usefulness of measurement of uterine electromyographic (EMG) activity, noninvasively monitored from the -abdominal surface of pregnant patients. The use of progesterone treatment for preterm birth is discussed and we conclude that present therapies with progesterone could be improved by changing the route of administration. -Finally we show the results of recent studies that show that progesterone injections completely inhibit uterine EMG activity when given several days to hours before normal delivery. These studies illustrate how progesterone suppresses labor at term or preterm, probably through repression of genes which control excitability and conduction of electrical activity. However, direct profusion of soluble progesterone into the uterine cavity has little immediate inhibitory action and this may demonstrate that progesterone has no direct, nongenomic effects, at least in the rat model used. Further studies are required to determine the effects of progesterone on human uterine EMG activity and whether progesterone treatments will prevent preterm birth.

Pressure prediction model for compression garment design.

Based on the application of Laplace's law to compression garments, an equation for predicting garment pressure, incorporating the body circumference, the cross-sectional area of fabric, applied strain (as a function of reduction factor), and its corresponding Young's modulus, is developed. Design procedures are presented to predict garment pressure using the aforementioned parameters for clinical applications. Compression garments have been widely used in treating burning scars. Fabricating a compression garment with a required pressure is important in the healing process. A systematic and scientific design method can enable the occupational therapist and compression garments' manufacturer to custom-make a compression garment with a specific pressure. The objectives of this study are 1) to develop a pressure prediction model incorporating different design factors to estimate the pressure exerted by the compression garments before fabrication; and 2) to propose more design procedures in clinical applications. Three kinds of fabrics cut at different bias angles were tested under uniaxial tension, as were samples made in a double-layered structure. Sets of nonlinear force-extension data were obtained for calculating the predicted pressure. Using the value at 0° bias angle as reference, the Young's modulus can vary by as much as 29% for fabric type P11117, 43% for fabric type PN2170, and even 360% for fabric type AP85120 at a reduction factor of 20%. When comparing the predicted pressure calculated from the single-layered and double-layered fabrics, the double-layered construction provides a larger range of target pressure at a particular strain. The anisotropic and nonlinear behaviors of the fabrics have thus been determined. Compression garments can be methodically designed by the proposed analytical pressure prediction model.

The effect of intertube van der Waals interaction on the stability of pristine and functionalized carbon nanotubes under compression.

This paper investigates the effect of intertube van der Waals interaction on the stability of pristine and covalently functionalized carbon nanotubes under axial compression, using molecular mechanics simulations. After regulating the number of inner layers of the armchair four-walled (5, 5)@(10, 10)@(15, 15)@(20, 20) and zigzag four-walled (6, 0)@(15, 0)@(24, 0)@(33, 0) carbon nanotubes, the critical buckling strains of the corresponding tubes are calculated. The results show that each of the three inner layers in the functionalized armchair nanotube noticeably contributes to the stability of the outermost tube, and together increase the critical strain amplitude by 155%. However, the three inner layers in the corresponding pristine nanotube, taken together, increase the critical strain of the outermost tube by only 23%. In addition, for both the pristine and functionalized zigzag nanotubes, only the (24, 0) layer, among the three inner layers, contributes to the critical strain of the corresponding outermost tube, by 11% and 29%, respectively. The underlying mechanism of the enhanced stability related to nanotube chirality and functionalization is analyzed in detail.

Effects of buccal bi-cortical anchorages on primary stability of dental implants: a numerical approach of natural frequency analysis.

The purpose of this study was to investigate influences of buccal bi-cortical anchorages on natural frequency (NF) values of dental implants in different diameters utilizing the three-dimensional finite element method. Three degrees of buccal bi-cortical engagements were generated in D2 and D3 bone quality models, which were 0-mm engagement (i.e. implants just had contact with the buccal cortex), 0.5-mm (i.e. implants were penetrated into the buccal cortex by 0.5 mm) and 1.0-mm engagement, while only 0- and 0.5-mm engagement were simulated in D4 bone models. The uni-cortical engagement was set as the control. By the modal analysis, NF values of bending and axial vibration mode were computed as a function of different bi-cortical engagements. The results showed that buccal bi-cortical anchorages significantly enhanced bending and axial NF values. The increasing rates resulting from 0.5-mm engagement ranged from 10.5 to 42.3%, with a mean of 24.3%. From 0- to 0.5-mm engagement, the NF values maintained an increasing trend, and from 0.5- to 1.0-mm engagement, the values levelled off or even decreased. In 0.5- and 1.0-mm engagement models, increasing implant diameter resulted in small increases of NF values. In conclusion, buccal bi-cortical anchorages could significantly increase both bending and axial NF values of dental implants, but extra-buccal cortical bone engagement could not produce considerable incremental increases of NF values as anticipated. Increasing implant diameter could result in limited increases of NF values in case of implants being bi-cortically anchored.

Inhibitory effects of electrical stimulation on delivery in pregnant rats.

OBJECTIVE: To study the efficacy of uterine electrical stimulation (ES) with various parameters in delaying delivery in term- and preterm-laboring animals. STUDY DESIGN: Catheters and electrodes, as well as ES electrodes, were sutured onto the uterine horn in day-15 pregnant rats. ES with various durations/frequencies (five sets of parameters) was tested from gestation day 21 to determine its effects on uterine contractility. The best set of ES parameters was applied in term (day 21) and preterm (day 18-labor induced) animals to determine the effects of ES on delivery. RESULTS: (1) Significant reduction in uterine contractions (0.54+/-0.11 vs. 0.86+/-0.08 contractions per minute, P<0.001) was noted with ES of only one of the five sets of parameters (set #5 with pulse train of 10s on and 10s off, 28ms pulse width, frequency of 30Hz and amplitude of 4mA); (2) ES with parameter set 5 delayed delivery by 12.5h (P=0.01) and reduced area under the curve of intrauterine pressure in mmHgs (311+/-147.21 vs. 848.75+/-350.38, P<0.05) and AUC-electromyographic activity is area under rectified (i.e. absolute value) uterine EMG trace in mVs (145.25+/-93.1 vs. 410+/-182.46, P<0.05) in the term rats; and (3) similar effects were noted with ES in preterm rats with a delay in delivery by 28h (P<0.001), and a decrease in IUP-AUC (intrauterine pressure-area under curve) (101.5+/-55.45 vs. 551+/-269.06, P=0.017) and EMG-AUC (64.25+/-43.63 vs. 172.5+/-62.91, P=0.03). CONCLUSION: ES of the uterus with appropriate parameters inhibits uterine contractions and delays delivery in both term and preterm rats.

Surface reconstructions and stability of X-shaped carbon nanotube junction.

A complete surface reconstruction takes place after a local connection between two crossed tubes is established, leading to the creation of an extended X-shaped junction constituted by topological defects with smooth negative curvature. Molecular-dynamics simulations show that the surface reconstructions occur through (1) generalized Stone-Wales transformation and (2) the movement of sp and sp3 atoms and their transformation to sp2 atoms by bond rearrangement. Based on both the principle of energy minimization and a generalized Euler's rule, it is demonstrated that the most stable structure for X junctions contains only 12 heptagons. The annealing temperature influences the topological structure and stability of junctions.

The effects of cervical application of inhibitors of inducible nitric oxide synthase, cyclooxygenase-1, and cyclooxygenase-2 on delivery in rats.

OBJECTIVE: To investigate the effect of cervical application of nonselective and selective inhibitors of nitric oxide synthases--N-nitro-L-arginine methyl ester, L-N-iminoethyl-lysine, and aminoguanidine--as well as inhibitors of cyclooxygenases--indomethacin, and nimesulide--on timing of delivery and fetal death and disease in pregnant rats. STUDY DESIGN: In a series of experimental protocols, timed-pregnant Sprague-Dawley rats (length of pregnancy, 22 days) were randomly allocated to daily cervical applications of (1) 0.04 mg (n = 6), 0.4 mg (n = 6), 4 mg (n = 6), or 40 mg (n = 6) L-N-iminoethyl-lysine or vehicle (n = 12) on days 19 to 22 of pregnancy; (2) 50 mg aminoguanidine (n = 6), 150 mg aminoguanidine (n = 6), or vehicle (n = 10) on days 19 to 22 of pregnancy; (3) 3 mg indomethacin (n = 6) or vehicle (n = 6) on days 19 to 22 of pregnancy; (4) 12.5 mg/kg nimesulide (n = 8), 25 mg/kg nimesulide (n = 8), 50 mg/kg nimesulide (n = 12), or vehicle (n = 12) on days 19 to 22 of pregnancy and 50 mg/kg nimesulide (n = 23) or vehicle (n = 23) on days 14 to 22 of pregnancy; (5) 50 mg/kg nimesulide (n = 10), 50 mg aminoguanidine plus 50 mg/kg nimesulide (n = 10), 50 mg aminoguanidine (n = 10), or vehicle (n = 10) on days 14 to 22 of pregnancy. The following variables were evaluated: proportion of animals that were delivered on day 23, time to delivery of the first pup (midnight on day 22 was considered to be 0 hour), number of stillborn pups, and average pup weight of each litter. RESULTS: Unlike L-N-iminoethyl-lysine, aminoguanidine, and indomethacin, 50 mg/kg nimesulide applied on the cervix daily for 8 days significantly increased the proportion of animals that were delivered on day 23 (18 of 23 versus 7 of 23; P =.003) and the time to delivery of the first pup by a mean of 10.8 hours (P <.001). Shorter treatment with nimesulide for 4 days increased only the time to delivery of the first pup at the 25-mg/kg dosage (P =.008). Simultaneous application of aminoguanidine and nimesulide significantly (P =.008) prolonged pregnancy to a degree similar to nimesulide alone. The experiment with N-nitro-L-arginine methyl ester was aborted because of severe maternal side effects. Unlike pups in the L-N-iminoethyl-lysine, aminoguanidine, and nimesulide groups, significantly more pups in the indomethacin group died in utero compared with the control group (36.1% versus 3.1%; P <.001), and the surviving pups had lower birth weights (P <.001). CONCLUSIONS: In an animal model, nimesulide was effective in delaying the onset of labor, was well tolerated during pregnancy, and affected cervical ripening directly independent of progesterone withdrawal. Conversely, cervical application of nitric oxide synthase and nonselective cyclooxygenase inhibitors do not extend the duration of pregnancy in the dosages studied, and some are associated with significant adverse effects in the mothers and fetuses.

Marked variation in responses to long-term nitric oxide inhibition during pregnancy in outbred rats from two different colonies.

OBJECTIVE: Some but not all studies have shown that long-term nitric oxide synthase inhibition during pregnancy induces symptoms similar to those of preeclampsia that include hypertension, proteinuria, and intrauterine growth restriction. This study was undertaken to compare the effects of long-term nitric oxide synthase inhibition during pregnancy on blood pressure and fetal weight between Sprague-Dawley rats from outbred colonies of two different suppliers. STUDY DESIGN: Osmotic minipumps were inserted on day 10 or day 17 of pregnancy in Sprague-Dawley rats obtained from Charles River Laboratories, Inc, Wilmington, Mass, or Harlan Sprague Dawley, Inc, Indianapolis, Ind. The pumps were set to deliver vehicle only (control group) or N omega-nitro-L -arginine methyl ester (a nitric oxide synthase inhibitor) at a rate of 50 mg/d until postpartum day 7. Systolic blood pressures were measured daily with the tail-cuff method. Neonatal weights and survival were recorded. RESULTS: N omega-nitro-L -arginine methyl ester infusion initiated on gestational day 10 increased blood pressure relative to control levels in all rats studied. Harlan rats were much more sensitive to the hypertensive effect of N omega-nitro-L -arginine methyl ester. When N omega-nitro-L -arginine methyl ester infusion was initiated on gestational day 17, blood pressure increased only in Harlan rats. Pups born to Harlan rats treated with N omega-nitro-L -arginine methyl ester had lower birth weights and a higher stillbirth rate than did pups of Charles River rats. The degree of hypertension was significantly correlated with the deleterious effects of N omega-nitro-L -arginine methyl ester on the fetuses. CONCLUSION: Within the same strain of rats the effects of long-term nitric oxide synthase inhibition on blood pressure and fetal outcome depended on the original animal colony, with animals from Harlan Sprague Dawley being more sensitive than those from Charles River Laboratories. This difference in response between animals from different suppliers is most likely caused by genetic differences inbred into the strain. In addition to explaining some of the reported inconsistencies between laboratories, these results may also provide insights into the genetic basis of preeclampsia.

Changes in light-induced fluorescence of cervical collagen in guinea pigs during gestation and after sodium nitroprusside treatment.

Light-induced fluorescence (LIF) of collagen was used to investigate in vivo changes in cervical collagen in guinea pigs during gestation and following sodium nitroprusside treatment. Natural fluorescence of collagen is due to collagen cross-linking molecules that connect single collagen fibers and therefore provide rigidity of the cervical stroma. LIF of cervical collagen was measured from the surface of the exocervix in anesthetized nonpregnant and timed pregnant guinea pigs at different times of gestation with an instrument designed in our lab (Collascope). Measurements were also performed in guinea pigs at midgestation before and 8 hours after intracervical treatment with sodium nitroprusside. Collagen fluorescence decreased significantly as pregnancy progressed, reached lowest values at delivery, and increased gradually postpartum. Treatment with sodium nitroprusside, but not with the vehicle, caused a significant decrease in LIF (p = 0.007). We conclude, that LIF changes in the cervix reflect the gradual cervical softening (ripening) during pregnancy and the return to the rigid state of the cervix postpartum. Cervical softening during pregnancy, and after sodium nitroprusside treatment, is associated with a decrease in collagen cross-links. Measurements of LIF can be used to investigate cervical softening in vivo.

Studies of cervical ripening in pregnant rats: effects of various treatments.

The exact mechanisms that regulate cervical softening or ripening during pregnancy are not completely understood. The aim of this study was to estimate the effects of various agents on cervical softening during pregnancy in rats. Cervical resistance was examined after treatment with nitric oxide (NO) donors and inhibitors and different hormonal agents. Cervical resistance was significantly reduced (P< 0.05) in rats treated with the NO donors: sodium nitroprusside, molsidomine and prostaglandin E(2). However, treatments with the NO synthase (NOS) inhibitors N(omega)-nitro-L-arginine methyl ester (L-NAME) and L-N(6)-1-iminoethyl-lysine (L-NIL), or the prostaglandin synthesis inhibitor, indomethacin, significantly increased resistance (P<0.05). The antiprogesterone, onapristone, reduced cervical resistance and its effects were only partially blocked by the progesterone agonist, promegestone. Relaxin reduced cervical resistance and NOS inhibitors partially blocked the effect of relaxin. These studies demonstrate that NO regulates cervical ripening. Relaxin also softens the cervix and may act by stimulating NO synthesis. Progesterone seems important in the control of cervical ripening, but its role appears complex. NO and prostaglandin pathways may independently control ripening by acting in parallel or synergistically.

Changes in cervical resistance and collagen fluorescence during gestation in rats.

During pregnancy the role of the cervix shifts between two opposing functions. Throughout most of gestation, the cervix is rigid and resists tension in order to maintain the products of conception inside the uterus. At term, however, cervical function changes drastically in order to accommodate stretch and delivery. The events that control cervical function are not known. The aim of this study was to characterize changes in cervical resistance and collagen content during pregnancy in the rat. To determine the change in cervical resistance, non-pregnant and timed pregnant Sprague Dawley rats were sacrificed at various times. Their cervices were isolated and suspended in organ baths connected to a cervimeter for measurement of the stretch-tension relationship. In a different group of animals, cervical collagen content was measured using light-induced fluorescence in non-pregnant and, longitudinally, in pregnant rats. Cervical resistance and collagen content decreased progressively during pregnancy. The changes in cervical resistance mirrored those in cervical collagen content and the nadir in both occurred about two days prior to the onset of labor. Our study suggests that cervical preparation for delivery does not occur acutely at the time of labor and that cervical collagen content determines cervical resistance.

In vivo effects of corticotropin-releasing factor in pregnant rats.

OBJECTIVES: Our purpose was to study the effects of corticotropin-releasing factor on (1) maternal blood pressure, (2) uterine vasculature, and (3) parturition in pregnant rats. STUDY DESIGN: Infusion minipumps containing vehicle, corticotropin-releasing factor, or alpha-helical corticotropin-releasing factor 9-41 (corticotropin-releasing factor receptor antagonist) were inserted subcutaneously in timed pregnant rats on day 16 of gestation. Systolic blood pressure was measured daily by the tail-cuff method. The time of onset of labor was determined and the newborn pups were weighed. Circulating levels of corticotropin-releasing factor were measured in untreated controls by radioimmunoassay. Relaxant responses to corticotropin-releasing factor were studied in isolated segments of uterine artery from late (day 18) and term (day 22) pregnant rats mounted in a wire myograph. RESULTS: The blood pressure was decreased by corticotropin-releasing factor and increased by alpha-helical corticotropin-releasing factor 9-41 (p < 0.05). The time of onset of labor was not affected by either treatment. Pup weight was decreased by corticotropin-releasing factor (p < 0.05). Circulating levels of corticotropin-releasing factor (immunoreactive) were not changed in pregnancy. In vitro, corticotropin-releasing factor caused relaxation of the uterine artery in a concentration-dependent manner and the relaxation was decreased at term compared with late pregnancy (p < 0.05). CONCLUSIONS: Endogenously produced corticotropin-releasing factor lowers blood pressure during pregnancy in rats. It is a relaxant of uterine vasculature and this effect is decreased at term. It does not play an essential role in the initiation of labor in rats.

Control and assessment of the uterus and cervix during pregnancy and labour.

Preterm labour and resultant preterm birth are the most important problems in perinatology. Countless efforts have failed to establish a single effective treatment of preterm labour, partly because the mechanisms regulating the uterus and cervix during pregnancy are not well understood. New knowledge is needed to inhibit early progression of labour (uterine contractility and cervical ripening), and adequate quantitative tools to evaluate the uterus and cervix during pregnancy are lacking. In this review, we outline studies showing that the uterus (myometrium) and cervix pass through a conditioning step in preparation for labour. This step is not easily identifiable with present methods to assess the uterus or cervix. In the uterus, this seemingly irreversible step consists of changes in the electrical properties to make muscle more excitable and responsive to produce forceful contractions. In the cervix, the step consists of softening of the connective tissue components. Progesterone appears to have a dominant role in controlling both the uterus and cervix, as antiprogestins induce early, preterm conditioning leading to preterm labour. Apparently, nitric oxide (NO) also controls conditioning of the uterus and cervix. In the uterus, NO, in concert with progesterone, inhibits uterine contractility. At term, NO production by the uterus and placenta are decreased and allow labour to progress. In contrast, NO in the cervix increases at the end of pregnancy and it may be the final pathway for stimulating cervical ripening by activation of metalloenzymes. The progress of labour can be assessed non-invasively using electromyographic (EMG) signals from the uterus (the driving force for contractility) recorded from the abdominal surface. Uterine EMG bursts detected in this manner characterize uterine contractile events during human and animal pregnancy. A low uterine EMG activity, measured transabdominally throughout most of pregnancy, rises dramatically during labour. EMG activity also increases substantially during preterm labour in humans and rats. This method may be used one day to predict impending preterm labour and identify control steps and treatments. A quantitative method also assesses the cervix, using an optical device which measures collagen fluorescence in the cervix. The collascope estimates cervical collagen content from a fluorescent signal generated when collagen cross-links are illuminated with excitation light of about 340 nm. The system has proved useful in rats and humans at various stages of pregnancy, and indicates that cervical softening occurs progressively in the last one-third of pregnancy. In rats, collascope readings correlate with resistance measurements made in the isolated cervix, which may help to assess cervical function during pregnancy, and indicate control and treatments.

[Ripening effect of mylis and tiluoan on the uterine cervix in pregnant rats].

Effect of Mylis and Tiluoan on cervical ripening and blood levels of estradiol and progesterone of pregnant rats were studied. Dehydroepiandrosterone (DHA) is the main component in both of the drugs. Pregnant rats groups were given the drugs on the 19th day of gestation at dosage of 10, 20 and 40 mg/kg respectively. The results indicated that both drugs at different dose were able to significantly decrease the cervical extensibility, to dilate the cervical OS, increase the cervical wet weight, and elevate the blood estradiol level, lower the progesterone concentration. It indicated that DHA enhances estradiol synthesis and suppresses progesterone secretion.

NORPLANT and the levonorgestrel IUD in Chinese family planning programmes.

NORPLANT was introduced into the Chinese family planning programmes in 1984 by the Population Council. After a pilot study of 1200 cases in four centres in China, the study was expanded to 12 centres with 10,718 cases of NORPLANT and 1208 cases of NORPLANT-2 followed up for more than 6 years. The 5 years net cumulative pregnancy rates were 0.5-1.2 and the net cumulative continuation rates were around 65-72 per 100 users. There were significant differences in pregnancy rates between different groups of body weight and age, i.e. the pregnancy rates were higher in groups with body weight over 70 kg and those aged below 25 years. The age, body weight and dependence on contraceptive effectiveness of NORPLANT should be taken into account in the selection of users. Nationwide large-scale studies in provincial and country rural areas and postmarketing surveillance are being carried out. Changes in ovarian function and endometrium have been studied. Levonorgestrel IUD (LNg-IUD) was introduced into China in 1985. Comparative clinical studies on NORPLANT and LNg-IUD, pharmacokinetic and pharmacodynamic studies and endometrial studies of LNg-IUD were performed. The higher percentage (55.1%) of ovarian suppression in Chinese users of LNg-IUD may be attributed to ethnic differences among Caucasian women in their susceptibility to steroid hormones. Results showed favourable acceptance of both devices among Chinese women. The studies promoted the incorporation of new long-acting contraceptive methods into the Chinese family planning programmes.