Giant cellular leiomyoma in the broad ligament of the uterus: A case report.

BACKGROUND: The treatment of large pelvic masses in postmenopausal women is a challenge in clinical practice. Although ultrasound or magnetic resonance imaging can be used to determine the size and location of the mass, it is still difficult to achieve a preoperative diagnosis. The majority of cellular leiomyomas are diagnosed by histopathology after surgery. We report the differential diagnosis and surgical management of a rare case of cellular leiomyoma in the broad ligament of the uterus. CASE SUMMARY: A 52-year-old Chinese woman without sexual history was admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine for the first time. The patient had a 1-year history of progressive abdominal enlargement as well as a 2-year history of menopause, and complained of frequent abdominal pain and low-grade fever. Computed tomography of the abdomen showed a solid cystic mass (29.4 cm × 18.8 cm × 37.7 cm) in the pelvis and abdomen. Moreover, routine blood test results indicated a baseline cancer antigen 125 (CA-125) level of 187.7 U/mL and C-reactive protein of 109.58 mg/L. Subsequently, retrograde hysterectomy and bilateral adnexectomy were performed in this patient. On histopathologic examination of the surgical specimen, a rare cellular leiomyoma in the broad ligament was diagnosed. CONCLUSION: Clinicians need to constantly improve diagnosis and treatment for the challenges posed during clinical assessment, differential diagnosis, and surgical management.

MiR-190b impedes pancreatic ß cell proliferation and insulin secretion by targeting NKX6-1 and may associate to gestational diabetes mellitus.

BACKGROUND: The dysfunction of pancreatic ß cells is related to the occurrence of gestational diabetes mellitus (GDM). This study aimed to investigate the mechanism underlying the effects of miR-190b on pancreatic ß cell proliferation and insulin secretion. METHODS: Quantitative real-time PCR was used to detect miR-190b expression in placenta tissues from GDM patients. The effects of miR-190b on islet cells activity, proliferation, and insulin secretion were measured using MTT assay, BrdU staining, and ELISA. The relationship between miR-190b and NK6 homeobox 1 (NKX6-1) was ensured by dual luciferase reporter assay. RESULTS: MiR-190b was overexpressed in placenta tissues from GDM patients compared to normal pregnant woman. MiR-190b inhibitor inhibited the cell activity, proliferation, and insulin secretion of islet ß cells, while miR-190b overexpression had an opposite effect. Additionally, miR-190b negatively regulated NKX6-1 expression. Overexpression of NKX6-1 reversed the inhibitory effect of miR-190b-mimics on islet ß cell activity, proliferation, and insulin secretion. In mouse islets, knockdown of miR-190b promoted insulin secretion by up-regulating NKX6-1 expression. CONCLUSION: Silence of miR-190b accelerated pancreatic ß cell proliferation and insulin secretion via targeting NKX6-1, which might be a mechanism underlying the effects of miR-190b on the progression of GDM.

Effects of arsenic trioxide combined with platinum drugs in treatment of cervical cancer: A protocol for systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: Cervical cancer is the second largest tumor disease threatening female reproductive tract health. AS2O3 is a multi-directional and multi-target anti-cervical cancer drug. It can be combined with platinum drugs to treat cervical cancer. The literatures of AS2O3 combined with platinum drugs related to cervical cancer have shown inconsistent results, and there is currently no high quality of systematic review to evaluate the effects of AS2O3 combined with platinum drugs in cervical cancer patients. METHODS AND ANALYSIS: English and Chinese literature about AS2O3 combined with platinum drugs treatment for cervical cancer published before August 31, 2020 will be systematic searched in PubMed, Embase, Web of Science, Cochrane Library, Open Grey, Clinicaltrials.gov, Chinese Clinical Trial Registry, WANFANG, VIP Chinese Science and Technology Journal Database, CNKI, Chinese biomedical document service system (SinoMed). Only randomized controlled trials (RCTs) of patients with cervical cancer will be included. Literature screening, data extraction, and the assessment of risk of bias will be independently conducted by 2 reviewers, and the 3rd reviewer will be consulted if any different opinions existed. Clinical total effective rate, adverse events, SCCAg, CYFRA21-1, quality of life, and immune function will be evaluated. Systematic review and meta-analysis will be produced by RevMan 5.3 and Stata 14.0. This protocol reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. RESULTS: The current study is a protocol for systematic review and meta-analysis without results, and data analysis will be carried out after the protocol. We will share our findings in the fourth quarter of 2021. CONCLUSION: Efficacy and safety of AS2O3 combined with platinum drugs in the treatment of cervical cancer will be assessed. The results will be published in a public issue journal to provide evidence-based medical evidence for Obstetrician and Gynecologists to make clinical decisions. ETHICS AND DISSEMINATION: Ethical approval is not required as the review is a secondary study based on published literature. The results of the study will be published in peer-reviewed publications and disseminated electronically or in print. PROTOCOL REGISTRATION NUMBER: INPLASY202080130.

Colla corii asini might upregulate ZNF471 and THOC5 by KRAB domain-containing zinc-finger protein pathway and THO complex subunit 5 pathway to improve anemia of pregnant women with ß-thalassemia.

Pregnant patients with ß-thalassemia are more likely to have progressive anemia which expose them to risk of adverse pregnancy outcomes, blood transfusion, and iron overload. Results from our previous study indicated that Colla corii asini (CCA, E'jiao), a natural ingredient of traditional Chinese medicine, could significantly increase hemoglobin level of pregnant women with ß- thalassemia, but the underlying molecular mechanism was unclear. Thus, we applied high-throughput transcriptome sequencing to study the transcriptomic change before and after the CCA treatment. Twenty eligible pregnant women were recruited and randomized to either the CCA treatment group or the blank control group in a 3:1 ratio. Patients in the treatment group orally received daily 15 g CCA powder for 4 weeks. We analyzed the therapeutic effect indexes and the transcriptomic change in subjects' peripheral blood before and after treatment. We found that ß CD 41-42(-TTCT)/ßA was the main genotype of the subjects. The regulatory impact of CCA treatment became more evident among the subjects of genotype ß CD 41-42(-TTCT)/ßA. Gene ontogenesis analysis revealed that the top five molecular functions of differentially expressed genes were involved in membrane functionality and cellular structure. We further identified two consistent upregulated genes ZNF471 and THOC5 in the effective treatment group, which were engaged in Kruppel-associated box (KRAB) domain-containing zinc-finger protein pathway and THOC5 pathway, respectively. Based on our current findings, we hypothesize that the anti-anemia effect of CCA on pregnant women with ß-thalassemia might be related to translation regulation of spectrin synthesis, membrane stability, and eventually prolonged the life span of erythrocytes.

Efficacy of Chinese herbal medicine Zengru Gao to promote breastfeeding: a multicenter randomized controlled trial.

BACKGROUND: Breastfeeding is recommended worldwide but not fully practiced. The first week after childbirth is regarded as a critical period for increasing breast milk production. The aim of the study was to investigate whether Chinese herbal medicine Zengru Gao would result in more women breastfeeding in the first week after childbirth. METHODS: A multicenter randomized controlled trial was conducted of 588 mothers considering breastfeeding in China. Among the mothers of the intervention group, the intervention included Chinese herbal medicine Zengru Gao; among those of the control group, it did not. Primary outcomes were the percentages of fully and partially breastfeeding mothers. Secondary outcome was baby's daily formula intake. RESULTS: At 3 d and 7 d after delivery, significant differences were found in favour of Zengru Gao group on the percentage of full/ partial breastfeeding (Z = - 3.0037, p = 0.0027). At day 7, the percentage of full/ partial breastfeeding of the active group increased to 71.48%/20.70% versus 58.67%/30.26% in the control group, the differences remained significant (Z = - 3.0037, p = 0.0027). No statistically significant differences were detected on primary measures at 1 d. While intake of formula differed between groups at 1 d and 3 d, this difference did not achieve statistical significance, but this difference was apparent by 7 d (55.45 ± 115.39 ml/day vs 90.66 ± 153.89 ml/day). CONCLUSION: In conclusion, Chinese Herbal medicine Zengru Gao enhanced breastfeeding success during one week postpartum. The approach is acceptable to participants and merits further evaluation. TRIAL REGISTRATION: ChiCTR-IPR-15007376 , December 11, 2015.

Therapeutic effect of Colla corii asini on improving anemia and hemoglobin compositions in pregnant women with thalassemia.

Currently there is no consensus on treating anemia in pregnant thalassemia patients. In China, Colla corii asini (CCA) has been widely used for treating anemia for more than 2000 years. However, its clinical application in the thalassemia population is limited by a lack of quantitative evidence. The present study aims to investigate the therapeutic effect of CCA in increasing hemoglobin (Hb) concentration and improving abnormal hemoglobin compositions in pregnant patients with ß-thalassemia. Seventy-two pregnant patients who met inclusion criteria were randomly assigned to either the treatment group or control group. Patients in the treatment group were given 15 g of CCA, while the control group were observed and followed up without any treatment. Levels of Hb, serum iron (SI), serum ferritin (SF) and three types of Hb components [adult hemoglobin (HbA), fetal hemoglobin (HbF), minor adult hemoglobin (HbA2)] were measured before and after treatment. Treatment with CCA led to a significant increase of Hb. The major Hb component induced by CCA was HbA, while levels of both HbA2 and HbF dropped after treatment. CCA treatment significantly increased SI, while SF remained unaffected. Our data suggest that CCA can improve anemia and optimize Hb components in pregnant patients with thalassemia without affecting iron reserves.

Successful term delivery of spontaneous twin pregnancy in a woman with bicorporeal septate uterus: A case report.

Herein, we report the first case of successful term delivery of twins in a patient with bicorporeal septate uterus via natural conception. The patient had been diagnosed with complete septate, didelphys and bicornuate uterus during different phases of her three pregnancies. Based on follow-up data at six weeks and then six months post-partum of the last pregnancy, we found that the abnormalities presented in our case did not fit the criteria of any categories following American Fertility Society and European Society of Human Reproduction and Embryology-European Society for Gynaecological Endoscopy classification systems. After comprehensive review of the uterine morphologic characteristics, embryology and pregnancy outcome, we considered 'bicorporeal septate uterus' the most appropriate diagnosis. This case emphasized the atypical changes of uterine shape as twin pregnancy advances and its influence on productive performance and pregnancy outcome in uterine malformation. It also raised concern regarding the usability and comprehensiveness of the two most popular classification systems.

[Clinical observation of analgesia in delivery treated with acupoint pressure therapy].

OBJECTIVE: To observe the efficacy of acupoint pressure therapy on relieving labor pain in primiparas. METHODS: One hundred and twenty primiparas were randomized into an observation group (60 cases) and a control group (60 cases). In the observation group, Hegu (LI 4), Sanyinjiao (SP 6), Taichong (LR 3), Neiguan (PC 6), Ciliao (BL 32) and Zhongliao (BL 33) on bilateral sides were selected. The acupoint pressure therapy was applied when the uterine orifice was dilated to 2 to 3 cm. In the control group, the acupoint pressure therapy was not used. Separately, when the orifice was dilated as 2 to 3 cm, 5 to 6 cm, 7 to 8 cm and 9 to 10 cm, the pain response grade was assessed (including physician's analgesia score and patient's self-evaluation score of analge-sia). The in labor pain was observed and compared in the puerperas between the two groups. The time of the first, second and third stages of labor, the time of total stage of labor as well as the cesarean section rate were compared in the puerperas between the two groups. RESULTS: (1) Analgesic effect:when the uterine orifice was dilated as 2 to 3 cm, 5 to 6 cm, 7 to 8 cm and 9 to 10 cm, the self-evaluation scores of analgesia in the puerperas of the observation group at each time point were all apparently lower than those in the control groups (all P<0.05). In the observation group, for the physician's analgesia score, 213 person-times presented analgesic effect and 18 person-times no effect. In the control group, 178 person-times presented analgesic effect and 44 person-times no effect. The analgesic effect in the observation group was better than that in the control group (P<0.05). (2) Stages of labor:the differences in the second and third stages of labor were not significant statistically between the two groups (both P>0.05). The time of the first stage of labor and the time of the total stages of labor in the observation group were shorter appa-rently than those in the control group[(8.07±2.08)h vs (9.58±2.79)h, (8.91±2.80)h vs (10.51±2.83)h, both P<0.05]. (3) Cesarean section rate:the cesarean section rate in the observation group was lower than that in the control group[5.0% (3/60) vs 10.0% (6/60), P>0.05]. CONCLUSIONS: Acupoint pressure therapy has definite efficacy on relieving labor pain. It shortens the stages of labor and cesarean section rate.

[Clinical study of Jiawei Bazhen decoction combined with oxytocin for cervical ripening of qi and blood deficiency type of pregnant women].

To study preliminarily the effect of Jiawei Bazhen decoction combined with oxytocin in promoting cervical ripening of full-term pregnancy women who were in the deficiency of qi and blood type through the syndrome differentiation of traditional Chinese medicine (TCM). 180 patients that met the inclusion criteria of the study were randomly divided into three groups: the control group(oxytocin group), the treatment group (Jiawei Bazhen decoction combined with oxytocin group), the blank control group (expected and observation group). Cervical maturity score (Bishop score), vaginal and cervical secretions fetal fibronectin (FFN), the result of induced labor, the result of mother and baby were observed in each group before and after treatment. The result comes out that the cervical Bishop score of pregnant women for treatment group were significantly higher than the control group and blank control group after treatment (P < 0.05). The FFN of pregnant women for the treatment group were significantly different from the control group and blank control group after treatment (P < 0.05). The pregnancy outcome of the three groups: the labor rate and rate of vaginal delivery of the treatment group were higher than the other two groups, and the difference was statistically significant (P < 0.05). The cesarean section rate of the treatment group was significantly lower than the other two groups, the difference was also statistically significant (P < 0.05). The three groups did not appear the phenomenon of neonatal asphyxia. Jiawei Bazhen decoction combined with oxytocin is effective in producing cervical ripening and induce labor. It is convenient, safe and reliable, for it is no obvious adverse effects on mother and fetus, but effective in reducing the rate of cesarean section, and playing a positive role in promoting natural delivery.

[Effect of Qiju Dihuang Pill on serum levels of IFN-gamma and IL-4 in pregnant women of Gan-Shen yin deficiency syndrome].

OBJECTIVE: To observe the effect of Qiju Dihuang Pill (QDP) on changes of Chinese medical syndrome types in pregnant women of Gan-Shen yin deficiency syndrome (GSYDS), and to explore the correlation between imbalanced cytokine levels and GSYDS. METHODS: This was a random controlled trail. A total of 163 pregnant women of GSYDS at 12 -16 gestational weeks were randomly allocated into the experimental group (86 cases) and the control group (77 cases). Patients in the experimental group took QDP for 2 -4 weeks. Changes of Chinese medical syndrome types and serum interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) levels were observed and compared between the two groups before and after treatment. RESULTS: (1) Totally 41 patients (47.7%) in the experimental group were transformed to normal Chinese medical syndrome type. In the same period of the follow-ups, 9 patients (11.7%) in the control group were transformed to normal Chinese medical syndrome type, showing statistical difference (P < 0.05). (2) In the experimental group, the serum level of IFN-gamma and the ratio of IFN-gamma/IL-4 in the peripheral blood were obviously lower after treatment than before treatment (P < 0.01), and obviously lower than those in the control group (P < 0.01). The level of IL-4 after treatment in the experimental group was higher than that before treatment, and also higher than that in the control group, but with no statistical difference. CONCLUSIONS: These results indicated that there was imbalanced IFN-gamma/IL-4 ratio in the peripheral blood of pregnant women of GSYDS. QDP might play a role in immunoregulation by affecting the IFN-gamma level.

Ranking the significance of fermentation conditions on the volatile organic compounds of Tuber melanosporum fermentation system by combination of head-space solid phase microextraction and chromatographic fingerprint similarity analysis.

Tuber melanosporum is highly appreciated in culinary contexts due to its unique and characteristic aroma. T. melanosporum fermentation has been established as a promising alternative for fruiting bodies to produce volatile organic compounds (VOCs). In this work, a technique using a combination of chromatographic fingerprint similarity analysis, head-space solid phase microextraction and gas chromatography was developed to rank the significance of fermentation conditions on the VOCs profile during T. melanosporum fermentation. Omission tests indicated that the absence of major carbon source (i.e., sucrose) in the fermentation media had the most significant effect on the profile of VOCs, followed by the absence of yeast extract or peptone. Consideration of the culture conditions revealed that VOCs produced was the most significantly affected by temperature. These results indicated that it is possible to adjust the aroma of truffles via fermentation process control.

Genome sequences of three species in the family Planctomycetaceae.

Most of the species in the family Planctomycetaceae are of interest for their eukaryotic-like cell structures and characteristics of resistance to extreme environments. Here, we report draft genome sequences of three aquatic parasitic species of this family, Singulisphaera acidiphila (DSM 18658T), Schlesneria paludicola (DSM 18645T), and Zavarzinella formosa (DSM 19928T).

Evaluation of aroma active compounds in Tuber fruiting bodies by gas chromatography-olfactometry in combination with aroma reconstitution and omission test.

The aroma active compounds of three Tuber fruiting bodies (i.e., Tuber himalayense, Tuber indicum, and Tuber sinense) were firstly systematically evaluated by instrumental gas chromatography-olfactometry combining with quantitative analysis, aroma reconstitution, and omission tests. Twelve aroma active compounds were characterized by aroma extract dilution analysis, and 3-(methylthio) propanal, 3-methylbutanal, and 1-octen-3-ol with the highest flavor dilution (FD) factor (i.e., 1,024-2,048) were suggested as key contributors to the aroma. Odor activity value (OAV) was employed to determine the relative contribution of each compound to the aroma, and the compound with the highest FD factor also had the highest OAV (i.e., 10,234-242,951). Then, the synthetic blends of odorants (aroma reconstitution) were prepared with OAV larger than 15, and their aromas were very similar to the originals. Omission tests were carried out to verify the significance of 3-(methylthio) propanal, 1-octen-3-ol, and 3-methylbutanal as key compounds in the aroma of tested Tuber fruiting bodies.

[Expression of p21(WAF1) and its relationship with p53 and PCNA protein in epithelial ovarian cancer].

BACKGROUND & OBJECTIVE: Recent researches manifested that down-regulation of p21(WAF1) had relationship with carcinogenesis and development in various tumors, but its association with epithelial ovarian cancer (EOC) was not clear. This study was designed to investigate the role of p21(WAF1) in the tumorigenesis and development of EOC and its relationship with p53 and proliferating cell nuclear antigen (PCNA) protein. METHODS: Fifty-five EOC tissues, 32 benign ovarian tumor tissues, and 30 normal ovarian tissues were collected. Reverse transcription polymerase chain reaction (RT-PCR) was applied to determine the p21(WAF1)mRNA expression. Immunohistochemistry was applied to examine the protein expression of p21(WAF1), p53, and PCNA. The relationship between the expression of these markers and the clinicopathological characteristics, prognosis of the patients was analyzed. RESULTS: The positive rates of p21(WAF1)mRNA in EOC, benign ovarian tumor, and normal ovary were 40%, 56.25%, and 73.33%, respectively (P=0.012). The positive rates of p21(WAF1) protein were 36.36%, 56.25%, and 80%, respectively (P=0.001). The positive expression rates of p21(WAF1)mRNA and its protein in EOC were lower than those of the other two groups, while the positive expression rates of p53 and PCNA protein in EOC were higher than those of the other two groups (P< 0.05). Expression of p21(WAF1)mRNA had positive relation to its protein, negative relation to PCNA protein, no relation to p53 protein, while expression of p21(WAF1) protein had negative relation to p53 and PCNA protein in EOC. Low-expression of p21(WAF1) protein was associated with advanced FIGO stage (P=0.032), but not with age, histological type, pathological grade, and remnant tumor (P >0.05). There was no relationship between p21(WAF1)mRNA and former parameters (P >0.05). Univariate analysis showed that the patients with low-expression of p21(WAF1)mRNA and p21(WAF1) protein had poor prognosis (P< 0.05). CONCLUSION: p21(WAF1) is down-regulated in EOC. p21(WAF1) might be able to be used as a marker to predict the prognosis of patients with EOC.