Comparing the clinical efficacy of three surgical methods for cesarean scar pregnancy

BACKGROUND

We aimed to compare the clinical efficacy of three surgical methods in the treatment of various types of cesarean scar pregnancy (CSP).

METHODS

Herein, 314 cases of CSP were treated in the department of Obstetrics and Gynecology of the First Affiliated Hospital of Gannan Medical University between June 2017 and June 2020. The patients were divided into three groups based on the treatment received: group A (n = 146; curettage by pituitrin combined with ultrasonic monitoring and hysteroscopy-guided surgery), group B [n = 90; curettage after methotrexate (MTX) injection into the local gestational sac], and group C (n = 78; laparoscopic, transvaginal, and transabdominal cesarean scar resection). These groups were divided into three subgroups (type I, type II, and type III) according to the CSP type of the patients.

RESULTS

The intraoperative blood loss, length of hospital stay, hospitalization cost, menstrual recovery time, and serum β-HCG normalization time were lower in groups A than in groups B or C with type I, II and III CSP (P < 0.05). Operative efficiency and Successful second pregnancy rate were higher in groups A than in groups B or C with type I and II CSP (P < 0.05). But in type III CSP, the complications were more serious in group A than group C.

CONCLUSIONS

Curettage by pituitrin combined with ultrasonic monitoring and hysteroscopy-guided surgery is an effective and relatively safe treatment for patients with type I and II CSP. Laparoscopic surgery is more suitable for type III CSP.

[Clinical characteristics of 272 437 patients with different histopathological subtypes of primary esophageal malignant tumors]

Objective: To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT). Methods: A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ² test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results: A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment. Conclusion: ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Integrated Analyses of Phenotype and Quantitative Proteome of CMTM4 Deficient Mice Reveal Its Association with Male Fertility

The chemokine-like factor (CKLF)-like MARVEL transmembrane domain-containing family (CMTM) is a gene family that has been implicated in male reproduction. CMTM4 is an evolutionarily conserved member that is highly expressed in the testis. However, its function in male fertility remains unknown. Here, we demonstrate that CMTM4 is associated with spermatogenesis and sperm quality. Using Western blotting and immunohistochemical analyses, we found CMTM4 expression to be decreased in poor-quality human spermatozoa, old human testes, and testicular biopsies with nonobstructive azoospermia. Using CRISPR-Cas9 technology, we knocked out the Cmtm4 gene in mice. These Cmtm4 knockout (KO) mice showed reduced testicular daily sperm production, lower epididymal sperm motility and increased proportion of abnormally backward-curved sperm heads and bent sperm midpieces. These mice also had an evident sub-fertile phenotype, characterized by low pregnancy rates on prolonged breeding with wild type female mice, reduced in vitro fertilization efficiency and a reduced percentage of acrosome reactions. We then performed quantitative proteomic analysis of the testes, where we identified 139 proteins to be downregulated in Cmtm4-KO mice, 100 (71.9%) of which were related to sperm motility and acrosome reaction. The same proteomic analysis was performed on sperm, where we identified 3588 proteins with 409 being differentially regulated in Cmtm4-KO mice. Our enrichment analysis showed that upregulated proteins were enriched with nucleosomal DNA binding functions and the downregulated proteins were enriched with actin binding functions. These findings elucidate the roles of CMTM4 in male fertility and demonstrates its potential as a promising molecular candidate for sperm quality assessment and the diagnosis or treatment of male infertility.

Synergistic antitumor activity of triple-regulated oncolytic adenovirus with VSTM1 and daunorubicin in leukemic cells

V-set and transmembrane domain-containing 1 (VSTM1), which is downregulated in bone marrow cells from leukemia patients, may provide a diagnostic and treatment target. Here, a triple-regulated oncolytic adenovirus was constructed to carry a VSTM1 gene expression cassette, SG611-VSTM1, and contained the E1a gene with a 24-nucleotide deletion within the CR2 region under control of the human telomerase reverse transcriptase promoter, E1b gene directed by the hypoxia response element, and VSTM1 gene controlled by the cytomegalovirus promoter. Real-time quantitative PCR and Western blot analyses showed that SG611-VSTM1 expressed VSTM1 highly efficiently in the human leukemic cell line K562 compared with SG611. In Cell Counting Kit-8 and flow cytometric assays, SG611-VSTM1 exhibited more potent anti-proliferative and pro-apoptotic effects in leukemic cells compared with SG611 and exerted synergistic cytotoxicity with low-dose daunorubicin (DNR) in vitro. In xenograft models, SG611-VSTM1 intratumorally injected at a dose of 1 × 10(9) plaque forming units combined with intraperitoneally injected low-dose DNR displayed significantly stronger antitumor effects than either treatment alone. Histopathologic examination revealed that SG611-VSTM1 induced apoptosis of leukemic cells. These results implicate an important role for VSTM1 in the pathogenesis of leukemia, and SG611-VSTM1 may be a promising agent for enhancing chemosensitivity in leukemia therapy.

First Report of Chaetomella raphigera Causing Leaf Spot on Rosa chinensis in China

China rose, Rosa chinensis Jacq., is extensively cultivated as an ornamental plant in China (1). During the course of a disease survey of China rose in Henan Province, a leaf spot was observed on about 20 China roses, cultivated in a garden in Zhengzhou, Henan Province, in early October 2012. The early symptom appeared as small round, pale brown lesions on the leaves. Lesions expanded into 5 to 15-mm-diameter spots that were near round or irregular and brown. Both sporodochial and pycnidial conidiomata developed in necrotic areas of diseased leaves when placed in moist chambers. Pycnidia were elongated, reniform, with a single raphe over the top, pale to dark brown, and 260 to 350 × 150 to 210 μm. Sporodochia were pale luteous and 100 to 280 × 80 to 180 μm. Setae, conidiophores, conidiogenous cells, and conidia were the same between two types of conidioma. Setae were pale to dark brown, 0 to 2 septate, straight with rounded end, clavate to curved at apex, and 22 to 60 × 2 to 5 μm. Conidiophores were up to 120 × 1 to 2 μm, filiform, cylindric, and branched. Conidiogenous cells were enteroblastic, collar and channel minute. Conidia were nonseptate, hyaline, ellipsoid or cymbiform, smooth, guttulate, and 4 to 6.5 × 1.5 to 2.5 μm. Two pure cultures (zm12276-1 and zm12276-2) were obtained by picking spores from independent conidiomata on one leaf and then subsequently grown on potato dextrose agar (PDA), producing the same two kinds of conidiomata. The characteristics of conidial size and distinctly different conidiomata with setae are diagnostic of Chaetomella raphigera M.E. Swift (3,4). The identity of our fungus (zm12276-1) was confirmed to be C. raphigera by DNA sequencing of the ITS1-5.8S-ITS2 region. The DNA sequence was 99% identical to those of the other C. raphigera isolates (AY487076 and AY487085) (2). The ITS sequence from zm12276-1 was deposited in GenBank (KF483474). Pathogenicity was tested by inoculating 10 leaves of R. chinensis with mycelia plug from colony of zm12276-1 (0.5 cm in diameter). An equal number of fresh leaves inoculated with the plugs of non-colonized PDA medium served as the control. All leaves were incubated in clear plastic box with a dish of sterile distilled water at 25°C under ambient light. After 7 days, 90% of the inoculated leaves showed symptoms identical to those observed on R. chinensis leaves affected in the field. From each of the symptomatic leaves, C. raphigera was recovered, whereas controls remained symptom-free and no fungus was isolated from the control leaves. Koch's postulates were repeated three times with the same results using the pure culture of zm12276-1. C. raphigera has been previously reported on Rosa sp. in the United States (4). To our knowledge, this is the first report of C. raphigera infecting R. chinensis in China. The disease cycle and the control strategies in the regions are being further studied. References: (1) C. Z. Gu and K. R. Robertson. Pages 339-381 in: Flora of China, vol. 9. Science Press, Beijing and Missouri Botanical Garden, 2003. (2) A. Y. Rossman et al. Mycol. Progr. 3:275, 2004. (3) B. C. Sutton. The Coelomycetes. CAB International Publishing, New York, 1980. (4) M. E. Swift. Mycologia 22:165, 1930.

[Preparation and identification of the polyclonal antibody against human VSTM1]

AIM

To prepare and characterize the polyclonal antibody against human VSTM1.

METHODS

VSTM1 has two main isoforms, VSTM1-v1, a type I transmembrane protein, and VSTM1-v2, a classical secretory protein, lacking only the transmembrane domain compared with VSTM1-v1. Two recombinant prokaryotic proteins of VSTM1-v2, Trx-His-S-VSTM1-v2 and GST-VSTM1-v2, were constructed, expressed, purified, and then used for immunization of New Zealand rabbits to prepare anti-VSTM1 antibody and coupling with CNBr-activated Sepharose 4B to purify the antibody by immunoaffinity chromatography, respectively. ELISA was performed to detect the titers of the antiserums. After purification, the antibody was identified by Western blotting and immunofluorescence cytochemistry.

RESULTS

The titers of the antiserums from the two immunized rabbits were both 1:10(6);. Western blotting confirmed that the purified antibody could recognize both the overexpressed and endogenous VSTM1 specifically. Immunofluorescence cytochemistry verified that the antibody could also recognize the overexpressed VSTM1-v1 on the surface of HEK293T cells.

CONCLUSION

The rabbit antibody against human VSTM1 of a high titer has been obtained, which can be used for recognizing endogenous VSTM1 in immunofluorescence cytochemistry.

[A novel cis-acting enhancer element between CKLF and CKLFSF1 genes]

AIM

To explore the roles of the CKLF gene and CKLFSF1 gene sequence (CCS) in transcriptional regulation.

METHODS

The target gene fragment was amplified by PCR and then inserted into pGL3-basic and pGL3-SV40 containing luciferase reporter vector gene to construct pGL3-basic-CCS and pGL3-SV40-CCS. Using liposome-mediated method, four recombinant plasmids were respectively transfected into Hela cells. Transient expression was analyzed.

RESULTS

The luciferase assay indicated that the no luciferase activity was detected in Hela cells transtected with pGL3-basic and pGL3-basic-CCS. However, the luciferase activity was doubled when pGL3-SV40-CCS was transfected into Hela cells.

CONCLUTION

The CCS has no promoter activity, whereas some important cis-acting enhancer elements which modulate its downstream gene expression may exist within this sequence.

[Stimulatory effect of chemokine-like factor 1 (CKLF1) on the growth of bone marrow cells]

OBJECTIVE

To investigate the activity of CKLF1 on the proliferation and differentiation of bone marrow cells.

METHODS

Human low density bone marrow cells and mouse bone marrow cells were plated in 96-well microplate and supernatants from transfected COS-7 cell culture were added. The cell proliferation was assayed by MTT method after 5 days incubation. The enhancing effect of CKLF1 on the colony formation of human hematopoietic progenitor cells was identified in semi-solid culture.

RESULTS

CKLF1 has obvious enhancing effect on both human and mouse bone marrow cells, it can stimulate the colony formation of human hematopoietic stem cells and has synergistic action with GM-CSF.

CONCLUSION

CKLF1 can promote the proliferation and differentiation of bone marrow cells.

[Effects of various growth factors on human mandibular condylar cartilage cell proliferation]

OBJECTIVE

To investigate the effects of transforming growth factor-beta 1 (TGF-beta 1) insulin-like growth factor I (IGF-I) and basic fibroblast growth factor(bFGF) on human mandibular condylar cartilage (MCC) cell proliferation.

METHODS

Isolated human MCC cells were cultured in DMEM supplemented with 10% newborn calf serum(NCS). The second passages were used in order to avoid chondrocyte dedifferentiation. Cells were seeded at 2 x 10(4)/well on 96-well plate. After synchronization, medium was replaced by DMEM containing 0.4% NCS or 10% NCS with various growth factors, concentrations and combinations. Dose-response and time-course were studied by MTT colorimetric method.

RESULTS

In 0.4% serum containing medium, bFGF stimulated the proliferation moderately, whereas TGF-beta 1 and IGF-I had less effect. In 10% NCS condition, all three growth factors had mitogenic effect and acted dose-dependently. The effects were significant after three days. Among them, bFGF was a potent mitogen(increased by 65%), IGF-I the next(24%). The effect of TGF-beta 1 (13%) might be mediated by some other factors in the serum. The synergetic effects were achieved when they were used in combination.

CONCLUSION

It is suggested that optimal combination of growth factors can promote the proliferation of MCC cells significantly, this might be an ideal way in dealing with cartilage damage during pathogenesis.