Meta-analysis of the use of hyaluronic acid gel to prevent intrauterine adhesions after miscarriage

BACKGROUND

Intrauterine adhesions are a severe complication after miscarriage. Hyaluronic acid gel has been used to prevent intrauterine adhesions after miscarriage.

OBJECTIVE

To systematically evaluate the efficacy of adjuvant therapy with hyaluronic acid gel to prevent intrauterine adhesions after miscarriage.

SEARCH STRATEGY

The Cochrane Library, Embase and PubMed databases were searched for articles published before 31 July 2018 using the terms: ('hyaluronic acid gel' or 'gel') and ('dilatation and curettage' or 'D&C' or 'abortion' or 'miscarriage' or 'hysteroscopic') and ('intrauterine adhesions' or 'Asherman syndrome' or 'IUA' or 'endometrial injury' or 'intrauterine adhesion').

SELECTION CRITERIA

Randomized controlled trials of hyaluronic acid gel therapy after miscarriage.

DATA COLLECTION AND ANALYSIS

Four studies were included in the meta-analysis (625 patients in total). Dichotomous outcomes were expressed as relative risk (RR) with 95 % confidence intervals (CI). Continuous variables were expressed as standardized mean differences (SMD).

MAIN RESULTS

Hyaluronic acid gel reduced the intrauterine adhesion scores after miscarriage (SMD -0.68, 95 % CI -1.08～-0.28; p = 0.0008) and the incidence of postoperative intrauterine adhesions after miscarriage (RR 0.44, 95 % CI 0.29～0.67; p = 0.0001). Subgroup analysis found that hyaluronic acid gel reduced the incidence of moderate and severe intrauterine adhesions after miscarriage (RR 0.18, 95 % CI: 0.07～0.47; p = 0.0004), but had no effect on the incidence of mild intrauterine adhesions (RR 0.77, 95 % CI 0.42～1.19; p = 0.19). Hyaluronic acid gel also improved the pregnancy rate after miscarriage (RR 1.94, 95 % CI 1.46～2.60; p < 0.00001).

CONCLUSION

Hyaluronic acid gel significantly reduced the incidence of moderate and severe intrauterine adhesions and significantly improved the pregnancy rate after miscarriage.

YWHAZ promotes ovarian cancer metastasis by modulating glycolysis

Ovarian cancer is one of the three most deadly gynecological cancers, with the highest mortality rate. As the main cause of death, metastasis is considered to be a crucial factor that reduces the survival time of ovarian carcinoma patients. YWHAZ (also known as 14‑3‑3ζ) influences diverse vital cellular processes such as metabolism, signal transduction, apoptosis and cell cycle regulation. In the present study, we determined that YWHAZ is upregulated in ovarian cancers in contrast to normal tissues by immunohistochemical staining. High YWHAZ expression was found to be associated with TNM stage and metastasis‑free prognosis of ovarian cancer patients. Silencing of YWHAZ inhibited the proliferation and facilitated serum starvation‑induced apoptosis of ovarian cancer cells. Cell migration was also suppressed by YWHAZ silencing. Furthermore, using an in vivo metastatic model, we found that YWHAZ silence also inhibited ovarian cancer metastasis in vivo. Notably, glycolysis was clearly inhibited in YWHAZ‑silenced ovarian cancer cells as determined by lactate production assay and Seahorse XF analysis. YWHAZ also regulated the PI3K/Akt1/vimentin signaling pathway in ovarian cancer cells as detected by western blot analysis. Taken together, our results demonstrated that YWHAZ plays an important role in the progression of ovarian cancer and can be used as a potential target for the diagnosis and treatment of epithelial ovarian cancer.

Upregulated CTHRC1 promotes human epithelial ovarian cancer invasion through activating EGFR signaling

Epithelial ovarian cancer (EOC) is the major cause of deaths from gynecologic malignancies, and metastasis is the main cause of cancer related death. Collagen triple helix repeat containing-1 (CTHRC1) is a secreted protein that has the ability to inhibit collagen matrix synthesis. In this study, we found that high CTHRC1 expression was associated with poor prognosis of EOC. In vitro experiments showed that CTHRC1 promoted migration and invasion of ovarian cancer cells. CTHRC1 had no effect on ovarian cancer cells viability. Additionally, EGFR inhibitors reduced the promotion effects of CTHRC1 on EOC cell invasion. After silencing of CTHRC1, downregulated expression of phosphorylation of EGFR/ERK1/2/AKT was observed in ovarian cancer cells. Taken together, our results suggest a role for CTHRC1 in the progression of ovarian cancer and identified CTHRC1 as a potentially important predictor for human ovarian cancer prognosis.

Plasma metabolomic profile and potential biomarkers for missed abortion

A missed abortion (MA) is an in utero death of the embryo or fetus before the 20th week of gestation with retained products of conception, and this condition is currently common in China. In order to discover novel biomarkers for MA, ultrahigh performance liquid chromatography was applied to study plasma metabolite profiles for 33 patients with MA and 29 control subjects. Thirty-seven differential plasma metabolites were found to discriminate between the two groups in the initial cohort (15 subjects with MA and 15 healthy controls). The feasibility of using these potential biomarkers to predict MA was further evaluated in the validation cohort (18 subjects with MA and 14 healthy controls) and 15 had an area under the receiver operating characteristic curve of >0.80, making them satisfactory. Tryptophan metabolism and sphingolipid metabolism were identified as important potential target pathways for MA using metabolic pathway impact analysis. Furthermore, three of the 15 satisfactory metabolites (glyceric acid, indole and sphingosine) were combined to establish a predictive model with 100% sensitivity and 100% specificity in the validation cohort. Taken together, these results suggest that MA results in significant disturbance of metabolism and those various novel biomarkers have satisfactory diagnostic and predictive power for MA.

[Notch signaling promotes receptor activator of nuclear factor kappa B ligand-induced ostoclastogenesis of RAW264.7 cells in vitro]

OBJECTIVE

This study aims to explore the effect of Notch signaling depression on the receptor activator of nuclear factor kappa B ligand (RANKL)-induced osteoclastogenesis of RAW264.7 cells.

METHODS

Mice RAW264.7 cells were cultured and differentiated into osteoclasts with the induction of RANKL. The expressions of Notch1, Notch2, Deltal, Jagged1, Hes1, tartrate-resistant acid phosphatase (TRAP), and Cathepsin K genes during osteoclastogenesis were analyzed using real-time polymerase chain reaction. Osteoclast formation was analyzed using TRAP assay with suppression of Notch receptors by a selective γ-secretase inhibitor (GSI).

RESULTS

Notch1, Notch2, Delta1, Jagged1, and Hes1 expressions in RAW264.7 cells were upregulated following 50 ng · mL-RANKL stimulation for 3 d, concomitant with the expression of the osteoclast differentiation markers TRAP and Cathepsin K. Notch2 and Jagged1 had the most remarkable increase in the Notch family members. GSI inhibited RANKL-induced osteoclastogenesis of RAW264.7 cells and Hes1 expression dose-dependently.

CONCLUSION

Notch signaling activation may promote RANKL-induced osteoclastogenesis of RAW264.7 cells.

Characterization of core-shell MOF particles by depth profiling experiments using on-line single particle mass spectrometry

Materials with core-shell structures have distinct properties that lend themselves to a variety of potential applications. Characterization of small particle core-shell materials presents a unique analytical challenge. Herein, single particles of solid-state materials with core-shell structures were measured using on-line aerosol time-of-flight mass spectrometry (ATOFMS). Laser 'depth profiling' experiments verified the core-shell nature of two known core-shell particle configurations (<2 μm diameter) that possessed inverted, complimentary core-shell compositions (ZrO2@SiO2 versus SiO2@ZrO2). The average peak area ratios of Si and Zr ions were calculated to definitively show their core-shell composition. These ratio curves acted as a calibrant for an uncharacterized sample – a metal-organic framework (MOF) material surround by silica (UiO-66(Zr)@SiO2; UiO = University of Oslo). ATOFMS depth profiling was used to show that these particles did indeed exhibit a core-shell architecture. The results presented here show that ATOFMS can provide unique insights into core-shell solid-state materials with particle diameters between 0.2-3 μm.

An evaluation comparing Californium252 neutron brachytherapy with neoadjuvant intra-arterial embolism chemotherapy assisted surgery effect for treating advanced cervical carcinoma patients

PURPOSE OF INVESTIGATION

To compare the therapeutic and side effects of using Californium252 (252Cf) neutron brachytherapy with neoadjuvant intra-arterial embolism chemotherapy in combination with surgery for treating Stage Ib2-IIb cervical cancers (CCs).

MATERIALS AND METHODS

Thirty-two Stage Ib2-IIb CC patients were enrolled and randomly divided into two groups from January 2007 to April 2010 in the present Hospital. Prior to surgery within four weeks, a total of 17 cases were treated with 252Cf neutron brachytherapy (700-800 cGy doses at point A) once a week (Group A), and 15 cases were treated by neoadjuvant intra-arterial embolism chemotherapy using a combination of bleomycin, carboplatin, and cyclophosphamide twice (Group B). The clinical symptoms and signs, side effects, and relapse condition follow up until July 2013 were compared between the two groups for the perioperation.

RESULTS

Reductions in tumor mass and CR+PR were not significantly different between the groups before the surgery (p > 0.05). Abdominal pain and pelvic adhesions were significantly more severe in Group B (p < 0.05). There were no significant differences in surgical time, blood loss or the other side effects between Groups A and B (p > 0.05). The percentage of pelvic tumor recurrences in Group A was lower than that of the patients in Group B (11.8% vs 20.0%) although with no significant difference at present. No distant metastasis has been found in both two groups.

CONCLUSION

Except for less abdominal pain and pelvic adhesions, 252Cf neutron brachytherapy has perioperative effects similar to those of neoadjuvant intra-arterial embolism chemotherapy.

[Esthetic reconstruction of the anterior teeth area following a combined periodontic-orthodontic treatment in adult periodontal patients]

OBJECTIVE

To evaluate the role of the combined periodontic-orthodontic treatment in the esthetic reconstruc- tion of the anterior teeth area following periodontitis.

METHODS

Thirteen adult patients with anterior teeth displacements were treated. The probing pocket depth (PD; 102 teeth, 612 sites), bleeding on probing (102 teeth, 204 sites), papilla index (PI; 128 papillae), and papillary height (PH; 128 papillae) of each patient were assessed at baseline, 3 months after the initial therapy, and the end of the orthodontic treatment. Non-parametric and paired-sample t tests were carried out for the statistical analysis of the data.

RESULTS

Three months after initial therapy, the sites with PD ≤ 3 mm accounted for 79.58% (487/612) of the observed teeth, and 88.73% (181/204) of the buccal and lingual sites of the teeth showed negative bleeding on probing. These findings were better than those at baseline [26.31% (161/612) and 22.06% (45/204), respectively] (P < 0.05), but no sig- nificant difference was observed compared with pro-orthodontic treatment (P > 0.05). Prior to orthodontic treatment, the levels of the PI of 8 and 21 papillae were III and II, respectively, among the 128 observed papillae. After the orthodontic treatment, 51 papillae were at level III and 68 papillae were at level II. The PH of the 102 papillae was 2.84 mm ± 0.62 mm after ortho- dontic treatment. This result indicated significant difference compared with that of pre-orthodontic treatment (1.69 mm ± 0.57 mm) (P < 0.05).

CONCLUSION

After initial therapy, moderate orthodontic teeth movements may reconstruct the interproximal soft tissue, with esthetic improvement of the papillary level and resolution of the periodontal defects.

[Esthetic reconstruction of the anterior teeth area following a combined periodontic-orthodontic treatment in adult periodontal patients]

OBJECTIVE

To evaluate the role of the combined periodontic-orthodontic treatment in the esthetic reconstruc- tion of the anterior teeth area following periodontitis.

METHODS

Thirteen adult patients with anterior teeth displacements were treated. The probing pocket depth (PD; 102 teeth, 612 sites), bleeding on probing (102 teeth, 204 sites), papilla index (PI; 128 papillae), and papillary height (PH; 128 papillae) of each patient were assessed at baseline, 3 months after the initial therapy, and the end of the orthodontic treatment. Non-parametric and paired-sample t tests were carried out for the statistical analysis of the data.

RESULTS

Three months after initial therapy, the sites with PD ≤ 3 mm accounted for 79.58% (487/612) of the observed teeth, and 88.73% (181/204) of the buccal and lingual sites of the teeth showed negative bleeding on probing. These findings were better than those at baseline [26.31% (161/612) and 22.06% (45/204), respectively] (P < 0.05), but no sig- nificant difference was observed compared with pro-orthodontic treatment (P > 0.05). Prior to orthodontic treatment, the levels of the PI of 8 and 21 papillae were III and II, respectively, among the 128 observed papillae. After the orthodontic treatment, 51 papillae were at level III and 68 papillae were at level II. The PH of the 102 papillae was 2.84 mm ± 0.62 mm after ortho- dontic treatment. This result indicated significant difference compared with that of pre-orthodontic treatment (1.69 mm ± 0.57 mm) (P < 0.05).

CONCLUSION

After initial therapy, moderate orthodontic teeth movements may reconstruct the interproximal soft tissue, with esthetic improvement of the papillary level and resolution of the periodontal defects.

IL-1beta caused pancreatic beta-cells apoptosis is mediated in part by endoplasmic reticulum stress via the induction of endoplasmic reticulum Ca2+ release through the c-Jun N-terminal kinase pathway

Endoplasmic reticulum (ER) homeostasis is crucial for beta-cell function and survival. Direct as well as indirect evidence has pointed toward Ca(2+) as an important determinant of interleukin-1beta (IL-1beta)-induced beta-cell dysfunction and apoptosis. In the present study, we show that IL-1beta-induced apoptosis and necrosis in primary rat beta-cells and MIN6 cells largely depends on ER stress, ER Ca(2+) release, and c-Jun N-terminal kinase (JNK) activation. beta-cells also showed marked sensitivity to apoptosis induced by sarcoendoplasmic reticulum Ca(2+) ATPase (SERCA) blockers, thapsigargin and cyclopiazonic acid (CPA). IL-1beta induced ER Ca(2+) release, which was paralleled by an IL-1beta-dependent induction of JNK activation and the ER stress response, including activation of PRK (RNA-dependent protein kinase)-like ER kinase (PERK). Furthermore, reduced activation of JNK, utilizing JNK inhibitor SP600125, resulted in significant protection from IL-1beta- or thapsigargin-induced apoptosis via ER stress. In conclusion, our results suggest that the IL-1beta-induced depletion of ER Ca(2+) and activation of the ER stress via JNK pathway are potential contributory mechanisms to beta-cell death.