Ultralight type I transvaginal mesh: an alternative for recurrent severe posterior vaginal prolapse

OBJECTIVE

This study aimed to analyze the medium-term outcomes of ultralight type I mesh for postmenopausal women with recurrent severe posterior vaginal prolapse (PVP).

METHODS

All participants underwent transvaginal ultralight type I mesh repair between April 2016 and April 2021 and were followed until May 2022. Pelvic Organ Prolapse Quantification System (POP-Q) staging, mesh-related complications, Patient Global Impression of Improvement (PGI-I) scale and quality of life questionnaire responses were evaluated. The primary outcome was composite surgical success rate at the last follow-up, composite success being defined as no vaginal bulge symptoms, no POP-Q point at or beyond the hymen and no re-treatment for POP. Secondary outcomes included anatomic outcomes (POP-Q score), symptomatic relief and complications.

RESULTS

The median follow-up was 37.3 months. At the last follow-up, the composite success rate was 75%, and POP-Q scores for the vault and posterior wall and quality of life questionnaire scores were significantly improved (p < 0.01). The subjective satisfaction (PGI-I ≤ 2) rate was 83.3%. There were no mesh-related complications.

CONCLUSIONS

Ultralight mesh can achieve good clinical outcomes and substantially improve the quality of life of patients with severe recurrent PVP in the medium term, and may thus be a viable alternative for treating this condition.

[Role of alternative activation of macrophages in hookworm therapy for inflammatory diseases: a review]

As a type of highly plastic innate immune cells, macrophages may be differentiated into M1 and M2 macrophages upon different stimuli, and M2 macrophages are involved in immune regulation, tissue remodeling and regeneration, and wound healing. Previous epidemiological studies have shown a significant negative correlation between the prevalence of helminth infections and the incidence of inflammatory diseases, such as allergy and autoimmune diseases. As a common type of intestinal helminths, hookworm infection may trigger high levels of type II host immune responses, with alternative activation of macrophages, which are effective to inhibit the development and progression of inflammatory diseases. This review summarizes the advances in alternative activation of macrophages in hookworm therapy for inflammatory diseases.

Fourfold Anisotropic Magnetoresistance of L1_{0} FePt Due to Relaxation Time Anisotropy

Experimental measurements show that the angular dependence of the anisotropic magnetoresistance (AMR) in L1_{0} ordered FePt epitaxial films on the current orientation and magnetization direction is a superposition of the corresponding dependences of twofold and fourfold symmetries. The twofold AMR exhibits a strong dependence on the current orientation, whereas the fourfold term only depends on the magnetization direction in the crystal and is independent of the current orientation. First-principles calculations reveal that the fourfold AMR arises from the relaxation time anisotropy due to the variation of the density of states near the Fermi energy under rotation of the magnetization. This relaxation time anisotropy is a universal property in ferromagnetic metals and determines other anisotropic physical properties that are observable in experiment.

Inorganic anions influenced the photoaging kinetics and mechanism of polystyrene microplastic under the simulated sunlight: Role of reactive radical species

The photo-transformation of microplastic (MP) in natural water may involve interactions with various ingredients, but the photoaging kinetics and underlying mechanism are not well understood. This work systematically explored the photoaging process of polystyrene microplastic (PS-MP) in the presence of commonly-found inorganic anions, including NO₃^-, HCO₃^-, Br^- and Cl^-. The addition of these ions led to more obvious changes in the morphology, functional groups and molecular weight of photoaging PS-MP. The evolution of carbonyl index value for the photoaged samples conformed to pseudo-first-order kinetic model, and the photoaging rate constant (k) in the presence of inorganic anions at their environmentally relevant concentrations of 0.6 mM, 1.2 mM, 0.1 M and 0.1 mM was calculated to be k_HCO3- = 0.0074 d^-1, k_NO3- = 0.01001 d^-1, k_Cl- = 0.00783 d^-1, and k_Br- = 0.00888 d^-1, which was higher than that in ultrapure water (k=0.00705 d^-1). Electron paramagnetic resonance technique and quenching experiments demonstrated that photo-transformation of PS-MP was mainly mediated by indirect photolysis, i.e., the formation of reactive radical species. The photosensitivity of NO₃^- promoted more •OH production, thereby accelerated the indirect photoaging of PS-MP. Meanwhile, the presence of halide ions promoted the generation of reactive halogen species, which were also involved in the indirect photoaging of PS-MP. Interestingly, as •OH scavenger, HCO₃^- had no inhibitory effect on PS-MP photoaging, attributing to the oxidation of CO₃^•-. This study provides valuable insights into the understanding of photo-transformation of MPs in natural aquatic environments.

First live birth in China after cryopreserved ovarian tissue transplantation to prevent premature ovarian insufficiency

OBJECTIVE

This article reports the first live birth after cryopreserved ovarian tissue transplantation to prevent premature ovarian insufficiency in China.

METHODS

A patient with myelodysplastic syndrome received ovarian tissue cryopreservation before hematopoietic stem cell transplantation, and six ovarian cortex strips were thawed and transplanted into her peritoneal pocket 2 years later.

RESULTS

Pregnancy occurred spontaneously 27 months after grafting, and a healthy girl was born at 38 weeks gestation. Until now, the child has developed normally without any major diseases.

CONCLUSIONS

We report the first live birth resulting from ovarian tissue cryopreservation and transplantation in China.

Brain functional changes in individuals with bulimia nervosa: a protocol for systematic review and meta-analysis

INTRODUCTION

Bulimia nervosa (BN) is a disorder with high health and socioeconomic burdens that typically arises in late adolescence and early adulthood. Previous neuroimaging studies have found functional brain changes in patients with BN. This study aims to review the latest neurobiological evidence from studies of individuals with BN, examine the consistency of these findings and evaluate the food addiction hypothesis of the disease.

METHODS AND ANALYSIS

A systematic search will be performed using the Cochrane Library, PubMed, Embase and Web of Science databases, covering the period from database inception to 30 November 2021. Two researchers will be responsible for study selection, quality assessment and data extraction. The anisotropic effect size version of the signed differential mapping method will be used to conduct a coordinate-based meta-analysis. Publication bias will be examined with the Egger test. The quality of studies will be evaluated using the Newcastle-Ottawa Scale.

ETHICS AND DISSEMINATION

No ethics approval is required for this is a systematic review protocol and does not require the collection of primary data. Findings will be disseminated through peer-reviewed journal or related conferences.

PROSPERO REGISTRATION NUMBER

CRD42022307233.

Longer follow-up intervals following EVAR are safe and appropriate after marked aneurysm sac regression

BACKGROUND

Abdominal aortic aneurysm (AAA) shrinkage after endovascular aortic aneurysm repair (EVAR) is a surrogate marker for successful exclusion. Our study characterized aneurysm sac remodeling after EVAR to identify a pattern that may be associated with benign AAA behavior and would safely allow a less rigorous follow-up regimen after EVAR.

METHODS

Elective infrarenal EVARs performed between 2008 and 2011 at our institution were retrospectively reviewed. AAA sac diameters using the minor axis measurement from ultrasound imaging or computer tomography angiogram imaging were compared with the baseline diameter from the 1-month postoperative computer tomography angiogram. The primary outcome was a composite of freedom from postoperative reintervention or rupture. We compared those with AAA sacs who regressed to predefined minimum diameter thresholds with those who did not. Outcomes were plotted with Kaplan-Meier curves and compared using log-rank testing and Fine-Gray regression using death as a competing risk, clustered on graft type. For patients whose AAA reached the minimum sac diameter, landmark analysis evaluated ongoing size changes including further regression and sac re-expansion.

RESULTS

A total of 540 patients (aged 75.1 ± 8.2 years; 82.0% male) underwent EVAR with an average preoperative AAA size of 55.2 ± 11.5 mm. The median postoperative follow-up was 5.3 years (interquartile range, 1.4-8.7 years) during which 64 patients underwent reintervention and 4 ruptured. AAA sac regression to ≤40 mm in diameter was associated with improved freedom from reintervention or rupture overall (log-rank, P < .01), which was maintained after controlling for the competing risk of death (P < .01). In 376 patients (70%) whose aneurysm sac remained >40 mm, 99 reinterventions were performed on 63 patients. Of 166 (31%) patients whose sac regressed to ≤40 mm, only 1 patient required a reintervention, and no one ruptured. The mean time to a diameter of ≤40 mm was 2.3 ± 1.9 years. Only eight patients (5%) developed sac re-expansion to >45 mm; all but two occurred at least 3 years after initially regressing to ≤40 mm.

CONCLUSIONS

In long-term follow-up, patients whose minimum AAA sac diameter regressed ≤40 mm after EVAR experienced a very low rate of reintervention, rupture, or sac re-expansion. Most sac re-expansion occurred at least 3 years after reaching this threshold and did not result in clinical events. Increasing follow-up frequency up to 3-year intervals once the AAA sac regresses to 40 mm would carry minimal risk of aneurysm-related morbidity.

[Observation of efficacy and safety of stereotactic-EEG-guided three-dimensional radiofrequency thermocoagulation for the treatment of drug-resistant insular epilepsy]

Objective: To investigate the safety and efficacy of stereotactic-EEG (SEEG)-guided radiofrequency thermocoagulation (RF-TC) with three-dimensional lesioning in the treatment of drug-resistant insular epilepsy. Methods: Seven patients with drug-resistant insular epilepsy who underwent SEEG-guided RF-TC with three-dimensional ablation at the Department of Neurosurgery of Xuanwu Hospital, Capital Medical University from February 2017 to June 2019 were retrospectively enrolled. Presurgical evaluation including semiology, EEG and imaging results suggested that the epileptogenic zone was located in the insular lobe. All patients underwent SEEG recording and three-dimensional RF-TC. Postoperative follow-up was conducted by outpatient visits or telephone, the clinical efficacy was evaluated based on Engel classification and the relevant complications were documented. Results: Seven patients were followed up at 18 months after surgery. Among them, 4 were seizure free (Engel ⅠA), 2 had nondisabling simple partial seizures (Engel ⅠB) and 1 achieved 75% decrease (Engel ⅢA) in seizure frequency. Postoperative complications occurred in 3 patients which included decreased sensation in the right lower extremity, decreased strength in the right upper extremity, glossolalia, decline in memory and comprehension. No permanent neurological dysfunction was detected. Conclusion: SEEG-guided RF-TC with three-dimensional lesioning is minimally invasive, safe and effective in the treatment of drug-resistant insular epilepsy and can serve as a complementary method for resection surgery.

[Oxymatrine improves renal fibrosis and inflammation in diabetic rats by modulating CHK1/2 phosphorylation]

OBJECTIVE

To explore the role of cell cycle checkpoint kinase 1/2 (CHK1/2) in mediating the inhibitory effect of oxymatrine (OMT) against renal inflammation and fibrosis in diabetic rats.

METHODS

SD rats were randomly divided into normal control group, diabetes model group (DM) and OMT treatment group (n=6). HE and Masson staining were used to observe histopathological changes of the renal tissue, and the expressions of CHK1, CHK2, p-CHK1 and p-CHK2 were localized by immunohistochemical staining. The contents of interleukin-6 (IL-6) and IL-1β in the renal tissue were detected using ELISA, and the expression levels of CHK1, CHK2, p-CHK1, p-CHK2, type Ⅲ collagen (Col-Ⅲ), type Ⅳ collagen (Col-Ⅳ), and fibronectin (FN) were determined using Western blotting. The changes in the expressions of CHK1, CHK2, p-CHK1, p-CHK2, Col-Ⅲ, Col-Ⅳ and FN proteins were also examined with Western blotting in NRK-52E cells in response to high glucose exposure, OMT treatment and siRNA-mediated CHK1/2 knockdown.

RESULTS

In diabetic rats, OMT treatment significantly decreased the levels of blood glucose, serum creatinine and 24 h urinary protein (P < 0.05) and obviously improved inflammatory cell infiltration and fibrosis phenotype in the renal tissue (P < 0.05). CHK1 and CHK2 were mainly expressed in the cytoplasm and nuclei of renal tubule cells, and their phosphorylation levels were significantly higher in DM group than in the control group and OMT group. OMT treatment significantly decreased the protein expression levels of p-CHK1, p-CHK2, Col-Ⅲ, Col-Ⅳ and FN in the renal tissue of diabetic rats and in NRK-52E cells exposed to high glucose (P < 0.05). In NRK-52E cells, CHK1/2 knockdown resulted in significant reduction of the protein expressions of p-CHK1/2, Col-Ⅲ, Col-Ⅳ and FN (P < 0.05).

CONCLUSION

The inhibitory effects of OMT against renal inflammation and fibrosis in diabetic rats are mediated probably by lowered phosphorylation levels of CHK1 and CHK2, which result in reduced release of the downstream inflammatory mediators and decreased secretion and deposition of extracellular matrix.

Dapagliflozin decreases atherosclerotic plaque instability via regulating macrophage pyroptosis

Background

Vulnerable plaques are characterized by infiltration of inflammatory cells, playing a key role in the progression of acute coronary events. It's important to clarify the inflammatory mechanism of unstable plaque formation. Several clinical trials have demonstrated that dapagliflozin could reduce major adverse cardiac events in whether diabetic or non-diabetic patients. However, the underlying cardioprotective mechanism of dapagliflozin remains unclear. This study was aimed to investigate the role of dapagliflozin in regulating macrophage pyroptosis and vulnerable plaque formation.

Methods

20 ApoE−/− mice (control) were fed with high fat diet while another 20 ApoE−/− mice were challenged with high fat diet plus dapagliflozin for 12 weeks. The extent and instability of atherosclerotic plaque was determined by oil-red staining, HE staining, immunofluorescence staining and electron microscopy. Changes in subsets of immune cells were evaluated by flow cytometry. Plasma cytokines were assessed by ELISA. Microarray analysis was applied to detect gene expressions while Western blot and real-time PCR was used to assess gene expression levels.

Results

Morphology studies revealed that dapagliflozin could inhibit plaque formation and reduce instability in ApoE−/− mice. FACS data showed that dapagliflozin could decrease CD11b+Ly6Chigh M1 macrophages differentiation and inhibit foam cells formation in ApoE−/− mice. Microarray analysis and in vitro studies exhibited that dapagliflozin could induce the down regulation of NLRP3, caspase-1, IL-1β, IL-18 and MMP-7/10/12/14 to retard macrophage pyroptosis and foam cell formation.

Conclusions

We have characterized a novel role for dapagliflozin in modulating atherosclerotic lesion development and progression. We envision that this study may provide several potential therapeutic targets for treatment of acute coronary syndromes.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Shanghai Sailing Program

A New Method of Isolation of Mouse Renal Primary Tubular Epithelial Cells

Kidney diseases are becoming an emerging public health problem. In order to further explore the etiology of various kidney diseases, we improved the methods of isolation of primary cultures of mouse renal tubular epithelial cells. At the first stage, the kidneys were perfused with collagenase solution. To this end, the superior mesenteric artery, celiac artery and thoracic aorta were ligated and perfusion was performed through the abdominal aorta. Then, the cells were isolated ex vivo and their integrity, purity, viability, and concentration were evaluated. The proposed cost-effective and simple method provides high purity and high concentration of primary renal epithelial cells for molecular biology studies of the kidneys.

Deciphering the transformation mechanism of substituted polycyclic aromatic hydrocarbons on Al(III)-montmorillonite: An experimental and density functional theory study

The researches on transformation of polycyclic aromatic hydrocarbons (PAHs) on clay minerals modified by metal ions have received increasing attention. However, the transformation of PAHs with electron-withdrawing or electron-donating substitutional groups on clay minerals is not well understood currently. In this study, the degradation of anthracene (ANT) with different substituents (including -CH₃, -CHO, -Br, -OMe, and -NO₂) on Al(III)-montmorillonite (MMT) was investigated in the dark. The results showed that aromatic compounds were degraded with the rate constants (k_obs) of 0.004-0.141 d^-1. Moreover, ANT with electron-donating substituents (e.g., -CH₃, -OMe) had a higher transformation rate than that with electron-withdrawing substituents (e.g., -Br, -NO₂). The reactive oxygen species (ROS) quenching experiments indicated that ROS played a significant role in the transformation of ANT and ANT derivatives. Density functional theory (DFT) calculations revealed that the reactivity of single substituted PAHs was highly correlated with their ionization potential (IP), the energy of highest occupied molecular orbital (E_HOMO), the energy of lowest unoccupied molecular orbital (E_LUMO), and electronegativity (ζ), while independent of hardness (η). This study provides novel insights into predicting the reactivity of PAHs derivatives, and lays a fundamental basis for better understanding the fate of substituted PAHs in soils.

Interfacial reaction between organic acids and iron-containing clay minerals: Hydroxyl radical generation and phenolic compounds degradation

Reactive oxygen species, especially hydroxyl radicals (OH), exert a distinguished role in the transformation of contaminants, and their in-situ generation attracts wide attentions in environmental and geochemical areas. The present work explored the potential formation of OH during the interactions between iron-containing clay minerals and environmentally prevalent organic acids in dark environments. The results demonstrated that the accumulative OH concentrations were related to the solution pH, the types of clay minerals, and the nature of organic acid species. At pH 5.5, 1.2- 15.2 times of OH were generated from the reduction of Na-nontronite-2 (Na-NAu-2) compared with other clay minerals in the presence of ascorbic acid (AA) at 144 h. X-ray photoelectron spectroscopy (XPS) and Fourier-transform infrared spectroscopy (FTIR) analyses indicated that Fe(III) was reduced to Fe(II) by AA during OH formation. Meanwhile, chemical probe tests coupled with quenching experiments confirmed the generation of H₂O₂ and superoxide radical (O₂^-), which participated in the formation of OH. The produced OH/O₂^- can transform 68.4%, 86.4%, and 50.1% of phenol, p-nitrophenol, and 2,4-dichlorophenol within 168 h in AA-Na-NAu-2 suspension, respectively. This work provides valuable insights into OH production in the mutual interaction between organic acids and iron-bearing clays, which is helpful for the development of a new method for removing organic pollutants from contaminated water and soil environments.

Understanding the sorption behaviors of heavy metal ions in the interlayer and nanopore of montmorillonite: A molecular dynamics study

The molecular-scale adsorption mechanism of heavy metal ions in the interlayer and nanopore regions of montmorillonite (MMT) were investigated by molecular dynamics simulations. Three typical heavy metals (zinc, cadmium, and lead) were selected as the model ions, and two types of MMT (Arizona and Wyoming) were considered. The results showed that Cd²⁺ and Pb²⁺ can form both inner- and outer-sphere complexes on Wyoming MMT, while Zn²⁺ only formed outer-sphere complex due to the stronger hydration interaction of Zn²⁺ than Cd²⁺ and Pb²⁺. For Arizona MMT, all of the three ions only formed outer-sphere complexes on its interlayer and external basal surface in which the cations remained a fully hydrated state. The calculated diffusion coefficients of three cations in interlayer and nanopore indicated that their diffusion abilities were significantly impaired, implying that MMT adsorbents have a strong ability to fix and retard heavy metal ions. The derived results and mechanisms are instrumental to a profound understanding of the transport and retention of heavy metal elements in subsurface environments, and provide guidance for the management of heavy metal pollution.

First pregnancy in China after ovarian tissue transplantation to prevent premature ovarian insufficiency

OBJECTIVE

This article reports the first case of pregnancy after frozen-thawed ovarian tissue transplantation to prevent iatrogenic premature ovarian insufficiency in China.

METHODS

Ovarian tissue cryopreservation was performed in a patient with myelodysplastic syndrome (MDS) before multi-agent chemotherapy and hematopoietic stem cell transplantation. Two years later, she showed complete remission from MDS, and six frozen-thawed ovarian tissue strips were transplanted into the peritoneal pocket.

RESULTS

The patient's ovarian activity was restored 3 months after transplantation, and pregnancy occurred spontaneously 27 months after grafting. Until now, the pregnancy has progressed for 30 weeks, and the repeated ultrasound showed normal fetal development.

CONCLUSION

This is the first pregnancy resulting from ovarian tissue cryopreservation and transplantation in China.

Greatly enhanced oxidative activity of δ-MnO2 to degrade organic pollutants driven by dominantly exposed {-111} facets

The reactivity of oxidizing materials is highly related to the exposed crystal facets. Herein, δ-MnO₂ with different exposure facets were synthesized and the oxidative activities of the as-prepared materials were evaluated by degrading phenol in water without light. The degradation rate of phenol by δ-MnO₂-{-111} was significantly higher than that by δ-MnO₂-{001}. δ-MnO₂-{-111} also displayed high degradation efficiency to a variety of other organic pollutants, such as ciprofloxacin, bisphenol A, 3-chlorophenol and sulfadiazine. Comprehensive characterization and theoretical calculation verified that the {-111} facet had high density of Mn³⁺, thus displaying enhanced direct oxidative capacity to degrade organic pollutants. In addition, the dominant {-111} facet promoted adsorption/activation of O₂, thus favored the generation of superoxide radical (O₂^•-), which actively participated in the degradation of pollutants. The phenol degradation kinetics could be divided into two distinct phases: the rapid phase (k1_obs = 0.468 min^-1) induced by Mn³⁺ and the slower phase (k2_obs = 0.048 min^-1) dominated by O₂^•-. The synergistically promoted non-radical and radical based reactions resulted in greatly enhanced the oxidative activity of the δ-MnO₂-{-111}. These findings deepen the understanding of facet-dependent oxidative performance of materials and provided valuable insights into the possible practical application of δ-MnO₂ for water purification.