Hysteroscopic tissue removal systems for the treatment of intrauterine pathology: a systematic review and meta-analysis

BACKGROUND

The use of mechanical tissue removal systems is more frequently implemented as the first line approach for the treatment of intrauterine pathology. Scientific evidence is provided that their use is easier and faster than the conventional resectoscope. It is necessary to objectively evaluate the results on tissue removal systems for the treatment of endometrial pathology as the reports in the literature are still conflicting.

OBJECTIVE

To review and compare mechanical hysteroscopic tissue removal systems (Truclear®, Myosure® or IBS®) versus conventional bipolar and monopolar resectoscopy for the treatment of polyp and myoma removal. Operation time, completeness of tissue removal, complication rate, fluid deficit, tolerability and learning curve were evaluated.

METHODS

Electronic databases PubMed; Medline and Web of Science were searched for papers published from 1st January 2010 to 1st May 2019 using terms: ("hysteroscopic" or "hysteroscopy" or "hysteroscopic surgery") and ("myoma" or "polyps"). Studies were included if they were retrospective, observational and prospective randomized clinical controlled trials if they investigated the techniques between the tissue removal systems (Truclear®, Myosure® or IBS®) and conventional resectoscopy for the treatment of intrauterine pathology. Data were extracted from the included studies by two independent reviewers. Meta-analysis was performed by Rev Man 5 software (Cochrane Collaboration, London, UK). Results: Overall, 498 patients were analysed from five studies in which there was no difference in age and size of pathology treated either by the hysteroscopic tissue removal systems and the conventional resectoscope. Hysteroscopic tissue removal systems showed a significantly higher success rate of complete endometrial pathology removal (P=0.002) and a significantly shorter operation time for polyp removal (P<0.0001) compared to conventional resectoscopy. No significant differences, in terms of complications rate, were found (P=0.09). The fluid deficit was significantly higher in the tissue removal system group, compared to conventional resectoscopy (P=0.02).

CONCLUSION

Hysteroscopic tissue removal systems showed a major advantage in successful removal of the pathology and total operation time. It is likely that the tissue removal systems are more accessible and have a lower complication profile including perforation, via falsa and bleeding due to its specific action mechanism and shorter operation time but higher-quality trials will be required to confirm this hypothesis.

Modulation of Manganite Nanofilm Properties Mediated by Strong Influence of Strontium Titanate Excitons

Hole-doped perovskite manganites have attracted much attention because of their unique optical, electronic, and magnetic properties induced by the interplay between spin, charge, orbital, and lattice degrees of freedom. Here, a comprehensive investigation of the optical, electronic, and magnetic properties of La_0.7Sr_0.3MnO₃ thin films on SrTiO₃ (LSMO/STO) and other substrates is conducted using a combination of temperature-dependent transport, spectroscopic ellipsometry, X-ray absorption spectroscopy, and X-ray magnetic circular dichroism. A significant difference in the optical property of LSMO/STO that occurs even in thick (87.2 nm) LSMO/STO from that of LSMO on other substrates is discovered. Several excitonic features are observed in thin film nanostructure LSMO/STO at ∼4 eV, which could be attributed to the formation of anomalous charged excitonic complexes. On the basis of the spectral weight transfer analysis, anomalous excitonic effects from STO strengthen the electronic correlation in LSMO films. This results in the occurrence of optical spectral changes related to the intrinsic Mott-Hubbard properties in manganites. We find that while lattice strain from the substrate influences the optical properties of the LSMO thin films, the coexistence of strong electron-electron (e-e) and electron-hole (e-h) interactions which leads to the resonant excitonic effects from the substrate plays a much more significant role. Our result shows that the onset of anomalous excitonic dynamics in manganite oxides may potentially generate new approaches in manipulating exciton-based optoelectronic applications.

Droplet Imbibition into Paper Coating Layer: Pore-Network Modeling Simulation

Liquid penetration into thin porous media such as paper is often simulated using continuum-scale single-phase Darcy's law. The underlying assumption was that a sharp invasion front percolates through the layer. To explore this ambiguous assumption and to understand the controlling pore-scale mechanisms, we have developed a dynamic pore-network model to simulate imbibition of a wetting phase from a droplet into a paper coating layer. The realistic pore structures are obtained using the FIB-SEM imaging of the coating material with a minimum resolution of 3.5 nm. Pore network was extracted from FIB-SEM images using Avizo software. Data of extracted pore network are used for statistically generating pore network. Droplet sizes are chosen in the range of those applicable in inkjet printing. Our simulations show no sharp invasion front exists and there is the presence of residual non-wetting phase. In addition, penetration of different sizes of droplets of different material properties into the pore network with different pore body and pore throat sizes are performed. We have found an approximately linear decrease in droplet volume with time. This contradicts the expected t -behavior in vertical imbibition that is obtained using macroscopic single-phase Darcy's law. With increase in flow rate, transition of imbibition invasion front from percolation-like pattern to a more sharper one with less trapping of non-wetting phase is also reported. Our simulations suggest that the single-phase Darcy's law does not adequately describe liquid penetration into materials such as paper coating layer. Instead Richards equation would be a better choice.

Cortistatin inhibits arterial calcification in rats via GSK3β/β-catenin and protein kinase C signalling but not c-Jun N-terminal kinase signalling

AIM

Cortistatin (CST) is a newly discovered endogenous active peptide that exerts protective effects on the cardiovascular system. However, the relationship between CST and aortic calcification and the underlying mechanism remain obscure. Therefore, we investigated effects of CST on aortic calcification and its signalling pathways.

METHODS

Calcium content and alkaline phosphatase (ALP) activity were measured using the o-cresolphthalein colorimetric method and ALP assay kit respectively. Protein expression of smooth muscle (SM)-ɑ-actin, osteocalcin (OCN), β-catenin, glycogen synthase kinase 3β (GSK3β), p-GSK3β, protein kinase C (PKC), p-PKC, c-Jun N-terminal kinase (JNK) and p-JNK was determined using Western blotting.

RESULTS

In aorta from a rat vitamin D3 calcification model, CST abrogated calcium deposition and pathological damage, decreased the protein expression of OCN and β-catenin and increased SM-ɑ-actin expression. In a rat cultured vascular smooth muscular cell (VSMC) calcification model induced by β-glycerophosphate (β-GP), CST inhibited the increase in ALP activity, calcium content and OCN protein and the decrease in SM-α-actin expression. CST also inhibited the β-GP-induced increase in p-GSK3β and β-catenin protein (both P < .05). The inhibitory effects of CST on ALP activity, calcium deposition and β-catenin protein were abolished by pretreatment with lithium chloride, a GSK3β inhibitor. CST promoted the protein expression of p-PKC by 68.5% (P < .01), but not p-JNK. The ability of CST to attenuate β-GP-induced increase in ALP activity, calcium content and OCN expression in the VSMC model was abolished by pretreatment with the PKC inhibitor Go6976.

CONCLUSION

These results indicate that CST inhibits aortic calcification and osteogenic differentiation of VSMCs likely via the GSK3β/β-catenin and PKC signalling pathways, but not JNK signalling pathway.

Large Enhancement of 2D Electron Gases Mobility Induced by Interfacial Localized Electron Screening Effect

The interactions between delocalized and localized charges play important roles in correlated electron systems. Here, using a combination of transport measurements, spectroscopic ellipsometry (SE), and X-ray absorption spectroscopy (XAS) supported by theoretical calculations, we reveal the important role of interfacial localized charges and their screening effects in determining the mobility of (La_0.3 Sr_0.7 )(Al_0.65 Ta_0.35 )O₃ /SrTiO₃ (LSAT/SrTiO₃ ) interfaces. When the LSAT layer thickness reaches the critical value of 5 uc, the insulating interface abruptly becomes conducting, accompanied by the appearance of a new midgap state. This midgap state emerges at ≈1 eV below the Ti t_2g band and shows a strong character of Ti 3d_xy - O 2p hybridization. Increasing the LSAT layer from 5 to 18 uc, the number of localized charges increases, resulting in an enhanced screening effect and higher mobile electron mobility. This observation contradicts the traditional semiconductor interface where the localized charges always suppress the carrier mobility. These results demonstrate a new strategy to probe localized charges and mobile electrons in correlated electronic systems and highlight the important role of screening effects from localized charges in improving the mobile electron mobility at complex oxide interfaces.

Bacteriocin biosynthesis contributes to the anti-inflammatory capacities of probiotic Lactobacillus plantarum

Plantaricin EF (PlnEF) is a class IIb bacteriocin produced by Lactobacillus plantarum. We compared L. plantarum NCIMB8826 and LM0419, a plnEFI deletion mutant of that strain lacking plnEF and the gene for the cognate immunity protein plnI, in a 2,4,6-trinitrobenzenesulfonic acid (TNBS) induced mouse model of acute inflammatory bowel disease. Mice fed either L. plantarum NCIMB8826 or LM0419 were not protected against TNBS according to either disease activity or histology (Ameho) scores. Mice consuming NCIMB8826 exhibited intermediate (non-significant) levels of colonic tumour necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) that ranged between the TNBS-treated animals and healthy controls. By comparison, TNF-α and IL-6 quantities were elevated in mice given L. plantarum LM0419 and equivalent to mice given TNBS alone. Both strains survived digestive tract transit in equal numbers and did not result in global changes to the bacterial composition in the intestine according to 16S rRNA gene sequencing either prior to or after TNBS administration. Examination of intestinal taxa showed that mice consuming wild-type L. plantarum, but not LM0419 contained lower proportions of Mucispirillum (Deferribacteres phylum) in the faeces prior to TNBS administration and Parabacteroides (Bacteroidetes phylum) in the caecum after disease induction. Parabacteroides also positively correlated with disease activity and histology scores. These findings suggest a role for PlnEFI production by L. plantarum in benefiting digestive tract health.

Integrative analyses reveal biological pathways and key genes in psoriasis

BACKGROUND

Psoriasis is a complex disease influenced by both genetic and environmental factors with abnormal gene expression in lesional skin. However, no studies are available on genome-scale gene expression of psoriatic lesions in the Chinese population. In addition, systematic studies on the biological pathways, pathogenicity and interaction networks of psoriasis-related genes with abnormal expression profiles require further investigation.

OBJECTIVES

To further explore the associated pathways in psoriasis by functional analysis and to identify the key genes by gene pathogenicity analysis.

METHODS

We performed RNA sequencing on 60 skin biopsy samples from patients with psoriasis and healthy controls to identify the primary differentially expressed genes in psoriatic lesional skin. We retrieved all reported psoriasis-associated genes and performed integrative analyses covering gene expression profiling, pathway analysis, gene pathogenicities and protein-protein interaction networks.

RESULTS

We found that internal and external stimuli may activate immunoinflammatory responses to promote the development of psoriasis. Pathways associated with infectious diseases and cancers were identified by functional and pathway analyses. The gene pathogenicity analysis revealed five key genes in psoriasis: PPARD, GATA3, TIMP3, WNT5A and PTTG1.

CONCLUSIONS

Our analyses showed that genes contributed to the pathogenesis of psoriasis by activating risk pathways with components abnormality in expression. We identified five potentially pathogenic genes for psoriasis that may serve as important biomarkers for the diagnosis and treatment.

The Mechanism of Electrolyte Gating on High-Tc Cuprates: The Role of Oxygen Migration and Electrostatics

Electrolyte gating is widely used to induce large carrier density modulation on solid surfaces to explore various properties. Most of past works have attributed the charge modulation to electrostatic field effect. However, some recent reports have argued that the electrolyte gating effect in VO₂, TiO₂, and SrTiO₃ originated from field-induced oxygen vacancy formation. This gives rise to a controversy about the gating mechanism, and it is therefore vital to reveal the relationship between the role of electrolyte gating and the intrinsic properties of materials. Here, we report entirely different mechanisms of electrolyte gating on two high-T_c cuprates, NdBa₂Cu₃O_7-δ (NBCO) and Pr_2-xCe_xCuO₄ (PCCO), with different crystal structures. We show that field-induced oxygen vacancy formation in CuO chains of NBCO plays the dominant role, while it is mainly an electrostatic field effect in the case of PCCO. The possible reason is that NBCO has mobile oxygen in CuO chains, while PCCO does not. Our study helps clarify the controversy relating to the mechanism of electrolyte gating, leading to a better understanding of the role of oxygen electro migration which is very material specific.

HCV viraemia associates with NK cell activation and dysfunction in antiretroviral therapy-treated HIV/HCV-co-infected subjects

The impact of hepatitis C virus (HCV) RNA levels on immune status in chronically HCV mono-infected when compared to HIV/HCV co-infected on antiretroviral therapy (ART) remains poorly understood. A total of 78 African American subjects HCV viraemic/naïve to HCV treatment (33 HCV genotype 1 mono-infected, 45 ART-treated HIV/HCV genotype 1 co-infected) were studied. Clinical and liver enzyme measurements were performed. Whole blood was analysed for immune subset changes by flow cytometry. Peripheral blood mononuclear cells (PBMC) were used for same-day constitutive and in vitro Interferon (IFN)-α-induced signal transducer and activator of transcription (STAT) phosphorylation, K562 target cell lysis and K562 target cell recognition-mediated IFN-γ production. Statistical analysis was performed using R (2.5.1) or JMP Pro 11. While both groups did not differ in the level of liver enzymes, HIV/HCV had higher T-cell activation/exhaustion, and constitutive STAT-1 phosphorylation compared to HCV. In contrast, CD4⁺ FoxP3⁺ CD25⁺ frequency, IFN-αR expression on NK cells, as well as constitutive and IFN-α-induced direct cytotoxicity were lower in HIV/HCV. Linear regression models further supported these results. Finally, increase in HCV viral load and CD4⁺ T-cell count had an opposite effect between the two groups on NK cell activity and T-cell activation, respectively. HCV viral load in ART-treated HIV/HCV co-infection was associated with greater immune activation/exhaustion and NK dysfunction than HCV viral load alone in HCV mono-infection. The more pronounced immune modulation noted in ART-treated HIV-co-infected/untreated HCV viraemic subjects may impact HCV disease progression and/or response to immunotherapy.

Genetic variants of microRNA processing genes and risk of non-syndromic orofacial clefts

OBJECTIVE

MicroRNA (miRNA) processing genes play important roles in the craniofacial development. The aim of this study was to explore the associations between single nucleotide polymorphisms (SNPs) of miRNA processing genes with the risk of non-syndromic orofacial clefts (NSOC).

METHODS

We genotyped 12 potentially functional SNPs from seven miRNA processing genes (GEMIN3, DROSHA, DGCR8, GEMIN4, PIWIL1, XPO5, and DICER) in a case-control study of 602 NSOC cases and 605 controls.

RESULTS

Two SNPs were associated with the susceptibility of CL/P: rs10719 in DROSHA led to an increased risk of cleft lip with or without palate (CL/P) (GA/AA: p = .024, OR = 1.33, 95% CI = [1.04, 1.70]; GG + GA/AA: p = .037, OR = 1.29, 95% CI = [1.02, 1.63]), while rs493760 in DROSHA (CC/TT: p = .049, OR = 0.58, 95% CI = [0.34, 0.99]) could reduce the risk of CL/P. In addition, rs10719 (A)-rs493760 (C) haplotype contributed to a decreased risk of CL/P (OR = 0.77, 95% CI = [0.63, 0.94]), whereas the rs10719 (G)-rs493760 (C) haplotype contributed to the increased risk of cleft palate only (CPO) (OR = 2.70, 95% CI = [1.15, 6.35]). However, there was no difference observed in these SNPs after the Bonferroni correction.

CONCLUSION

Taken together, our results provided the potential evidence that rs10719 and rs493760 might contribute to the risk of CL/P and suggested potential genetic basis and mechanisms of CL/P. The lack of association between these SNPs and CPO might be due to the limited sample size of CPO subgroup.

Tunable inverted gap in monolayer quasi-metallic MoS2 induced by strong charge-lattice coupling

Polymorphism of two-dimensional transition metal dichalcogenides such as molybdenum disulfide (MoS₂) exhibit fascinating optical and transport properties. Here, we observe a tunable inverted gap (~0.50 eV) and a fundamental gap (~0.10 eV) in quasimetallic monolayer MoS₂. Using spectral-weight transfer analysis, we find that the inverted gap is attributed to the strong charge–lattice coupling in two-dimensional transition metal dichalcogenides (2D-TMDs). A comprehensive experimental study, supported by theoretical calculations, is conducted to understand the transition of monolayer MoS₂ on gold film from trigonal semiconducting 1H phase to the distorted octahedral quasimetallic 1T’ phase. We clarify that electron doping from gold, facilitated by interfacial tensile strain, is the key mechanism leading to its 1H–1T’ phase transition, thus resulting in the formation of the inverted gap. Our result shows the importance of charge–lattice coupling to the intrinsic properties of the inverted gap and polymorphism of MoS₂, thereby unlocking new possibilities for 2D-TMD-based device fabrication.

MoS₂ exhibits multiple electronic properties associated with different crystal structures. Here, the authors observe inverted and fundamental gaps through a designed annealing-based strategy, to induce a semiconductor-to-metal phase transition in monolayer-MoS₂ on Au, facilitated by interfacial strain and electron transfer from Au to MoS₂.

Oxygen Passivation Mediated Tunability of Trion and Excitons in MoS_{2}

Using wide spectral range in situ spectroscopic ellipsometry with systematic ultrahigh vacuum annealing and in situ exposure to oxygen, we report the complex dielectric function of MoS_{2} isolating the environmental effects and revealing the crucial role of unpassivated and passivated sulphur vacancies. The spectral weights of the A (1.92 eV) and B (2.02 eV) exciton peaks in the dielectric function reduce significantly upon annealing, accompanied by spectral weight transfer in a broad energy range. Interestingly, the original spectral weights are recovered upon controlled oxygen exposure. This tunability of the excitonic effects is likely due to passivation and reemergence of the gap states in the band structure during oxygen adsorption and desorption, respectively, as indicated by ab initio density functional theory calculation results. This Letter unravels and emphasizes the important role of adsorbed oxygen in the optical spectra and many-body interactions of MoS_{2}.

Lithium enhances alveolar bone formation during orthodontic retention in rats

OBJECTIVE

To investigate the effect of lithium on alveolar bone formation during orthodontic retention in rats.

MATERIALS AND METHODS

After 2 weeks of orthodontic tooth movement (OTM), 42 8-week-old male Wistar rats were randomly divided into two orthodontic retention groups: one without (control) and the other with LiCl treatment (LiCl group). Samples were collected on days 0, 3, 7 and 14 during the retention period. We evaluated the bone volume/total volume (BV/TV) ratio and new bone formation in the region of interests (ie, the root, the periodontal ligament and the adjacent alveolar bone around the distal buccal surface of the distal root of the maxillary first molar). We performed quantitative analyses, including histology, histomorphometry and immunohistochemistry to identify Runx2 and Osterix expression.

RESULTS

The density of trabecular bone, the quantity of osteoblasts and the expression of osteogenic markers, Runx2 and Osterix, were significantly higher in the LiCl group than in the control group during the orthodontic retention period.

CONCLUSION

LiCl enhances alveolar bone formation during orthodontic retention in rats.

Relationships among Bone Quality, Implant Osseointegration, and Wnt Signaling

A variety of clinical classification schemes have been proposed as a means to identify sites in the oral cavity where implant osseointegration is likely to be successful. Most schemes are based on structural characteristics of the bone, for example, the relative proportion of densely compact, homogenous (type I) bone versus more trabeculated, cancellous (type III) bone. None of these schemes, however, consider potential biological characteristics of the bone. Here, we employed multiscale analyses to identify and characterize type I and type III bones in murine jaws. We then combined these analytical tools with in vivo models of osteotomy healing and implant osseointegration to determine if one type of bone healed faster and supported osseointegration better than another. Collectively, these studies revealed a strong positive correlation between bone remodeling rates, mitotic activity, and osteotomy site healing in type III bone and high endogenous Wnt signaling. This positive correlation was strengthened by observations showing that the osteoid matrix that is responsible for implant osseointegration originates from Wnt-responsive cells and their progeny. The potential application of this knowledge to clinical practice is discussed, along with a theory unifying the role that biology and mechanics play in implant osseointegration.