Uterine rupture complicating mid-trimester abortion in a young woman of low parity

Comprehensive network analysis of the molecular mechanisms associated with sorafenib resistance in hepatocellular carcinoma

OBJECTIVE

Hepatocellular carcinoma (HCC) is an intractable disease because patients with HCC frequently develop sorafenib resistance after long-term chemotherapy. Although studies has demonstrated the availability of cumulative information on drug-resistant patients, little is known about the strategies and molecular mechanisms to reverse sorafenib resistance. Here, the present study identified critical mRNAs and transcription factors (TFs) associated with sorafenib resistance of HCC and evaluated the significance correlation between drug-resistant genes and TFs in comprehensive network for HCC xenografts mice.

METHODS

The expression profiles of mRNAs were compared between sorafenib-acquired resistant tissue and sorafenib sensitive tissue utilizing RNA-Seq data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). Gene Ontology and KEGG pathway analysis were performed to investigate the biological function of significantly dysregulated mRNA. Furthermore, the Kaplan-Meier survival analyses were performed to evaluate the effect of mRNA on over survival. Subsequently, TFs were predicted using TRANSFAC and TF-mRNA regulatory networks were visualized using cytoscape software.

RESULTS

A total of 827 mRNAs were found to be differentially expressed in sorafenib-acquired resistant tissue compared with control. Thereafter, the results of functional enrichment analysis showed the dysregulated mRNAs involved in drug-resistant signaling pathway, including MAPK, JAK-STAT, TGF-β and drug-metabolism cytochrome P450 signaling pathway. CDK1, CDKN1A and TAPBP might serve as prognostic signature of resistance of HCC to sorafenib according to the survival analysis. Furthermore, TF-mRNA networks were constructed. There were 18 TFs were predicted to regulate differentially expressed mRNAs, which play an essential role in the regulation of dysfunctional gene networks. NFKB1 was presented in the TF-mRNA networks as the node with the highest degree and MYC was predicted as prognostic TF in drug resistance of HCC CONCLUSIONS: Taken together, our findings showed that novel mRNAs and TFs, which served as critical biomarkers to predict survival and therapeutic targets of resistance to sorafenib in HCC. Furthermore, we constructed the TF-mRNA networks, which provides valuable theoretical references to further evaluate the molecular mechanisms of resistance to sorafenib in HCC.

Uterine rupture during induced mid-trimester abortion

Uterine rupture during induced mid-trimester abortion is infrequent. Often the diagnosis is established only after manual exploration of the uterus, exploratory laparotomy or even autopsy. It is crucial to establish the diagnosis rapidly and to offer efficient treatment, since the unexpected occurrence of this catastrophe adds to its inherent seriousness. Fourteen cases revealed by a Med-line search and two additional personal cases were reviewed. The most common complaint heralding the rupture was abdominal pain and secondary to it there were signs of blood loss, such as vaginal bleeding, decreased hematocrit level and decreased blood pressure. 72% of women with uterine rupture (10 out of 14) did not abort within 24 h after intra-amniotic injection, and 85% (11 out of 13) had large quantities of oxytocin administered for more than 12 h. The rupture occurred predominantly in the lower segment and there was no preference either for the right or left side of the uterus. It was shown that uterine rupture during mid-trimester induced abortion is not unique to women of high parity or old age. The major complications occurring in induced mid-trimester abortions are similar to those seen in patients who deliver in the third trimester.