Chemoresistance and metastasis are the major challenges for the current ovarian cancer treatment. Understanding the mechanisms of ovarian cancer progression and metastasis is critically important for ...developing novel therapies. The advances in extracellular vesicles (EVs) research in recent years have attracted extensive attention. EVs contain a variety of proteins, RNAs, DNAs, and metabolites. Accumulating evidence indicates that ovarian cancer cells secrete a large amount of EVs, playing an important role in tumor progression and recurrence. In the microenvironment of ovarian tumor, EVs participate in the information transmission between stromal cells and immune cells, promoting the immune escape of ovarian cancer cells and facilitating cancer metastasis. Here, we review the recent advances of EVs in chemoresistance, mechanisms of metastasis, and immune evasion of ovarian cancer. Furthermore, we also discuss the challenges of EV research and future application of EVs as promising biomarker sources in response to therapy and in therapy-delivery approaches for ovarian cancer patients.
Polysomnographic studies have been performed to examine sleep abnormalities in posttraumatic stress disorder (PTSD), but clear associations between PTSD and sleep disturbances have not been ...established. A systematic review of the evidence examining the polysomnographic changes in PTSD patients compared with controls was conducted using MEDLINE, EMBASE, All EBM databases, PsycINFO, and CINAHL databases. Meta-analysis was undertaken where possible. The searches identified 34 studies, 31 of which were appropriate for meta-analysis. Pooled results indicated decreased total sleep time, slow wave sleep and sleep efficiency, and increased wake time after sleep onset in PTSD patients compared with healthy controls. PTSD severity was associated with decreased sleep efficiency and slow wave sleep percentage. Rapid eye movement (REM) sleep percentage was significantly decreased in PTSD patients compared with controls in studies including participants with mean age below 30 y, but not in studies with other mean age groups (30–40 y and >40 y). Our study shows that polysomnographic abnormalities are present in PTSD. Sex, age, PTSD severity, type of controls, medication status, adaptation night, polysomnographic scoring rules and study location are several of the demographic, clinical and methodological factors that contribute to heterogeneity between studies.
Subdural anesthesia and spinal subdural hematoma are rare complications of combined spinal-epidural anesthesia. We present a patient who developed both after multiple attempts to achieve combined ...spinal-epidural anesthesia.
A 21-year-old parturient, gravida 1, para 1, with twin pregnancy at gestational age 34
weeks underwent cesarean delivery. Routine combined spinal-epidural anesthesia was planned; however, no cerebrospinal fluid outflow was achieved after several attempts. Bupivacaine (2.5 mL) administered via a spinal needle only achieved asymmetric blockade of the lower extremities, reaching T12. Then, epidural administration of low-dose 2-chlorprocaine caused unexpected blockade above T2 as well as tinnitus, dyspnea, and inability to speak. The patient was intubated, and the twins were delivered. Ten minutes after the operation, the patient was awake with normal tidal volume. The endotracheal tube was removed, and she was transferred to the intensive care unit for further observation. Postoperative magnetic resonance imaging suggested a spinal subdural hematoma extending from T12 to the cauda equina. Sensory and motor function completely recovered 5 h after surgery. She denied headache, low back pain, or other neurologic deficit. The patient was discharged 6 days after surgery. One month later, repeat MRI was normal.
All anesthesiologists should be aware of the possibility of SSDH and subdural block when performing neuraxial anesthesia, especially in patients in whom puncture is difficult. Less traumatic methods of achieving anesthesia, such as epidural anesthesia, single-shot spinal anesthesia, or general anesthesia should be considered in these patients. Furthermore, vital signs and neurologic function should be closely monitored during and after surgery.
Objective
Parkinson’s disease (PD) is usually accompanied by rapid eye movement sleep behavior disorder (RBD). A systematic review has concluded that motor manifestations are associated with RBD in ...PD patients, but whether the same is true of non-motor symptoms is unclear.
Methods
A systematic review and meta-analysis was conducted by searching studies related to PD and RBD in PubMed, Web of Science, Embase, and Cochrane databases. Data were pooled where appropriate and used to calculate odds ratios (ORs), mean differences (MDs), or standardized mean differences (SMDs) with 95% confidence intervals (CI). Heterogeneity was assessed using the
I
2
statistic.
Results
PD patients with RBD were more likely to be male (OR 1.26, 95% CI 1.14–1.40) and older (MD 1.70 years, 95% CI 1.24–2.16) than those of patients without RBD. Patients with RBD were at a higher risk of non-motor symptoms such as constipation (OR 1.94, 95% CI 1.57–2.38), hallucination (OR 2.62, 95% CI 2.01–3.41), depression (SMD 0.39, 95% CI 0.25–0.53), and cognitive impairment (SMD − 0.29, 95% CI − 0.42 to − 0.17) based on standardized questionnaire scores. Similarly, PD patients with RBD suffered more severe motor symptoms and required higher doses of levodopa therapy.
Conclusions
The available evidence suggests that PD patients with RBD suffer severer non-motor and motor symptoms than those without RBD. A potential explanation is that PD patients with RBD present more diffuse neurodegeneration.
Simvastatin exerts pleiotropic effects on cardiovascular system. However, its effect on non-alcoholic fatty liver disease, especially the liver fibrosis, remains obscure. We aimed to clarify the ...relationship between simvastatin and liver fibrosis both in vivo and in vitro.
A High-fat diet was given to establish rat models with non-alcoholic steatohepatitis (NASH)-related liver fibrosis and simvastatin (4mg·kg(-1)·d(-1)) was administrated intragastrically until hepatic histological findings confirmed the appearance of fibrosis. Human hepatic stellate cell (HSC) line lx-2 cells were cultured in an adipogenic differentiating mixture (ADM) and then were treated with transforming growth factorβ1 (TGF-β1), served as a positive control, simvastatin, TGF-β1 plus simvastatin, Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME, a inhibitor of nitric oxide synthase), and L-NAME plus simvastatin, respectively. The expressions of endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), and Collagen І as well as cellular α-smooth muscle actin (α-SMA) were measured by real-time reverse transcriptase-polymerase chain reaction (qRT-PCR) and Western blot in liver tissue and HSC.
With the progress of NASH-related fibrosis, hepatic mRNA and protein expressions of iNOS, α-SMA, and Collagen І were increased while those of eNOS were decreased. Compared with model rats in 24(th) week group, rats in simvastatin group had less expressions of iNOS, α-SMA, and Collagen І and more expressions of eNOS. In vitro, LX-2 cells acquired quiescent phenotype when cultured in ADM, and TGF-β1 could activate the quiescent HSC. Simvastatin inhibited LX-2 cells activation due to TGF-β1 or L-NAME by increasing the expression of eNOS and decreasing the expression of iNOS.
Simvastatin improves the prognosis of NASH-related fibrosis by increasing the expression of eNOS, decreasing the expression of iNOS, and inhibiting the activation of HSC.
The paper was aimed to isolate a strain of
Saccharomyces cerevisiae
with higher alcohol, butanol. 32 strains of
S. cerevisiae
were isolated and identified from the dough starters from different ...regions. First, sterile flour solution (SFS) was developed as a substrate, and the HS-SPME-GC/MS technique was used to detect the volatile compounds, especially butanol. Then, gas production rate and acid-producing efficacy of
S. cerevisiae
were detected by Wickerham’s method and pH meter for assessing the ability to metabolize different sugar, respectively. Finally, pulsed-field gel electrophoresis (PFGE) was performed to determine the genetic relationships among the strains. As a result, the SC-X1 obtained the highest concentration of butanol by metabolizing SFS, and the SC-N1 produced the richest variety of flavors during fermentation. The SC-X1 had a better acid-producing ability, it metabolized glucose, sucrose and maltose to produce acid which lower the pH value by 2.26, 2.17 and 1.46, respectively. The SC-X1 had higher gas-producing efficiency by utilizing glucose and sucrose, and the SC-N1 had perfect performance in gas-producing. The PFGE similarity coefficient was high in relationship with the
S. cerevisiae
resource. Through comprehensive analysis, SC-X1 and SC-N1 were chosen for further research due to their excellent chemical and microbiological performances. Especially, the SC-X1 is very potential for commercial usage with high production of butanol.
Uterine leiomyoma (UL) is a common benign pelvic tumor in women that has a high recurrence rate. Our aim is to propose a prognostic index (PI) model for predicting the long-term recurrence risk of ...uterine leiomyoma (UL). A total of 725 women who underwent myomectomy were enrolled in this retrospective multicenter study. Patients were contacted for follow-up. A PI model was proposed based on the multivariate Cox regression analysis in the model group. The predictive value of this model was tested in both internal and external validation group. PI formula = 1.5(if 3-5 leiomyomas) or 2(if >5 leiomyomas)+1(if residue)+1(if not submucosal)+1(if combined endometriosis). The PI value was divided into low-risk, intermediate-risk, and high-risk group by cut-off values 1.25 and 3.75. In the model group, the high-risk group had a significantly 4.55 times greater recurrence risk of UL than that in the low-risk group cumulative recurrence rate (CR): 82.1% vs 29.5%, HR = 4.55, 95% CI 2.821-7.339; the intermediate-risk group had a significantly 2.81 times greater recurrence risk of UL than that in the low-risk group (CR: 62.3% vs 29.5%, HR = 2.81, 95% CI 2.035-3.878). The differences between any two risk groups were also significant (P< 0.05) in both internal and external validation groups. The model was proved to be effective in predicting recurrence of UL after myomectomy.
Purpose
We aimed to investigate the association between sleep disturbance and menstrual problems in female Chinese university students.
Methods
A convenience sample of 1006 female university students ...participated in this study. Sleep duration, sleep quality, and insomnia symptoms were assessed by the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. A structured questionnaire was used to assess participants’ demographics and menstrual characteristics.
Results
The prevalence rates of irregular menstrual cycle, heavy menstrual bleeding, menstrual flow length ≥ 7 days, period pain, and premenstrual syndrome were significantly higher in participants with sleep disturbance than those without sleep disturbance (all
p
< 0.05). After adjusting for potential confounding variables, poor sleep quality and insomnia symptoms were significantly associated with menstrual flow length ≥ 7 days (OR = 1.81, 95% CI = 1.23–2.68, OR = 1.67, 95% CI = 1.13–2.45), period pain (OR = 1.55, 95% CI = 1.02–2.35, OR = 1.56, 95% CI = 1.02–2.37), and premenstrual syndrome (OR = 1.71, 95% CI = 1.30–2.24, OR = 1.93, 95% CI = 1.46–2.56). In addition, poor sleep quality was significantly associated with heavy menstrual bleeding (OR = 1.75, 95% CI = 1.12–2.72), and insomnia symptoms were significantly associated with irregular menstrual cycle (OR = 1.36, 95% CI = 1.02–1.80). However, short sleep duration (≤ 6 h) was only associated with premenstrual syndrome.
Conclusion
Our results suggested that sleep disturbance is associated with menstrual problems among female university students. More attention should be paid to improving the sleep quality and insomnia symptoms in individuals with menstrual problems.
Excessive daytime sleepiness (EDS) in multiple system atrophy (MSA) has received scant attention in the literature, thus the present cross-sectional study aimed to investigate the prevalence of EDS ...and its potential risk factors among Chinese patients with MSA.
A total of 66 patients with MSA (60.6% males) were consecutively recruited. Eighteen patients (27.3%, 13 men) with Epworth Sleepiness Scale score >10 were defined as having EDS. Demographic, motor Unified Multiple-System Atrophy (UMSARS) and non-motor symptoms Non-Motor Symptoms Scale (NMSS), and sleep parameters polysomnography (PSG) were compared between patients with MSA with and without EDS. A logistic regression analysis was used to calculate the risk factors of EDS in patients with MSA.
There were no significant differences in age, sex, MSA onset age, disease duration, MSA sub-type, and motor symptom severity between MSA patients with and without EDS. However, compared with the MSA patients without EDS, their counterparts with EDS had higher scores of NMSS (65.3 ± 23.1 vs. 43.4 ± 25.3,
= .0002), Hamilton Anxiety (HAMA) 15.3 (10.3-20.0) vs. 9.5 (3.0-15.0),
= 0.006, Hamilton Depression (HAMD) 13.7 (12.5-17.8) vs. 9.0 (4.0-13.0),
= 0.015, and Fatigue Severity Scale (FSS) 29.8 (17.3-47.8) vs. 18.7 (10.3-21.8),
= 0.040. Conversely, the patients with EDS had lower score of Mini-Mental State Examination (MMSE) 23.3 (20.3-27.0) vs. 25.7 (22.0-29.0),
= 0.023. Similarly, there was a significantly lower percentage of N3 sleep (%) 0.3 (0-0) vs. 2.0 (0-0),
= 0.007 and a higher apnea-hypopnea index (AHI/h) 30.5 (14.5-47.8) vs. 19.3 (5.0-28.7),
= 0.034 in patients with EDS. After adjusting for age, sex, disease duration, MSA sub-type, and UMSARS score, the odds ratio (OR) (95% CI) of EDS was higher while increasing scores in FSS 1.06 (1.02-1.11), HAMA 1.16 (1.04-1.28), HAMD 1.13 (1.02-1.25), NMSS 1.04 (1.01-1.07), and AHI 1.03 (1.00-1.10). The OR of EDS was lower while the MMSE score was increasing 0.85 (0.72-1.00).
The presence and severity of EDS may be significantly associated with the non-motor dysfunction, including fatigue, anxiety, depression, cognitive dysfunction, and sleep-related breathing disorder, but not with the motor dysfunction in MSA.
Abstract
Aldolase A (ALDOA) is an enzyme that plays an important role in glycolysis and gluconeogenesis, which is closely related to tumor metabolism. In this study, the overall roles of ALDOA in ...pan-cancer have been investigated from several aspects using databases and online analysis tools. Using the ONCOMINE database, the expression of ALDOA in various cancers was analyzed. The prognostic role of ALDOA was explored by PrognoScan, GEPIA, and Kaplan–Meier Plotter. The immune-related role of ALDOA and its downstream substrates was decided by TIMER, cBioPortal and String. Our data indicate that ALDOA expression level in lung adenocarcinoma, liver hepatocellular carcinoma, head and neck squamous cell carcinoma is higher than that in normal tissues. Increased expression of ALDOA often indicates a poor prognosis for patients. The correlation between ALDOA and immune infiltration among different tumors is very different. We also investigate the relationship between ALDOA and its upstream/downstream proteins. Our results showed that ALDOA could be used as a biomarker for the tumor prognosis, and could be correlated with the infiltrating levels of macrophages, CD4+ T cells and CD8+ T cells.
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