Management of Cesarean Scar Pregnancy: A Case Series

Objective To survey effective treatment strategies for cesarean scar pregnancy(CSP). Methods The clinical data of 78 patients diagnosed with CSP from January 2010 to December 2013 were reviewed. Results Among these patients, 17 patients were first treated at our hospital; of them, 2 were misdiagnosed. The other 61 patients were referred from other hospitals; of them, 21 were initially misdiagnosed. There were 9 patients who were treated with laparotomy, 50 patients with curettage after uterine artery embolization(UAE) with or without local methotrexate(MTX) infusion, 10 patients with dilatation and curettage, 6 patients with transvaginal sonographic guided local intragestational MTX injection, and 3 patients with systemic MTX injection. All patients finally recovered. Patients with excessive vaginal hemorrhage underwent either emergency UAE treatment or laparotomy. These two treatments had similar success rates(81.82% vs. 100%, χ2 =0.289, P>0.05). Conclusions The accurate diagnosis of CSP is important. Curettage after UAE with or without local MTX infusion is a safe and effective method.

Switching between the Functions of Half-Wave Plate and Quarter-Wave Plate Simply by Using a Vanadium Dioxide Film in a Terahertz Metamaterial

We propose a switchable THz metamaterial that can be switched between two functions of half-wave plate and quarter-wave plate.The two switchable functions can be simply achieved by inserting a VO2 film in the metamaterial design.Finite-difference time-domain(FDTD)simulation results show that the proposed metamaterial can convert x-polarized incident wave to y-polarized reflected wave when VO2 is at metal phase,and convert x-polarized wave to circularly polarized wave when VO2 is at insulator phase.The metamaterial performs well in the two functions,i.e.,the same broad working frequency band and near perfect polarization conversion.The switching effect originates from the switchable Fabry-Perot cavity length induced by the phase change of VO2.We believe that our findings provide a reference in designing switchable metamaterials.

Multi-functional vanadium dioxide integrated metamaterial for terahertz wave manipulation

We proposed a vanadium dioxide(VO2)-integrated multi-functional metamaterial structure that consists of three metallic grating layers and two VO2 films separated by SiO2 dielectric spacers.The proposed structure can be flexibly switched among three states by adjusting temperature,incident direction,and polarization.In state 1,the incident wave is strongly transmitted and perfectly converted to its orthogonal polarization state.In state 2,the incident wave is perfectly absorbed.In state 3,incident wave is totally reflected back.The working frequency of the multi-functional metamaterial can be arbitrarily tuned within a broad pass band.We believe that our findings are beneficial in designing temperature-controlled metadevices.

Gamma-aminobutyric acid enhances miR-21-5p loading into adipose-derived stem cell extracellular vesicles to alleviate myocardial ischemia-reperfusion injury via TXNIP regulation

BACKGROUND Myocardial ischemia-reperfusion injury(MIRI)poses a prevalent challenge in current reperfusion therapies,with an absence of efficacious interventions to address the underlying causes.AIM To investigate whether the extracellular vesicles(EVs)secreted by adipose mesenchymal stem cells(ADSCs)derived from subcutaneous inguinal adipose tissue(IAT)underγ-aminobutyric acid(GABA)induction(GABA-EVs^(IAT))demonstrate a more pronounced inhibitory effect on mitochondrial oxidative stress and elucidate the underlying mechanisms.METHODS We investigated the potential protective effects of EVs derived from mouse ADSCs pretreated with GABA.We assessed cardiomyocyte injury using terminal deoxynucleotidyl transferase dUTP nick end-labeling and Annexin V/propidium iodide assays.The integrity of cardiomyocyte mitochondria morphology was assessed using electron microscopy across various intervention backgrounds.To explore the functional RNA diversity between EVs^(IAT)and GABA-EVs^(IAT),we employed microRNA(miR)sequencing.Through a dual-luciferase reporter assay,we confirmed the molecular mechanism by which EVs mediate thioredoxin-interacting protein(TXNIP).Western blotting and immunofluorescence were conducted to determine how TXNIP is involved in mediation of oxidative stress and mitochondrial dysfunction.RESULTS Our study demonstrates that,under the influence of GABA,ADSCs exhibit an increased capacity to encapsulate a higher abundance of miR-21-5p within EVs.Consequently,this leads to a more pronounced inhibitory effect on mitochondrial oxidative stress compared to EVs from ADSCs without GABA intervention,ultimately resulting in myocardial protection.On a molecular mechanism level,EVs regulate the expression of TXNIP and mitigating excessive oxidative stress in mitochondria during MIRI process to rescue cardiomyocytes.CONCLUSION Administration of GABA leads to the specific loading of miR-21-5p into EVs by ADSCs,thereby regulating the expression of TXNIP.The EVs derived from ADSCs treated with GABA effectively ameliorates mitochondrial oxidative stress and mitigates cardiomyocytes damage in the pathological process of MIRI.