The incidence rate and histological characteristics of intimal hyperplasia in elastase-induced experimental abdominal aortic aneurysms in mice

Intimal hyperplasia(IH)is a negative vascular remodeling after arterial injury.IH occasionally occurs in elastase-induced abdominal aortic aneurysm(AAA)mouse models.This study aims to clarify the incidence and histological characteristics of IH in aneurysmal mice.A retrospective study was conducted by including 42 male elastaseinduced mouse AAA models.The IH incidence,aortic diameters with or without IH,and hyperplasia lesional features of mice were analyzed.Among 42 elastase-induced AAA mouse models,10 mice developed mild IH(24%)and severe IH was found in only 2 mice(5%).The outer diameters of the AAA segments in mice with and without IH did not show significant difference.Both mild and severe IH lesions show strong smooth muscle cell positive staining,but endothelial cells were occasionally observed in severe IH lesions.There was obvious macrophage infiltration in the IH lesions of the AAA mouse models,especially in mice with severe IH.However,only a lower numbers of T cells and B cells were found in the IH lesion.Local cell-secreted matrix metalloproteinases(MMP)2 was highly expressed in all IH lesions,but MMP9 was only overexpressed in severe lesions.In conclusion,this study is the first to demonstrate the occurrence of aneurysmal IH and its histological characteristics in an elastaseinduced mouse AAA model.This will help researchers better understand this model,and optimize it for use in AAA-related research.

Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method.Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized.Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from <40 mL (80%) to >80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations.Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.

circRNA3669 promotes goat endometrial epithelial cells proliferation via miR-26a/RCN2 to activate PI3K/AKT-mTOR and MAPK pathways

The development of receptive endometrium(RE) from pre-receptive endometrium(PE) for successful embryo implantation is a complex dynamic process in which the morphology and physiological states of the endometrial epithelium undergo a series of significant changes, including cell proliferation and apoptosis. However, the molecular mechanisms are not yet fully understood. In this study, a higher circRNA3669 level was observed in PE than in RE of goats. Functional assays revealed that this overexpression promoted the proliferation of goat endometrial epithelial cells(GEECs) by activating the expression of genes related to the PI3K/AKT-mTOR and MAPK pathways,thereby inhibiting apoptosis in vitro. Furthermore, circRNA3669 functioned as a competing endogenous RNA(ceRNA) to upregulate Reticulocalbin-2(RCN2) expression at the post-transcriptional level by interacting with and downregulating miR-26a in GEECs. In addition, RCN2, which is highly expressed in the PE of goats, was found to be regulated by β-estradiol(E2) and progesterone(P4). Our results demonstrated that RCN2 also affected the key proteins PI3K, AKT, mTOR, JNK, and P38 in the PI3K/AKT-mTOR and MAPK pathways, thereby facilitating GEECs proliferation and suppressing their apoptosis in vitro. Collectively, we constructed a new circRNA3669-miR-26aRCN2 regulatory network in GEECs, which further provides strong evidence that circRNA could potentially play a crucial regulatory role in the development of RE in goats.

Antitumor Effect of Apcin on Endometrial Carcinoma via p21-Mediated Cell Cycle Arrest and Apoptosis

Objective Endometrial carcinoma(EC)is a prevalent gynecological malignancy characterized by increasing incidence and mortality rates.This underscores the critical need for novel therapeutic targets.One such potential target is cell division cycle 20(CDC20),which has been implicated in oncogenesis.This study investigated the effect of the CDC20 inhibitor Apcin on EC and elucidated the underlying mechanism involved.Methods The effects of Apcin on EC cell proliferation,apoptosis,and the cell cycle were evaluated using CCK8 assays and flow cytometry.RNA sequencing(RNA-seq)was subsequently conducted to explore the underlying molecular mechanism,and Western blotting and coimmunoprecipitation were subsequently performed to validate the results.Animal studies were performed to evaluate the antitumor effects in vivo.Bioinformatics analysis was also conducted to identify CDC20 as a potential therapeutic target in EC.Results Treatment with Apcin inhibited proliferation and induced apoptosis in EC cells,resulting in cell cycle arrest.Pathways associated with apoptosis and the cell cycle were activated following treatment with Apcin.Notably,Apcin treatment led to the upregulation of the cell cycle regulator p21,which was verified to interact with CDC20 and consequently decrease the expression of downstream cyclins in EC cells.In vivo experiments confirmed that Apcin treatment significantly impeded tumor growth.Higher CDC20 expression was observed in EC tissue than in nonmalignant tissue,and increased CDC20 expression in EC patients was associated with shorter overall survival and progress free interval.Conclusion CDC20 is a novel molecular target in EC,and Apcin could be developed as a candidate antitumor drug for EC treatment.

Echinacoside attenuates glandular fibrosis in benign prostatic hyperplasia via inhibiting MKK6/MK2 signaling pathway

Background:Lower urinary tract symptoms commonly occur in the elderly population and seriously constrain the quality of life.Glandular fibrosis is an important pathobiological process in benign prostatic hyperplasia and is also a main inducing factor for benign prostatic hyperplasia-associated lower urinary tract symptoms.Cistanches species is an important herbal medicine resource and is traditionally used in ameliorating renal and prostatic defects.Methods:This study was to investigate the potential protective function of echinacoside(a bioactive compound from Cistanches)against prostatic fibrosis in mice and human benign prostatic hyperplasia epithelial-1 cell models.Results:It was found that echinacoside attenuated testosterone-induced prostatic hyperplasia and collagen deposition in mice,relieved prostate local inflammation and oxidative damage,and ameliorated prostatic epithelial-mesenchymal transition.Additionally,echinacoside inhibited the activation of the MKK6/MK2 signaling pathway both in vivo and in vitro.Conclusion:This study added new evidence for the anti-fibrotic function of echinacoside on the prostate and provided new insights for understanding its possible pharmacological mechanisms.

Development and validation of a circulating tumor DNA-based optimization-prediction model for short-term postoperative recurrence of endometrial cancer

BACKGROUND Endometrial cancer(EC)is a common gynecological malignancy that typically requires prompt surgical intervention;however,the advantage of surgical management is limited by the high postoperative recurrence rates and adverse outcomes.Previous studies have highlighted the prognostic potential of circulating tumor DNA(ctDNA)monitoring for minimal residual disease in patients with EC.AIM To develop and validate an optimized ctDNA-based model for predicting shortterm postoperative EC recurrence.METHODS We retrospectively analyzed 294 EC patients treated surgically from 2015-2019 to devise a short-term recurrence prediction model,which was validated on 143 EC patients operated between 2020 and 2021.Prognostic factors were identified using univariate Cox,Lasso,and multivariate Cox regressions.A nomogram was created to predict the 1,1.5,and 2-year recurrence-free survival(RFS).Model performance was assessed via receiver operating characteristic(ROC),calibration,and decision curve analyses(DCA),leading to a recurrence risk stratification system.RESULTS Based on the regression analysis and the nomogram created,patients with postoperative ctDNA-negativity,postoperative carcinoembryonic antigen 125(CA125)levels of<19 U/mL,and grade G1 tumors had improved RFS after surgery.The nomogram’s efficacy for recurrence prediction was confirmed through ROC analysis,calibration curves,and DCA methods,highlighting its high accuracy and clinical utility.Furthermore,using the nomogram,the patients were successfully classified into three risk subgroups.CONCLUSION The nomogram accurately predicted RFS after EC surgery at 1,1.5,and 2 years.This model will help clinicians personalize treatments,stratify risks,and enhance clinical outcomes for patients with EC.

Alleviatory effect of isoquercetin on benign prostatic hyperplasia via IGF-1/PI3K/Akt/mTOR pathway

We evaluated the effect of isoquercetin(quercetin-O-3-glucoside-quercetin,IQ)as a functional component of Abeliophyllum disistichum Nakai ethanol extract(ADLE)on prostate cell proliferation and apoptosis and its effects on the IGF-1/PI3K/Akt/mTOR pathway in benign prostatic hyperplasia(BPH).Metabolites in ADLE were analyzed using UHPLC-qTOF-MS and HPLC.IQ was orally administered(1 or 10 mg/kg)to a testosterone propionate-induced BPH rat model,and its effects on the prostate weight were evaluated.The effect of IQ on androgen receptor(AR)signaling was analyzed in LNCaP cells.Whether IGF-1 and IQ affect the IGF-1/PI3K/Akt/mTOR pathway in BPH-1 cells was also examined.The metabolites in ADLE were identified and quantified,which confirmed that ADLE contained abundant IQ(20.88 mg/g).IQ significantly reduced the prostate size in a concentration-dependent manner in a BPH rat model,and significantly decreased the expression of AR signaling factors in the rat prostate tissue and LNCaP cells in a concentration-dependent manner.IQ also inhibited the PI3K/AKT/mTOR pathway activated by IGF-1 treatment in BPH-1 cells.In BPH-1 cells,IQ led to G0/G1 arrest and suppressed the expression of proliferation factors while inducing apoptosis.Thus,IQ shows potential for use as a pharmaceutical and nutraceutical for BPH.

Decoding exercise-induced atomic components and prognostic shifts in endometrial carcinoma through differentially expressed genes

Background:This study aimed to portray the atomic intelligence and prognostic implications of differentially expressed genes and their involvement in biological pathways in endometrial carcinoma,with a specific focus on the impacts of exercise on cancer.Methods:We utilized a multi-faceted approach,including volcano plots,Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses,Venn diagrams,protein-protein interaction networks,Kaplan-Meier survival analysis,Gene Set Variety Analysis,and single-cell transcriptomic analysis.Furthermore,we profiled tumor mutational scenes,assessed the prognostic value of immune-related features,and conducted a comprehensive examination of genetic variations and their impact on tumor mutational burden across different cancer types.Multidimensional genomic interactions and methylation elements were also investigated.Using real-time quantitative PCR and immunofluorescence staining,the effects of B-cell lymphoma 2(BCL2)silencing on TNF-αand caspase-3 gene expression were evaluated.Results:Our study identified a noteworthy number of differentially expressed genes in endometrial carcinoma with potential links to athletic performance traits.BCL2 expression levels were found to be associated with survival outcomes,and its changeability across cancers was related to immune cell infiltration and immune checkpoint gene expression.Single-cell investigations uncovered cellular complexity within tumor microenvironments and critical biological pathways in BCL2-overexpressing cells.The expression flow and mutational effect of BCL2 in endometrial carcinoma were characterized,and the prognostic implications of immune-related features were assessed.Hereditary variations,including copy number variations and their relationship with gene expression and tumor mutational burden,were investigated.Multidimensional genomic transaction highlighted the essential role of regulatory genes in cancer pathogenesis.Silencing of the BCL2 gene significantly inhibited the proliferation of HEC-108 cells and promoted apoptosis,as evidenced by decreased TNF-αgene expression and increased caspase-3 gene expression.Immunofluorescence staining further confirmed these results.Conclusion:This study gives a point-by-point understanding of the atomic intelligence and prognostic implications in endometrial carcinoma and across various other cancers.BCL2’s role as a modulatory factor within the tumor-resistant environment and its potential impact on disease prognosis and response to immunotherapy were underscored.The multidimensional genomic analysis provides insights into the complex interaction between genetic and epigenetic variables in cancer,which may shed light on future therapeutic strategies.This study indicates that silencing the BCL2 gene can significantly inhibit tumor cell proliferation and promote apoptosis through the regulation of the TNF-αand caspase-3 pathways.

ZNF554 Inhibits Endometrial Cancer Progression via Regulating RBM5 and Inactivating WNT/β-Catenin Signaling Pathway

Objective:Uterine corpus endometrial carcinoma(UCEC),a kind of gynecologic malignancy,poses a significant risk to women’s health.The precise mechanism underlying the development of UCEC remains elusive.Zinc finger protein 554(ZNF554),a member of the Krüppel-associated box domain zinc finger protein superfamily,was reported to be dysregulated in various illnesses,including malignant tumors.This study aimed to examine the involvement of ZNF554 in the development of UCEC.Methods:The expression of ZNF554 in UCEC tissues and cell lines were examined by qRT-PCR and Western blot assay.Cells with stably overexpressed or knocked-down ZNF554 were established through lentivirus infection.CCK-8,wound healing,and Transwell invasion assays were employed to assess cell proliferation,migration,and invasion.Propidium iodide(PI)staining combined with fluorescence-activated cell sorting(FACS)flow cytometer was utilized to detect cell cycle distribution.qRT-PCR and Western blotting were conducted to examine relative mRNA and protein levels.Chromatin immunoprecipitation assay and luciferase reporter assay were used to explore the regulatory role of ZNF554 in RNA binding motif 5(RBM5).Results:The expression of ZNF554 was found to be reduced in both UCEC samples and cell lines.Decreased expression of ZNF554 was associated with higher tumor stage,decreased overall survival,and reduced disease-free survival in UCEC.ZNF554 overexpression suppressed cell proliferation,migration,and invasion,while also inducing cell cycle arrest.In contrast,a decrease in ZNF554 expression resulted in the opposite effect.Mechanistically,ZNF554 transcriptionally regulated RBM5,leading to the deactivation of the Wingless(WNT)/β-catenin signaling pathway.Moreover,the findings from rescue studies demonstrated that the inhibition of RBM5 negated the impact of ZNF554 overexpression onβ-catenin and p-glycogen synthase kinase-3β(p-GSK-3β).Similarly,the deliberate activation of RBM5 reduced the increase inβ-catenin and p-GSK-3βcaused by the suppression of ZNF554.In vitro experiments showed that ZNF554 overexpression-induced decreases in cell proliferation and migration were counteracted by RBM5 knockdown.Additionally,when RBM5 was overexpressed,it hindered the improvements in cell proliferation and migration caused by reducing the ZNF554 levels.Conclusion:ZNF554 functions as a tumor suppressor in UCEC.Furthermore,ZNF554 regulates UCEC progression through the RBM5/WNT/β-catenin signaling pathway.ZNF554 shows a promise as both a prognostic biomarker and a therapeutic target for UCEC.

Current Status of Mongolian Medicine Treatment for Breast Hyperplasia

Through literature and clinical research,the current status of Mongolian medicine treatment for breast hyperplasia is discussed,such as oral administration of Mongolian medicine for treatment,oral administration of Mongolian medicine combined with external application for treatment,combination of Mongolian medicine acupuncture therapy and oral administration of Mongolian medicine for treatment,integrated treatment of Mongolian and Western medicine,and combination therapy of Mongolian and traditional Chinese medicine,providing new ideas and choices for clinical research.

Giant Brunner's gland hyperplasia of the duodenum successfully resected en bloc by endoscopic mucosal resection: A case report

BACKGROUND Duodenal Brunner's gland hyperplasia(BGH)is a therapeutic target when complications such as bleeding or gastrointestinal obstruction occur or when malignancy cannot be ruled out.Herein,we present a case of large BGH treated with endoscopic mucosal resection(EMR).CASE SUMMARY An 83-year-old woman presented at our hospital with dizziness.Blood tests revealed severe anemia,esophagogastroduodenoscopy showed a 6.5 cm lesion protruding from the anterior wall of the duodenal bulb,and biopsy revealed the presence of glandular epithelium.Endoscopic ultrasonography(EUS)demonstr-ated relatively high echogenicity with a cystic component.The muscularis propria was slightly elevated at the base of the lesion.EMR was performed without complications.The formalin-fixed lesion size was 6 cm×3.5 cm×3 cm,showing nodular proliferation of non-dysplastic Brunner's glands compartmentalized by fibrous septa,confirming the diagnosis of BGH.Reports of EMR or hot snare polypectomy are rare for duodenal BGH>6 cm.In this case,the choice of EMR was made by obtaining information on the base of the lesion as well as on the internal characteristics through EUS.CONCLUSION Large duodenal lesions with good endoscopic maneuverability and no evident muscular layer involvement on EUS may be resectable via EMR.

Endometrial Hyperplasia: Epidemiological Profile of Patients and Anatomical and Clinical Aspects of Lesions at Conakry University Hospital

Summary: Estimate the incidence of endometrial hyperplasia according to socio-demographic parameters and the type of lesions histological. Methodology: This was a retrospective, and 15-year descriptive study from January 1, 2000 to December 31, 2014 conducted at the Department of Anatomy and Pathological Cytology of the National Hospital Donka in collaboration with the obstetric gynecology departments of the Conakry University Hospital. Results: We collected 296 cases of malignant and benign endometrial hyperplasia in 15 years, accounting for 37% of all endometrial biopsy curettages examined. The age group 47 to 56 years was the most affected (81 cases) or 27, 36%. The mean age was 53.6 years with extremes of 27 and 83 years. Metrorrhagia was the main reason for consultation (206 cases), i.e. 69.59%. The suspicion of endometrial hyperplasia by physicians was the most frequently diagnosed circumstance (149 cases) or 50.33%. Biopsy curettage was the most frequently used method (176 cases), is 59.45%. Histological endometrial lesions of atypical complex adenomatous hyperplasia (79 cases) represented 26.69%. Benign behavior was most frequently observed in (235 cases) or 79.39%. Conclusion: Endometrial hyperplasia is an endometrial lesion whose atypical histological types represent the borderline lesions between benignity and malignancy.

Efficacy of the Levonorgestrel-Releasing Intrauterine Device as an Alternative to Oral Progesterone in the Management of Endometrial Hyperplasia without Atypia

The following article has been retracted due to the strong authorship problem regarding publication and the first author of this manuscript is insisting to withdraw it. This paper published in Vol. 4 No. 7 349-355, 2014, has been removed from this site.

Atypical endometrial hyperplasia in a 35-year-old woman:A case report and literature review

BACKGROUND Atypical endometrial hyperplasia(AEH)is a common precancerous lesion of endometrial carcinoma(EC).The risk factors for AEH and EC directly or indirectly related to estrogen exposure include early menarche,nulliparity,polycystic ovarian syndrome,diabetes,and obesity.Both AEH and EC rarely occur in young patients(<40-years-old),who may desire to maintain their fertility.Evaluating the cancer risk of AEH patients is helpful for the determination of therapeutic plans.CASE SUMMARY We report a rare case of AEH in a 35-year-old woman who presented to the Hunan Provincial Maternal and Child Health Care Hospital with a large mass in the uterus.She married at 20-years-old,and had been married for more than 15 years to date.Several characteristics of this patient were observed,including nulliparity,limited sexual activity(intercourse 1-2 times a year)in recent years,and irregular vaginal bleeding for 2 years.Gynecological examination revealed an enlarged uterus,similar to the uterus size in the fourth month of pregnancy,and the uterine wall was relatively hard.Curettage was performed based on transvaginal sonography and magnetic resonance imaging results.Findings from the pathological examination were typical for AEH.The patient was cured after treatment with the standard therapy of high-dose progesterone.CONCLUSION In patients with intrauterine lumps that may be malignant,a pathological report should be obtained.

Is the Use of Frozen Section Indispensable in the Surgical Treatment of Endometrial Hyperplasia?

Objective: To evaluate the reliability and accuracy of frozen section (FS) compared with final pathology and to determine whether they should be obligatory in every patient with atypical endometrial hyperplasia (AEH). Methods: We retrospectively assessed the medical records of 192 patients whose endometrial biopsy results were endometrial hyperplasia and underwent hysterectomy at our center. Results: Twenty-two (11.4%) of the 192 patients in our study had concurrent endometrial carcinoma (EC). Of these, 21 (95.5%) were EC and 1 (4.5%) was non-endome- trioid. Of the 140 patients with AEH, 20 (14.3%) had concurrent EC. Overall, 157 patients had FS. Two (1%) patients’ EC was higher than grade 1B and needed lymphadenectomy. The positive and negative predictive value, specifity and sensitivity of FS were found to be 77.8%, 95.7%, 97% and 70%, respectively. Conclusion: Patients who have AEH without high-risk comorbidities do not have to be referred to oncology centers and can undergo hysterectomy in community hospitals without FS.

Endometrial Thickness as a Predictor of Endometrial Hyperplasia in Infertile Patients with Polycystic Ovary Syndrome

Background: Women with polycystic ovary syndrome (PCOS) are at higher risk of developing endometrial hyperplasia (EH). This study determined the prevalence of EH among women with infertility due to PCOS and assessed the predictive value of endometrial thickness (ET) measurement by trans-vaginal scan (TVS). Study Type & Population: This was a prospective study on infertile women with and without PCOS in which clinical data, hormonal profile, ET and endometrial biopsy (EB) for histopathological examination were collected. Methods: Thirty-seven women with PCOS and 23 women without PCOS presenting with infertility and/or abnormal uterine bleeding underwent TVS, hysteroscopy, laparoscopy and EB. Results: The overall prevalence of EH was 23.3 % while in PCOS group: 18.3 %. The mean ET (14.8 mm) was significantly higher in patients with EH (t = -2.74, P value = 0.009). The lower value of ET among women with EH was 10 mm. A cut-off point of 9.5 mm was set. An ET of >9.5 mm had 92.9% sensitivity and 51.85% specificity for the presence of EH. Women with ET ≥ 9.5 mm were 1.28 times more at risk of EH than women with ET 9.5 mm. Women with oligomenorrhea and irregular cycles were 5.5 and 13.7 times more at risk of EH compared to those with regular cycles, respectively. ET was positively correlated with insulin resistance (r = 0.439, P = 0.007). Conclusion: ET ≥ 9.5 mm predicts EH in infertile women with PCOS, with a high degree of sensitivity and a moderate degree of specificity. In PCOS patients with oligomenorrhea or irregular cycles, the risk of EH is higher than women with regular cycles.

LECTIN HISTOCHEMICAL STUDY ON ENDOMETRIAL PROLIFERATION, HYPERPLASIA AND ADENOCARCINOMA

The binding capacity of 5 lectins in endemetrial proliferation, hyperplasia and adenocarcinoma were studied histochemicaily. The staining density of ConA and WGA bound to intercellular and basal protion, the positive reaction and the density of both agglutinins to luminal borders were increased with the proliferative degree of endometrial glandular cells from proliferation to neoplasm, with the most significant binding in adenocarcinomaHowever, WGA and RCA binding to basal portion of malignant cells was weak, but stronger in the outer edge of tumor mass. The authors suggest that lectin binding capacity provides a new probe to judge the proliferative degree and malignant transformation of endometrial glandular cells.

Alterations of gut microbiota diversity, composition and metabonomics in testosterone-induced benign prostatic hyperplasia rats

Background: Studies had shown many diseases affect the stability of human microbiota, but how this relates to benign prostatic hyperplasia(BPH) has not been well understood. Hence, this study aimed to investigate the regulation of BPH on gut microbiota composition and metabonomics.Methods: We analyzed gut samples from rats with BPH and healthy control rats, the gut microbiota composition and metabonomics were detected by 16S rDNA sequencing and liquid chromatography tandem mass spectrometry(LC–MS/MS).Results: High-throughput sequencing results showed that gut microbiota beta-diversity increased(P<0.01) in the BPH group vs. control group. Muribaculaceae(P<0.01), Turicibacteraceae(P<0.05), Turicibacter(P<0.01) and Coprococcus(P<0.01) were significantly decreased in the BPH group, whereas that of Mollicutes(P<0.05) and Prevotella(P<0.05)were significantly increased compared with the control group. Despite profound interindividual variability, the levels of several predominant genera were different. In addition, there were no statistically significant differences in several bacteria. BPH group vs. control group: Firmicutes(52.30% vs. 57.29%, P>0.05), Bacteroidetes(46.54% vs. 41.64%,P>0.05), Clostridia(50.89% vs. 54.66%, P>0.05), Ruminococcaceae(25.67% vs. 20.56%, P>0.05). LC–MS/MS of intestinal contents revealed that differential metabolites were mainly involved in cellular processes, environmental information processing, metabolism and organismal systems. The most important pathways were global and overview maps, lipid metabolism, amino acid metabolism, digestive system and endocrine system. Through enrichment analysis, we found that the differential metabolites were significantly enriched in metabolic pathways, steroid hormone biosynthesis,ovarian steroidogenesis, biosynthesis of unsaturated fatty acids and bile secretion. Pearson correlation analysis(R=0.94) showed that there was a strong correlation between Prevotellaceae, Corynebacteriaceae, Turicibacteraceae,Bifidobacteriaceae and differential metabolites.Conclusions: Our findings suggested an association between the gut microbiota and BPH, but the causal relationship between the two groups is unclear. Thus, further studies are warranted to elucidate the potential mechanisms and causal relationships between BPH and gut microbiota.

Bcl-X expression in normal endometrium, endometrialhyperplasia and adenocarcinoma

Objective: To evaluate the relationships between Bcl-X expression and apoptosis in normal endometrium (NE), endometrial hyperplasia (EH) and adenocarcinoma (EA). Methods: Immunohistochemical technique was used to examine the localization and expression of Bcl-X proteins in 55 cases of NE, 18 cases of EH and 13 cases of EA. The expression form of Bcl-X protein in normal or abnormal endometrium was further characterized by Western blot analysis. Results: As assessed by immunohistochemistry, Bcl-X proteins were predominantly localized in cytoplasm and nuclear membrane of glandular epithelial cells of the basal layer during the proliferative phase, and the functional layer during the secretory phase. Level of Bcl-X protein was lower in proliferative phase and remarkably increased in the late secretory and the menstrual phase. By Western blotting, it was found the form of Bcl-X was mainly Bcl-XL in proliferative and secretory endometrium. Weak expression of Bcl-Xs was only found in secretory endometrium. Weak Bcl-X expression was also found in cytoplasm of glandular cells of nonatypical hyperplasia, but strong staining presented in atypical hyperplasia, and the only form detected by Western blotting was Bcl-XL. While in adenocarcinoma, both Bcl-XL. and Bcl-Xs existed but the amount of the long form was much higher than that of the short one. Conclusion: Our results suggest that the existance of Bcl-X, especially Bcl-XL plays a role in the regulation of apoptosis in the human endometrium, not only in cycling endometrium but also in endometrial hyperplasia and adenocarcinoma just like the other members of the Bcl-2 family.

Fertility sparing management of endometrial complex hyperplasia and endometrial carcinoma

The standard treatment of endometrial cancer or atypical hyperplasia is surgical removal of the uterus and ovaries. In early stage disease this has an excellent chance of cure but results in infertility. Although the majority of patients are postmenopausal an increasing number of patients with atypical hyperplasia or endometrial cancer are presenting with a desire to retain their fertile potential. In the last 8 years a number of studies have been published involving 403 patients with endometrial cancer and 151 patients with Atypical hyperplasia treated with high dose progestagens. The response rate is 76.2% and 85.6% respectively with endometrial cancer having a recurrence rate of 40.6%. There is a 26% recurrence rate in atypical hyperplasia. Overall 26.3% of those wishing to conceive had a live baby. Although concerns exist about the risks of medical treatment, those that fail this treatment do not appear to have a significantly poorer prognosis although 20 patients(3.6%) had either ovarian cancer or metastatic disease discovered during treatment or follow up.