Case report: Conservative treatment for fertility preservation in a woman with hemoperitoneum due to an invasive mole

BackgroundInvasive moles are a subtype of gestational trophoblastic neoplasia (GTN) that usually develops after hydatidiform molar pregnancies. Uterine rupture in high-risk GTN is a rare and potentially catastrophic event. The treatment of invasive mole perforation with uterine rupture is particularly challenging in young women who desire fertility preservation.Case presentationWe present the case of a 22-year-old woman with a rapidly transformed invasive mole after two evacuations for a complete molar pregnancy. Within 21 days of the second molar evacuation, the serum β-hCG level surged from 5,718 mIU/ml to 444,617 mIU/ml. An ultrasonography examination showed the uterus was 9.2×8.9×7.8 cm in size with an uneven echo area of 6.9×5.2 cm near the fundus of the uterine cavity; the convex anterior wall had no normal muscle layer, and the outer margin was about 0.24 cm from the serosal layer. The patient was diagnosed with an invasive mole. Since she desired fertility preservation, we proposed a methotrexate (MTX) chemotherapy regimen. Before the planned chemotherapy, she experienced sudden abdominal pain accompanied by a blood pressure of 76/48 mmHg and a pulse rate of 116 bpm. An emergency abdominal ultrasound scan showed acute intra-abdominal bleeding (approximately 2,000 ml), and blood tests showed a hemoglobin concentration of 7.9 g/dL. Immediate uterine artery embolization was performed, and 35 mg MTX was administered bilaterally through the uterine arteries. The next day, the serum β-hCG decreased to 83,530 mIU/ml, and the vital signs remained stable. Seven days later, the patient received a combination of etoposide, methotrexate, dactinomycin, cyclophosphamide, and vincristine (EMACO), and the serum β-hCG level normalized after cycle five. At the 13-month follow-up after therapy completion, the woman was disease-free with a normal β-hCG level.ConclusionOur experience highlights the potential feasibility and efficacy of conservative treatment for fertility preservation in such scenarios

A new optimized method in wellbore to improve gas recovery in shale reservoirs

With the scale development of shale gas, the importance of selecting appropriate deliquification process has become increasingly evident in maintaining well productivity and improving shale gas recovery rate. At present, the preferred deliquification process are macro-control plate method and field experience method. The existing methods can only qualitatively select the deliquification process by considering limited influencing factors, resulting in poor process implementation. Based on the results of error analysis, the Gray model was optimized to calculate the pressure distribution in the shale gas wellbore and determine the applicable pressure limit. The W.Z.B. empirical model, which fully considers the influence of wellbore inclination, is used to calculate the gas-liquid carrying situation and determine the applicable liquid carrying limit. By analyzing the technical limits of five commonly used deliquification processes in the Changning shale gas field, namely, plunger lift, optimizing pipe string, gas lift, foam drainage, and intermittent production, a quantitative optimization method for deliquification processes was established. This method was then used to obtain the optimization chart for deliquification processes in shale gas wells. This method was applied in Well Ning 209-X, where the corresponding optimization chart for deliquification processes was drawn based on the production characteristics of the gas well. By quantitatively optimizing the deliquification processes and adjusting to suitable techniques, it effectively guided the production of the gas well and improved the gas field recovery rate

Autophagy regulates the maturation of hematopoietic precursors in the embryo

An understanding of the mechanisms regulating embryonic hematopoietic stem cell (HSC) development would facilitate their regeneration. The aorta-gonad-mesonephros region is the site for HSC production from hemogenic endothelial cells (HEC). While several distinct regulators are involved in this process, it is not yet known whether macroautophagy (autophagy) plays a role in hematopoiesis in the pre-liver stage. Here, we show that different states of autophagy exist in hematopoietic precursors and correlate with hematopoietic potential based on the LC3-RFP-EGFP mouse model. Deficiency of autophagy-related gene 5 (Atg5) specifically in endothelial cells disrupts endothelial to hematopoietic transition (EHT), by blocking the autophagic process. Using combined approaches, including single-cell RNA-sequencing (scRNA-seq), we have confirmed that Atg5 deletion interrupts developmental temporal order of EHT to further affect the pre-HSC I maturation, and that autophagy influences hemogenic potential of HEC and the formation of pre-HSC I likely via the nucleolin pathway. These findings demonstrate a role for autophagy in the formation/maturation of hematopoietic precursors.</p

OsSIDP301, a Member of the DUF1644 Family, Negatively Regulates Salt Stress and Grain Size in Rice

As a major environmental factor, salt stress substantially retards growth and reduces the productivity of rice (Oryza sativa). Members of the DUF1644 family, “the domains of unknown function 1644 motif” are predicted to play an essential regulatory role in response to abiotic stress. However, the specific molecular mechanisms of most members of this family remain elusive. Here, we report that the OsSIDP301 (stress-induced DUF1644 protein) was induced by salt stress and abscisic acid (ABA). We found that overexpression of OsSIDP301 (OE) in plants conferred salt hypersensitivity and reduced grain size, whereas plants with OsSIDP301 RNA interference (RNAi) exhibited salt tolerance and increased grain size in rice. OsSIDP301 determines salt stress tolerance by modulating genes involved in the salt-response and ABA signaling pathways. Further studies suggest that OsSIDP301 regulates grain size by influencing cell expansion in spikelet hulls. Moreover, OsSIDP301 interacts with OsBUL1 COMPLEX1 (OsBC1), which positively regulates grain size in rice. Our findings reveal that OsSIDP301 functions as a negative regulator of salt stress and grain size, and repressing its expression represents a promising strategy for improving salt stress tolerance and yield in rice

Pancreatic Cancer Epidemiology, Detection, and Management

PC (pancreatic cancer) is the fourth most common cause of death due to cancer worldwide. The incidence and mortality rates have been increasing year by year worldwide, and this review has analyzed the most recent incidence and mortality data for pancreatic cancer occurrence in China. Several possible risk factors have been discussed here, involving known established risk factors and novel possible risk factors. The development of this cancer is a stepwise progression through intraepithelial neoplasia to carcinoma. Though early and accurate diagnosis is promising based on a combination of recent techniques including tumor markers and imaging modalities, lacking early clinical symptoms makes the diagnosis late. Correct staging is critical because treatment is generally based on this parameter. Treatment options have improved throughout the last decades. However, surgical excision remains the primary therapy and efficacy of conventional chemoradiotherapy for PC is limited. Recently, some novel new therapies have been developed and will be applied in clinics soon. This review will provide an overview of pancreatic cancer, including an understanding of the developments and controversies

Charge redistribution and local lattice structure of (F, Zn)-codoped LaFeAsO superconductor

To understand the abnormal behavior of the superconducting transition temperature (T-c) because of the presence of a non-magnetic Zn impurity in the (F, Zn)-codoped LaFeAsO system (Li et al 2010 New J. Phys. 12 083008), we investigated its unique electronic and local structures via x-ray absorption spectroscopy and first-principles calculations. The data obtained showed that the presence of a Zn impurity induces an electron transfer from As to Fe atoms in both the F-underdoped and -overdoped regions. Moreover, due to the lattice mismatch, the local lattice structure is finely modulated by both F and Zn impurities. Actually, in the F-underdoped region doping by Zn is associated with regular FeAs4 tetrahedra, while distorted FeAs4 tetrahedra occur in the F-overdoped region where superconductivity is significantly suppressed

Water and sediment graded management to alleviate the “secondary suspended river” in the lower reaches of the Yellow River

The “secondary suspended river” poses a huge threat to the safety of embankment in the lower reaches of the Yellow River. The formation of the “secondary suspended river” is mainly attributed to the “less water and more sediment, inconsistent water-sediment relationship” of the Yellow River. Through the analysis of the relationship between the evolution of the lower reaches of the Yellow River and the loss caused by disasters and flood and magnitude of sediment concentration, this paper thinks that the Yellow River must pay attention to the graded regulation of water and sediment. For small and medium-sized flood with small sediment concentration, according to the flood magnitude and the reservoir water volume in the upper and middle reaches, Impoundment and filling water to build the peak time at the right time is necessary and the flood processes which are less than 2600 m3/s should be avoided in the scheduling process. Based on the shape of river channel of high flow flood in floodplain and average flow flood in floodplain, and the difference between the sediment transport efficiency of flood and the difference between the loss to the lower floodplain area, the average flow flood in floodplain which is between 6000 m3/s should be avoided in the scheduling process as far as possible. In order to relieve the development trend of the “secondary suspended river”, the regulation of “brushing groove of silt beach” should be insisted on for large flood. But the high sediment concentration flood should be avoided because of its serious destructive effect on the lower reach. At the same time, it also calls for strengthening the research and popularization of reservoir sediment treatment and sediment resource utilization technology