Long-term multidisciplinary integrative therapy management resulted in favorable outcomes for ovarian cancer during pregnancy: a case report and literature review

Abstract Background Ovarian cancer during pregnancy is relatively rare and treatment strategies are inexperienced in surgery and chemotherapy. Multidisciplinary management of advanced epithelial ovarian cancer in pregnant patients with strong desire of fertility including sufficient mental and medical understanding, perioperative consideration, intraoperative decision, chemotherapy sensitivity and follow-up after treatment can gain successful outcomes for both maternal disease and fetus’s development. Case presentation A 34-year-old primigravidae was diagnosed with advanced epithelial ovarian tumor and then first cytoreductive surgery to resect macroscopical lesions and protect the uterus for fetus was performed following with four chemotherapy courses (docetaxel and carboplatin) before delivery and four other chemotherapy courses after delivery. Chemotherapy drugs were decided by sensitivity test and the patient’s anaphylaxis. Second surgery involved cesarean section with a healthy offspring and secondary cytoreductive surgery. Operative strategies were considered to gain a balance of disease and risk for fetus. Psychosocial support was provided during the course of diagnosis and treatment for a healthy coping situation. This patient relapsed 19 months after the last chemotherapy course and was treated by additional adjuvant therapy to a clinical remission. The 33-month baby boy has no evidence with disease until now. The follow-up of both mother and baby is still continuing. Conclusions Ovarian cancer during pregnancy has low incidence which must increase in future as women delay reproduction age. Ovarian cancer cytoreductive surgery and chemotherapy have limitation to handle conditions under a desire of fetus protection. Multidisciplinary treatment model is a therapeutic solution and a challenge for gynecological surgeons, medical oncologists, pathologists, obstetricians, neonatologists, pharmacists, anesthetist, and psychologists

Sp1 is necessary for gene activation of Adamts17 by estrogen

Adamts17 is a member of a family of secreted metalloproteinases. In this report, we show that knockdown of Adamts17 expression induces apoptosis and inhibits breast cancer cell growth. Adamts17 expression can rapidly be induced by estrogens. siRNA knockdown of Sp1 or Myc demonstrated that Sp1 is required to induce Adamts17 gene expression in response to estrogen. Moreover, reporter assays showed that the proximal promoter and the upstream sequences were not capable of conferring estrogen responsiveness, suggesting that Sp1 elements may be located in the downstream intronic region. We further demonstrated that Sp1 and Myc binding in the proximal promoter region contributed to the Adamts17 basal expression. Furthermore, histone deacetylase (HDAC) and methylase inhibitors also induced Adamts17 expression, indicating that epigenetic alterations, such as aberrant HDAC and/or methylation are associated with dysregulated Adamts17 expression. By meta-analysis using Oncomine microarray data, we found that higher Adamts17 expression is found in several human cancer cell subtypes, especially in breast ductal carcinoma. Moreover, we found that there is an inverse correlation between higher Adamts17 expression and patients' survival. Our study suggests that Adamts17 may support breast cancer cell growth and survival

Coastal Ecosystem Restoration Strategy Based on Carbon Storage Change: A Case Study of the Southeast Coastal Zone of Hainan Island

Carbon peak and neutralization, land space ecological restoration, and sustainable management of sea areas and islands are all important components of national development strategies. In recent years, owing to the impact of natural factors, human interference, and global climate change, the ecosystem of the southeast coast of Hainan has been seriously damaged, and its carbon sink function has decreased significantly. This decline in the ecological quality of the southeast coast of Hainan is inconsistent with the positioning requirements of the Hainan Free Trade Port and the National Ecological Civilisation Construction Pilot Zone. Thus, ecosystem restoration based on carbon storage needs to be urgently explored. Using the southeast coast of Hainan Island as an example, the carbon storage module based on the InVEST model, combined with the land use data of the study area in 2000, 2010, and 2020, the carbon storage of the study area was estimated. The carbon sink and carbon source areas were divided, and the carbon storage function was evaluated. Over the past two decades, carbon loss in the study area has been identified, and areas with serious carbon loss were identified, with the ecological restoration functional area divided. The results showed that the ecosystem in the study area was damaged to varying degrees, decreasing by 1.11 Gt over 20 years. Traditionally, the area of the carbon source is always larger than that of the carbon sink. Areas with poor and extremely poor carbon storage functions were 39.84 and 27.31 km2, respectively. According to the superposition results of the carbon storage function and terrestrial ecosystem service value, four restoration units (natural restoration area, artificial auxiliary area, reconstruction restoration area, and moderate development area) were selected. In light of the different restoration areas and under the guidance of land space planning and the idea of carbon neutral and carbon peaks, ecological restoration strategies, including rehabilitation and restoration of wetlands, shoreline restoration, wetland reconstruction, and strengthening supervision, have been proposed in a targeted and differentiated manner. The research results have important reference value for strengthening the protection of the restoration area in the southeast coastal zone of Hainan, stabilizing the carbon storage capacity, reversing the trend of carbon loss, and realizing effective protection and restoration of the damaged ecosystem. Furthermore, the ecological service function and quality of coastal zones, and the marine ecological compensation mechanism, can be further improved

Additional file 1: Fiugre S1. of HECTD1 controls the protein level of IQGAP1 to regulate the dynamics of adhesive structures

Generation of Hectd1 mutant animals. (PPTX 142 kb

Additional file 5: Figure S4. of HECTD1 controls the protein level of IQGAP1 to regulate the dynamics of adhesive structures

Loss of HECTD1 leads to mislocalization of α-actinin and paxillin/zyxin. (PPTX 1571 kb)