Risk factors associated with changes in serum anti-Müllerian hormone levels before and after laparoscopic cystectomy for endometrioma

BackgroundThe objective of our study was to investigate the risk factors for a decrease in ovarian reserve in patients with endometriomas after standardized laparoscopic procedures and evaluation to provide corresponding clinical guidance for patients with fertility requirements.MethodsAnti-Müllerian hormone (AMH) levels and other clinical data from 233 patients with endometriomas and 57 patients with non-endometrioma ovarian cysts admitted to the Peking Union Medical College Hospital between January 2018 and September 2023 were prospectively analysed. The pretreatment AMH levels of the study groups were compared to assess the impact of endometrioma on ovarian reserve, and the decrease in AMH after treatment was analysed to determine potential risk factors contributing to this change.ResultsPretreatment AMH levels did not significantly differ between patients with endometriomas and those with non-endometrioma ovarian cysts. Within the endometrioma group, older age, higher body mass index (BMI), and shorter menstrual cycles were found to be associated with decreased AMH levels prior to treatment (p<0.05). Participants presenting with bilateral cysts, advanced surgical staging, or a completely enclosed Douglas pouch demonstrated significantly lower levels of AMH prior to treatment compared to those without these conditions (p<0.05). Furthermore, their AMH levels further declined within one year after undergoing laparoscopic cystectomy (p<0.05). However, there was no difference in AMH levels after surgery between patients who successfully became pregnant and those who did not (p>0.05).ConclusionLaparoscopic removal of endometriomas can adversely affect ovarian reserve, especially during bilateral cysts removal and when patients are diagnosed as having a higher stage of endometriosis, further impacting ovarian function. It should be noted that a decrease in AMH levels may not necessarily indicate an absolute decline in fertility. Therefore, it is crucial to conduct thorough patient evaluations and provide comprehensive patient education to offer appropriate guidance for fertility preservation

PPP2R2A inhibition contributes to preeclampsia by regulating the proliferation, apoptosis, and angiogenesis modulation potential of mesenchymal stem cells

Abstract Background The precise mechanisms underlying preeclampsia (PE) pathogenesis remain unclear. Mesenchymal stem cells (MSCs) are involved in the pathology of PE. The aim of our study was to identify the effects of protein phosphatase 2 regulatory subunit B α (PPP2R2A) on MSCs and ascertain its latent role in the progression of PE. Methods Reverse-transcription quantitative polymerase chain reaction and western blot analyses were performed to determine the expression of PPP2R2A in decidual tissue and decidual (d)MSCs from healthy pregnant women and patients with PE as well as the expression levels of Bax and Bcl-2 in dMSCs. The levels of p-PI3K, PI3K, p-AKT, and AKT were determined using western blotting. Cell growth, apoptosis, and migration were analyzed using MTT, flow cytometry, and Transwell assays, respectively. Human umbilical vein endothelial cell (HUVEC) tube formation ability was assayed using a HUVEC capillary-like tube formation assay. Results PPP2R2A was downregulated in decidual tissues and dMSCs of patients with PE when compared with that in healthy pregnant women. Moreover, upregulation of PPP2R2A enhanced cell proliferation, reduced apoptotic dMSC, inhibited Bax expression, and increased Bcl-2 levels. Conditioned medium from PPP2R2A-overexpressing dMSCs promoted HTR-8/SVneo cell migration and angiogenesis of HUVEC. Furthermore, the PPP2R2A plasmid suppressed PI3K/AKT pathway activation in dMSCs. However, these effects were partially reversed by LY2940002 treatment. Conclusion PPP2R2A inhibition contributes to PE by regulating the proliferation, apoptosis, and angiogenesis of MSCs, providing a new therapeutic target for PE diagnosis and treatment

Effects of localization of uterine adenomyosis on clinical features and pregnancy outcome

Abstract The purpose of this study was to implore the association among clinical features, long-term fertility outcomes and the anatomical location of adenomyosis identified by ultrasound. We collected data of non-pregnant patients between 20 and 40 years old who had undergone surgical exploration for benign gynecological conditions at our institution between January 2010 and December 2017. A total of 158 women met the inclusion criteria and were allocated into three groups according to the ultrasound-determined adenomyosis anatomical location: anterior (Group A), posterior (Group B), both posterior and anterior (Group C). 44.3% (70/158) adenomyosis was located at the posterior side. History of miscarriage and parity were significantly higher in Group C (p = 0.036 and 0.001 respectively). Group C also had a higher concurrence rate of ovarian endometrioma (OEM) (80.4%, p = 0.002), pelvic adhesion (80.4%, P = 0.003) and the revised American Fertility Society (rAFS) Score (median64, range2-100, P  0.05). During the follow-up, 59.2% (61/103) patients had clinical pregnancies, and 26.2% (16/61) of them experienced pregnancy loss. Total in vitro fertilization and embryo transfer pregnancy rate was 64.6% (42/65) and spontaneous pregnancy rate was 50.0% (19/38). The Kaplan–Meier curves demonstrated significant lower cumulative pregnancy rate in Group C than Group A and Group B (p = 0.01). Severe obstetric complications such as placenta previa, placenta accreta, preeclampsia, and preterm birth were only found in women with adenomyosis located in the posterior side. In conclusion, types of adenomyosis based on sonographic location had different clinical features and pregnancy outcome. Patients with adenomyosis lesion in both anterior and posterior sides had higher combination of OEM, pelvic adhesion and rAFS score

How Do Different Types of Environmental Regulations Affect Green Innovation Efficiency?

Environmental regulation policies are being continuously enriched today. To effectively improve green innovation efficiency through environmental regulations, it is urgent to better understand the impact of different environmental regulations on green innovation efficiency (GIE). However, due to the defects of previous methods for measuring GIE, existing studies may have deviations when analysing the effect of environmental regulations on GIE. To fill this gap, using Shaanxi, China, as a case study, the present study proposes a network data envelopment analysis (DEA) model based on neutral cross-efficiency evaluation to accurately measure the GIE of Shaanxi during the period of 2001–2017. On this basis, this study further analysed the impact of different types of environmental regulations on GIE from three aspects: causality, evolutionary relationships, and effect paths. The results indicate that (1) the GIE of Shaanxi Province showed a “fluctuation-slow growth-steady growth” trend during 2001–2017, and after 2014, the problem of an uncoordinated relationship between technology research and design (R&D) and technology transformation began to appear; (2) there was a linear evolutionary relationship between command-and-control environmental regulation and GIE and a “U”-shaped evolutionary relationship between market-based/voluntary environmental regulation and GIE; and (3) command-and-control environmental regulation and voluntary environmental regulation affected GIE mainly at the technology R&D stage, while market-based environmental regulation ran through the entire process of green innovation activities. This study improves the evaluation methods and theoretical systems of GIE and provides the scientific basis for government decision-makers to formulate environmental regulation policies

Clinical features of patients with previous spontaneous rupture of ovarian endometrioma operated electively: a case-control study

Abstract Background The aim of the study is to investigate the proportion and clinical features of previous spontaneously ruptured ovarian endometrioma among women who underwent elective surgery for endometrioma. Methods This retrospective study was based on a cohort of elective surgeries for endometrioma performed by the same gynecologic team at Peking Union Medical College Hospital from January 2017 to October 2022. Patients diagnosed with previous spontaneously ruptured endometrioma during elective surgery were enrolled in the ruptured group. In the same cohort, patients with unruptured endometrioma treated during the same period were selected as the unruptured group by 1:2 matching according to age. Demographic and clinical information were collected and compared between two groups. Results A total of 422 patients in the cohort were diagnosed with endometrioma. There were 38 patients (9.0%) in ruptured group and 76 patients in unruptured group. All enrolled participants were treated by laparoscopic surgery. In ruptured group, 86.8% patients had a history of acute abdominal pain, which was only 13.2% in unruptured group (P < 0.001). Compared to unruptured group, patients diagnosed with ruptured endometrioma had a lower BMI (P = 0.021), larger maximum diameter of endometrioma (P = 0.040), higher proportion of cul-de-sac partial obliteration rather than complete obliteration (P = 0.003). Conclusions Spontaneous rupture of endometrioma is not rare. The proportion of spontaneous rupture of endometrioma in our study was higher than that reported in the literatures. In women with endometrioma, the onset of acute abdominal pain should be considered a rupture of cyst, especially in patients with big cysts

Research on the Development of Rural E-commerce in China

At present, rural e-commerce is characterized by obvious improvement in market prospect, development scale and development momentum, but there are also some problems, such as farmers' low acceptance of e-commerce, lack of promotion and training of rural e-commerce, and lack of rural e-commerce talents. Based on these problems, the government needs to increase financial support for rural e-commerce, improve the distribution logistics system, and strengthen the training of rural e-commerce personnel to promote the sustainable development of rural e-commerce

Reflections on the High-quality Development of Rural Areas in Guangshan County, Xinyang City

The problems faced by the development of Guangshan County were analyzed from the aspects of rural management talents, industrial structure, e-commerce development, and farmers' ideology, and corresponding solutions were proposed to improve the development speed of rural areas in the county and promote the high-quality development of the county as a whole

Research on the Development of Rural E-commerce in China

At present, rural e-commerce is characterized by obvious improvement in market prospect, development scale and development momentum, but there are also some problems, such as farmers' low acceptance of e-commerce, lack of promotion and training of rural e-commerce, and lack of rural e-commerce talents. Based on these problems, the government needs to increase financial support for rural e-commerce, improve the distribution logistics system, and strengthen the training of rural e-commerce personnel to promote the sustainable development of rural e-commerce