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SMARCB1/INI1-deficient soft tissue tumors with epithelioid and myxoid features are diverse and mainly include soft tissue myoepithelial tumor, extraskeletal myxoid chondrosarcoma, and the recently described myoepithelioma-like tumor of the vulvar region and myxoepithelioid tumor with chordoid features. Because of their overlapping features, the accurate diagnosis and classification of these tumors are often challenging. Herein, we report two unique cases of SMARCB1/INI1-deficient soft tissue neoplasm with epithelioid and myxoid features occurring in male paratesticular region. The first case was a 52-year-old man presented with an intermittent painful left paratesticular mass for 1 year. The second case was a 41-year-old man presented with a painless paratesticular mass on the right side for 3 months. Both patients underwent an orchiectomy. After 6 and 26 months of follow-up, both were alive with no evidence of recurrence or metastasis. In both cases, the tumor was relatively well-demarcated and showed monomorphic round to epithelioid cells arranged in a nested, trabecular, reticular, and corded pattern, setting in a myxohyalinized and vascularized matrix. The tumor cells showed relatively uniform round nuclei with vesicular chromatin and variably prominent nucleoli. No rhabdoid cells were identified. Mitoses numbered 3 and 2 per 10 high-power fields. Tumor necrosis or lymphovascular invasion was absent. Immunohistochemically, both tumors expressed epithelial membrane antigen (focal), calponin (focal), and CD99. SMARCB1/INI1 expression was deficient in both cases. In addition, case 1 diffusely expressed pan-cytokeratin, and case 2 diffusely expressed CD34 and synaptophysin. Molecular genetically, case 1 showed SMARCB1 homozygous deletion as detected by fluorescence in-situ hybridization (FISH), and case 2 demonstrated SMARCB1 copy number deletions by next-generation sequencing and SMARCB1 monoallelic deletion by FISH. Both cases lacked EWSR1 rearrangements by FISH. The overall clinicopathologic profiles of the two cases made it difficult to classify them as one of the established categories of SMARCB1/INI1-deficient mesenchymal tumors. Our study further expands the clinicopathologic and molecular spectrum of SMARCB1/INI1-deficient epithelioid and myxoid neoplasms and highlights the challenges to diagnose these tumors. • SMARCB1/INI1-deficient soft tissue neoplasms with epithelioid and myxoid features in paratesticular region are exceptional. • Heterogeneity in morphology, immunohistochemistry, and molecular genetics could elicit a wide range of differential diagnoses. • These tumors may have close relationship to myoepithelioma-like tumors of the vulvar region or myxoepithelioid tumors with chordoid features. [ABSTRACT FROM AUTHOR]

• Pregnancy outcomes of women with polycystic ovary syndrome (PCOS) remain unsatisfactory. • Chinese herbal medicine is widely used for treating gynecological endocrine disorders. • Bu-Shen-Jian-Pi Formula (BSJPF) can improve fertility potential among PCOS population. • BSJPF significantly enhanced bone morphogenetic protein 15 levels in follicular fluids. Chinese herbal medicine is widely used for treating polycystic ovary syndrome (PCOS). The present study aimed to explore the effects of Bu-Shen-Jian-Pi Formula, a Chinese herbal medicine formula, on the pregnancy outcomes of women with PCOS undergoing in vitro fertilization and embryo transfer (IVF-ET) based on a retrospective cohort study. One hundred and forty-six females with PCOS undergoing IVF-ET were included in the study from Women's Hospital, School of Medicine, Zhejiang University between July 2016 and June 2021, of whom 73 patients received Bu-Shen-Jian-Pi Formula treatment for 12 weeks before IVF-ET, while the other 73 did not. The clinical data were collected from the medical records of the included patients. Bone morphogenetic protein 15 (BMP15) and leukemia inhibitory factor levels in the follicular fluids were detected. After the treatment of Bu-Shen-Jian-Pi Formula, women with PCOS undergoing IVF-ET exhibited significant improvement in the fertilization (P<0.05), good-quality embryo (P<0.01), clinical pregnancy (P<0.01), and live birth (P<0.01) rates, and single birthweight in newborns (P<0.05). The expression levels of BMP15 in the follicular fluids of the women with PCOS were significantly increased after Bu-Shen-Jian-Pi Formula treatment (P<0.05). This study provided preliminary evidence of a significant association of Bu-Shen-Jian-Pi Formula treatment with improved pregnancy outcomes in women with PCOS undergoing IVF-ET, partly through increasing BMP15 levels in the follicular fluids. [ABSTRACT FROM AUTHOR]

Objectives: To explore whether transcutaneous electrical acupoint stimulation (TEAS) can improve the outcomes of in vitro fertilization (IVF).Design: A prospective, randomized, and controlled study.Setting: IVF center in a university hospital.Participants: Four hundred and eighty-one infertile patients with bilateral tubal blockage who were referred for IVF. Patients were randomized into four groups.Intervention: TEAS was administered for 30min, respectively, at 24h before TVOR and two hours before ET. The acupoints included SP10 (Xuehai, bilateral), SP8 (Diji, bilateral), LR3 (Taichong, bilateral), ST36 (Zusanli, bilateral), EX-CA1 (Zigong, bilateral), RN4 (Guanyuan), PC6 (Neiguan, bilateral), and RN12 (Zhongwan). Based on different frequencies of TEAS, patients were grouped into a TEAS-2Hz group, a TEAS-100Hz group and a TEAS-2/100Hz group. Patients in the control group only received routine IVF treatment and no TEAS was applied on them.Primary and Secondary Outcome Measures: The number of mature oocytes, normally fertilized oocytes and good-quality embryos were used to evaluate oocyte developmental competence of the patients. Data of clinical pregnancy rate (CPR), implantation rate (IR), and live birth rate (LBR) were also obtained. The levels of neuropeptide Y (NPY), transforming growth factor alpha and granulocyte colony-stimulating factor in the follicular fluids were measured with enzyme-linked immunosorbent assay (ELISA).Results: No significant differences were found between the control, TEAS-2Hz, TEAS-100Hz and TEAS-2/100Hz groups on the numbers of metaphase II oocytes, normally fertilized zygotes, early cleavage embryos or good quality embryos (P > .05). However, the CPR, IR and LBR of the TEAS-2/100Hz group were significantly higher than those of the other groups, respectively (P < .05). The NPY levels in the follicular fluids of TEAS-2/100Hz group were significantly higher than those of the other groups (P < .05).Conclusion: TEAS using a frequency of 2/100Hz could help to improve the IVF outcomes partly by increasing NPY levels in the follicular fluids. [ABSTRACT FROM AUTHOR]

Mn 0.1 Ce 0.9 O x and a series of Nb m Mn 0.1−m Ce 0.9 O x catalysts with different Nb doping ratios were successfully synthesized by the citric acid method. Experimental results indicated that the catalytic performances of the Nb m Mn 0.1−m Ce 0.9 O x were significantly ameliorated by Nb modification. In particular, the Nb 0.06 Mn 0.04 Ce 0.9 O x catalyst exhibited over 90% NO conversion in the temperature range of 175–325 °C and had good resistance to SO 2 &H 2 O. The characterization results revealed that Nb 0.06 Mn 0.04 Ce 0.9 O x exhibited a larger specific surface area, superior surface acidity and redox property, higher Mn4+ and oxygen vacancy contents compared to Mn 0.1 Ce 0.9 O x. Furthermore, the more active ad-NH 3 and ad-NO x species on the Nb 0.06 Mn 0.04 Ce 0.9 O x sample also greatly accelerated the NH 3 -SCR reaction on it. [Display omitted] • Nb 0.06 Mn 0.04 Ce 0.9 O x catalyst exhibited over 90 % NO x conversion in 175–325 °C. • More active ad-NH 3 and ad-NO x species are available on the Nb 0.06 Mn 0.04 Ce 0.9 O x sample. • The SCR reaction over Nb 0.06 Mn 0.04 Ce 0.9 O x catalyst was accelerated through the L-H mechanism. [ABSTRACT FROM AUTHOR]

Introduction A systematic review and meta-analysis was carried out to assess the clinical effectiveness of acupuncture in treating polycystic ovarian syndrome (PCOS). Methods RCTs that compared either acupuncture with no/sham (placebo) acupuncture or a certain therapy with acupuncture added in the treatment of PCOS were included in the review. Measures of treatment effectiveness were the pooled odds ratios (OR) for women with PCOS having acupuncture compared with women in the control group for the recovery of menstrual cycles, standardized mean difference (SMD) for body mass index (BMI), fasting insulin (FINS), fasting plasma glucose (FPG), luteinizing hormone (LH), follicle stimulating hormone (FSH), and the ratio of LH/FSH. Results A total of nine RCTs (531 women) met criteria for inclusion into the systematic review. Using the random effects model, pooling of the effect estimates from all RCTs showed recovery of menstrual cycles (OR = 0.20, 95% CI: 0.09–0.41, P < 0.01), BMI (SMD = −0.63, 95% CI: −1.04 to −0.21, P = 0.04), and LH (SMD = −0.39, 95% CI: −0.65 to −0.12, P < 0.01) which favored the acupuncture group. No significant differences were observed for FINS, FPG, FSH and the ratio of LH/FSH between acupuncture and control groups ( P > 0.05). Conclusions Acupuncture appears to significantly improve the recovery of the menstrual cycles and decrease the levels of BMI and LH in women with PCOS. However, the findings should be interpreted with caution due to the limited methodological quality of included RCTs. [ABSTRACT FROM AUTHOR]

This paper aims to investigate major pollutant formation and emissions from a typical biomass fired boiler. Emission tests were conducted on a 500 kW, wet wood chip fired district heating system under two operational conditions: (1) with flue gas recirculation (FGR) and (2) without FGR. Mathematical modelling work using FLIC (FLuid dynamic Incinerator Code) and FLUENT codes was carried out for both cases to simulate the overall performance of the boiler. Results show CO emissions in the case with FGR were higher than those in the case without FGR. FGR reduced both the average NOx and PM emissions from the wood chip fired boiler. The mathematical modelling shows that the introduction of FGR reduces the whole temperature level in the furnace. This helps to prevent slagging in the combustion chamber and the formation of thermal NOx. The distribution of the primary and secondary air jets must also be optimised in order to reduce the fuel-NOx formation. [ABSTRACT FROM AUTHOR]

When using Chinese Herbal Medicine (CHM) to treat endometriosis, the effects of CHM on the ovarian function have received little attention. This systematic review and meta-analysis aimed to evaluate the effects and safety of CHM on the ovarian function in patients with endometriosis. Eight electronic databases were searched from their inception to March 2, 2021. We compared those receiving CHM with controls, all studies included were randomized controlled trials (RCTs). Statistical analysis was performed using standard mean difference of hormonal levels: Estradiol(E 2), Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH). Subgroup analysis and sensitivity analysis were conducted. A total of 844 patients from 11 RCTs were included. In E 2 levels, the analysis revealed a significant effect in favor of CHM group compared with the control group (SMD = 3.05, 95%CI = 0.29 to 1.32, P = 0.002). After subgroup analyses, there were still significant effects in both non-operative subgroup (SMD = 2.04, 95%CI = 0.04 to 1.88, P = 0.04) and post-operative subgroup (SMD = 2.19, 95%CI = 0.08 to 1.42, P = 0.03). There were no significant differences between the two subgroups in both FSH levels (P > 0.05) and LH levels (P > 0.05), and the subgroup analyses showed similar results. No adverse events were reported. CHM may improve ovarian function in patients with endometriosis through increasing E 2 levels whether there is surgery or not, which may indicate a referable and safe treatment for endometriosis. Due to the weak evidence, high-quality clinical trials are needed to support this conclusion. (PROSPERO ID is CRD42021240162) [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The incidence of polycystic ovary syndrome (PCOS) increases in women with epilepsy (WWE), which appears to vary with ethnicity. This study was conducted to determine the incidence and risk factors of PCOS in Chinese WWE. Methods: The study was carried out in 102 of 139 Chinese WWE at reproductive ages, with 32 receiving valproic acid (VPA), 40 receiving other antiepileptic drugs (AEDs), and 30 without AEDs therapy. PCOS was defined as having 2 or more of the following components: polycystic ovaries, hyperandrogenism, and amenorrhoea or oligomenorrhoea (a/oligomenorrhoea). Results: One or more isolated components of PCOS were found in 56 (54.9%) patients, with 29 (28.4%) having polycystic ovaries, 20 (19.6%) with a/oligomenorrhea, 7 (6.9%) with hyperandrogenism, and 13 (12.7%) with defined PCOS. Their average age at the start of seizure was 13.8±6.5years, younger than that of patients without these disorders (16.9±8.6years, p <0.05). VPA therapy increased the incidence of PCOS (11/32, 34.4%), in addition to increased blood levels of testosterone and luteinizing hormone (LH) as well as LH to FSH (follicle-stimulating hormone) ratio. No significant relationship was found between the incidence of PCOS and the type, duration, or frequency of seizures in these WWE. Conclusion: There is an increased incidence of PCOS in Chinese WWE at reproductive ages, by more than 2 times of that in the general population. Risk factors include seizures starting at a young age and VPA therapy. [Copyright &y& Elsevier]

Abstract: Valproic acid (VPA) is a well-established anticonvulsant drug that has been increasingly used in the treatment of many forms of generalized epilepsy. Although there are many reports of adverse effects of VPA, studies focusing on the concentration–response relationships of VPA and its metabolites in patients with epilepsy are extremely limited. In this study, a rapid and specific high performance liquid chromatography-ultraviolet (HPLC-UV) method to simultaneously detect the concentrations of VPA and its major hepatotoxic metabolite 2-propyl-4-pentenoic acid (4-ene VPA) in human plasma has been established, using 2,4′-dibromoacetophenone and octanoic acid as the derivatization reagent and internal standard, respectively. This method was used to analyze plasma samples (n =64) of Chinese patients with epilepsy. The results revealed that 4-ene VPA concentrations in Chinese patients were much higher than those in patients in other countries such as United States and Iran. Significant correlations between aspartate aminotransferase (AST), alanine aminotransferase (ALT) and 4-ene VPA concentration suggest that the simultaneous determination of VPA and 4-ene VPA is an effective tool for the prediction of clinical hepatotoxicity in epileptic patients. Furthermore, the present study describes a less costly and complex technique for the clinical monitoring of VPA plasma levels and the risk of hepatotoxicity which may be of particular interest in developing countries like China. [Copyright &y& Elsevier]

Objective: The aim of this study was to explore the effect of a defined formula of Chinese medicinal herbs, GengNianAn (GNA, also called menopausal symptom-relieving formula) formula in relieving menopausal symptoms in ovariectomized women. Design: A double-blind randomized placebo-controlled trial. Method: Between May 2003 and June 2006, 69 ovariectomized Chinese women were recruited to complete 12 weeks of intervention with either a defined formula of GNA (n = 36) or placebo (n = 33) taken twice daily as a beverage. Clinical symptoms were assessed by the modified Kupperman scale. The levels of venous blood serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and the maturation index (MI) of vaginal epithelial cells were respectively measured. Results: There existed significant differences between the two groups in the total Kupperman scoring, MI of vaginal exfoliative cells, and the levels of FSH, LH, and E2 after treatment (P < .05). Conclusion: Chinese herbs may be a useful alternative treatment for ovariectomized women suffering from menopausal symptoms, who are unable or do not want to receive hormone replacement therapy (HRT). [Copyright &y& Elsevier]

Abstract: Previous studies have found a strong association between HLA-B*1502 and carbamazepine-induced Stevens–Johnson syndrome in Asian areas including Taiwan, Hongkong and Thailand. This study explores the association between HLA-B*1502 allele and carbamazepine-induced cutaneous adverse reactions in Han Chinese of southern China mainland, and find the genetic marker that can predict carbamazepine-induced cutaneous adverse reactions. HLA-B*1502 allele genotyping was performed by a polymerase chain reaction–sequence specific primers (PCR–SSP) method in 48 Han Chinese subjects who had carbamazepine-induced cutaneous adverse reactions, including 9 severe cutaneous adverse reaction patients with Stevens–Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) and 39 cutaneous adverse reaction patients with maculopapular eruption (MPE). Meanwhile 80 carbamazepine-tolerant controls and 62 healthy individuals were also tested. The frequency of HLA-B*1502 allele among SJS/TEN patients (100%) is significantly higher than carbamazepine-tolerant controls (13.75%, P <0.001) and healthy individuals (17.74%, P <0.001). But the frequency between MPE patients and carbamazepine-tolerant controls (25.64% vs.13.75%, P =0.110) did not have any significant difference. The data showed that HLA-B*1502 allele is strongly associated with carbamazepine-induced SJS/TEN but not MPE in Han Chinese of southern China mainland. [Copyright &y& Elsevier]

Abstract: Introduction: The comprehensive review was to appraise the current evidence from both randomized and non-randomized trials by using both Chinese and western databases and to highlight the issues which could guide future trial design. Many infertile couples have chosen acupuncture as an adjunct when they undergo in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. More than forty trials have emerged since the first clinical research published in 1999 explored the effects of acupuncture on the outcomes of IVF. However, the current evidence makes it difficult for clinical practitioners and patients to make a decision on whether to choose acupuncture as an adjunct when undergoing IVF or ICSI treatment. Methodology: A total of thirty-three randomized and 5 non-randomized controlled trials were included in the review. Results: Based on this comprehensive review and analysis of all the relevant trials, the authors identify the factors which have contributed to these inconsistencies, and which should be considered in the design of future studies. Discussion/conclusions: These items included in the review could provide useful recommendations and guidelines, which will in turn promote better trial design and improve the evidence base for the use of acupuncture for IVF. [Copyright &y& Elsevier]