Search

Background Venous thromboembolism (VTE) and bleeding are serious and potentially fatal complications of surgical procedures. Pharmacological thromboprophylaxis decreases the risk of VTE but increases the risk of major post-operative bleeding. The decision to use pharmacologic prophylaxis therefore represents a trade-off that critically depends on the incidence of VTE and bleeding in the absence of prophylaxis. These baseline risks vary widely between procedures, but their magnitude is uncertain. Systematic reviews addressing baseline risks are scarce, needed, and require innovations in methodology. Indeed, systematic summaries of these baseline risk estimates exist neither in general nor gynecologic surgery. We will fill this knowledge gap by performing a series of systematic reviews and meta-analyses of the procedure-specific and patient risk factor stratified risk estimates in general and gynecologic surgeries. Methods We will perform comprehensive literature searches for observational studies in general and gynecologic surgery reporting symptomatic VTE or bleeding estimates. Pairs of methodologically trained reviewers will independently assess the studies for eligibility, evaluate the risk of bias by using an instrument developed for this review, and extract data. We will perform meta-analyses and modeling studies to adjust the reported risk estimates for the use of thromboprophylaxis and length of follow up. We will derive the estimates of risk from the median estimates of studies rated at the lowest risk of bias. The primary outcomes are the risk estimates of symptomatic VTE and major bleeding at 4 weeks post-operatively for each procedure stratified by patient risk factors. We will apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate evidence certainty. Discussion This series of systematic reviews, modeling studies, and meta-analyses will inform clinicians and patients regarding the trade-off between VTE prevention and bleeding in general and gynecologic surgeries. Our work advances the standards in systematic reviews of surgical complications, including assessment of risk of bias, criteria for arriving at the best estimates of risk (including modeling of the timing of events and dealing with suboptimal data reporting), dealing with subgroups at higher and lower risk of bias, and use of the GRADE approach. Systematic review registration PROSPERO CRD42021234119

To determine the role of outer dense fiber (ODF) in multiple morphological abnormalities of the sperm flagella in Akap4 gene defect mice. Methods: Akap4 knock-out (KO) mouse model was established by using gene editing technology. Akap4-KO male mice were identified by genotype. Seven sexually mature male Akap4-KO mice served as an experimental group, and 7 sexually mature wild-type (WT) male mice served as a control group. The changes in body weight and testicular weight were measured. Computer aided sperm analysis (CASA) was used to detect sperm motility. Sperm morphology was detected by modified Periodic Acid-Schif (PAS) staining. The ultra-structure of sperm was observed under the scanning and transmission electron microscope. Sperm flagella associated protein expression and localization were detected by immunofluorescence. Spermatogenesis function of testis was evaluated by HE and PAS staining. Ultra-structure of seminiferous tubules was observed under the transmission electron microscope. Results: Akap4-KO mice had no natural fertility. The sperm motility of Akap4-KO male mice was lower than that of WT male mice (8.81% vs 46.02%, P0.01). In Akap4-KO male mice the percentage of sperm, with shortened tail and coiled tail was 91.18% which was higher than that of WT male mice (P0.01). There was no statistically significance in the testicular weight, spermatogensis function, and sperm count between the 2 groups (P0.01). The longitudinal column of fibrous sheath in Akap4-KO male mice was absent, and the residues of transverse rib remained, which was consistent with the immunofluorescence localization of AKAP3 protein. No. 3 and No. 8 ODF in the principal piece were disordered, which was in consistent with ectopic localization of ODF2 protein. Conclusion: Multiple morphological abnormalities of the sperm flagella in mice are resulted from disorder of "9+2" microtubules and the abnormally expanded lumen at the proximal of the principal piece via causing dysplasia of the transverse rib due to Akap4 gene defect, and separation of the ODF of No. 3 and No. 8 via loss of longitudinal column.目的：探讨外层致密纤维(outer dense fobres，ODF)在Akap4基因缺陷引起小鼠精子尾部多种形态异常中的作用。方法：通过基因编辑技术构建Akap4基因缺陷小鼠模型。实验分为2组：成年Akap4基因缺陷雄鼠为实验组(n=7)，成年野生型雄鼠为对照组(n=7)，比较2组小鼠的体重和睾丸重量；采用计算机辅助精液分析(computer aided sperm analysis，CASA)检测精子活动力，改良巴氏染色(modified pap staining)检测精子形态学，扫描及透射电镜观察精子超微结构，免疫荧光检测精子尾部蛋白表达及定位，睾丸切片HE及PAS染色检测睾丸生精功能，透射电镜观察曲精细管超微结构。结果： Akap4基因缺陷小鼠精子总活动力为8.81%，明显低于野生型小鼠(P0.01)，且无正常形态精子，尾部缩短与尾部卷曲比例达91.18%，明显高于野生型小鼠(P0.01)，睾丸重量、睾丸生精功能、精子数量2组比较差异无统计学意义(P0.01)； Akap4基因缺陷精子的纤维鞘纵柱缺失，横肋柱结构部分残留，主段的3和8号ODF排列紊乱，与ODF2蛋白定位结果相符；睾丸中精子纤维鞘发育障碍，无正常纤维鞘结构形成，但未见异常膨大的精子尾部。结论：Akap4基因缺陷使纤维鞘横肋发育不良，纵肋的缺失引起3和8号ODF分离，“9+2”微管结构紊乱，使主段管腔异常膨大，导致小鼠精子尾部多种形态异常。.

Glaucocalyxin A (GLA), a major component isolated from Rabdosia japonica, has been proven to show anti-bacterial and anti-tumor biological characteristics according to previous studies. However, its potential effect on bladder cancer remains unknown. The present research aims to investigate the underlying mechanism in treating bladder cancer in vivo and in vitro. Cell proliferation was analyzed by CCK-8 assay and colony formation. Flow cytometry was used to measure the cell cycle distribution and apoptosis. The expressions of the cell cycle and apoptosis-related proteins were detected by western blotting and immunofluorescence staining. Meanwhile, the in vivo study was performed to evaluate the anti-tumor effect on a UMUC3 subcutaneous tumor of NOD/SCID mice model. GLA suppressed colony-formation ability, triggered G2/M arrest and promoted apoptosis of UMUC3 cells in a dose-dependent manner. Furthermore, western blotting showed that GLA downregulated the expressions of PI3K p85, p-Akt, Bcl-2, CDK1, Cyclin B1 whereas upregulated the levels of PTEN, Bax, Cleaved Caspase-3. In vivo, GLA at a dosage of 20 mg/kg significantly inhibited tumor growth compared with the control group by intraperitoneal injection. These results suggested that GLA-related G2/M arrest and apoptosis in UMUC3 cells were mediated by a suppressed PI3K/Akt signaling pathway, which regulated p21Waf1/Cip1 as well as intrinsic caspase cascade. Collectively, our observations could help to develop new drugs targeting the PI3K/Akt pathway for the treatment of bladder cancer.

Programmed cell death protein 1 (PD-1) blockade is a promising therapeutic strategy against prostate cancer. Nitroxoline has been found to have effective anticancer properties in several cancer types. We investigated the efficacy of a combination therapy involving nitroxoline and PD-1 blockade in a prostate cancer mouse model. In our in vitro analysis, we found that nitroxoline inhibited the viability and proliferation of the mouse prostate cancer cell line RM9-Luc-PSA. Additionally, nitroxoline downregulated the expressions of phospho-PI3 kinase, phospho-Akt (Thr308), phospho-Akt (Ser473), phospho-GSK-3β, Bcl-2, and Bcl-xL. Nitroxoline also downregulated programmed death-ligand 1 (PD-L1) expression levels in prostate cancer cell line and tumor tissue. In our murine prostate cancer orthotopic model, nitroxoline plus PD-1 blockade synergistically suppressed tumor growth when compared with nitroxoline or PD-1 blockade alone, leading to reductions in tumor weight, bioluminescence tumor signals, and serum prostate-specific antigen levels. Furthermore, fluorescence-activated cell sorting analysis showed that the combination strategy significantly enhanced antitumor immunity by increasing CD44+CD62L+CD8+ memory T cell numbers and reducing myeloid-derived suppressor cell numbers in peripheral blood. In conclusion, our findings suggest that nitroxoline plus PD-1 blockade may be a promising treatment strategy in patients with prostate cancer.

Bufalin, one of the active ingredients of the Chinese drug Chan su, exhibits significant antitumor activity against various cancer types. However, the role of bufalin in renal cell carcinoma (RCC) remains unclear. In the present study, it was demonstrated that bufalin inhibited cell proliferation, blocked the cell cycle in the G2/M phase, and reduced the metastasis of human RCC ACHN cells via the upregulation of p21waf/cip1 and E-cadherin and the downregulation of cyclin dependent kinase 1, cyclin B1, N-cadherin, and hypoxia-inducible factor-1α (HIF-1α). Further mechanistic study revealed that bufalin reduced the expression of phosphorylated (phospho)-Akt and phospho-mammalian target of rapamycin (mTOR). Moreover, HIF-1α expression may be regulated through the inhibition of the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt)/mTOR signaling pathway. Thus, the present results suggest that bufalin induces cell cycle arrest and suppresses metastasis; this process may be associated with the PI3K/Akt/mTOR signaling pathway. Accordingly, it is suggested that bufalin is a therapeutic agent for RCC.

To confirm the reductive dehalogenation ability of the aerobic strain of Delftia sp. EOB-17, finding more evidences to support the hypothesis that reductive dehalogenation may occur extensively in aerobic bacteria. Delftia sp. EOB-17, isolated from terrestrial soil contaminated with halogenated aromatic compounds, completely degraded 0.2 mM DBHB in 28 h and released two equivalents of bromides under aerobic conditions in the presence of sodium succinate. LC–MS analysis revealed that DBHB was transformed to 4-hydroxybenzoate via 3-bromo-4-hydroxybenzoate by successive reductive dehalogenation. Highly conserved DBHB-degrading genes, including reductive dehalogenase gene (bhbA3) and the extra-cytoplasmic binding receptor gene (bhbB3), were also found in strain EOB-17 by genome sequencing. The optimal temperature and pH for DBHB reductive dehalogenation activity are 30 °C and 8, respectively, and 0.1 mM Cd2+, Cu2+, Hg2+ and Zn2+ strongly inhibited dehalogenation activity. The aerobic strain of Delftia sp. EOB-17 was confirmed to reductively dehalogenate DBHB under aerobic conditions, providing another evidence to support the hypothesis that reductive dehalogenation occurs extensively in aerobic bacteria.