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A dose-dependent relationship between RDW levels and 3-month death was revealed in the restricted cubic spline plot. Seven observational studies with 4,407 patients were identified for systematic review. When combining our study and previous studies, the association was significant for RDW predicting death (5 studies with 3,366 patients, OR 1.25, 95% CI, 1.15, 1.35), as well as for poor outcome (4 studies with 3,483 patients, OR 1.23, 95% CI, 1.05, 1.44). Conclusions RDW was an independent predictor of 3-month functional outcome, and a trend of dose-dependent relationship between RDW and 3-month death was detected. 2020 Annals of Translational Medicine. All rights reserved.Background The administration of calcineurin inhibitors (CNIs) posttransplant has been implicated as an independent risk factor for the recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT). The new immunosuppressive agent sirolimus (SRL) acts as a primary immunosuppressant or antitumor agent. In this study we investigated the effect of sirolimus-based immunosuppression compared to CNIs (non-SRL) on the outcomes of LT candidates with HCC. Methods We retrospectively analyzed 204 HCC patients who underwent LT in our hospital between January 2, 2014 and December 10, 2017. The median of the follow-up duration of patients was 24.5 months. The patients were divided into a sirolimus (SRL) group (76 patients) and a non-sirolimus (non-SRL) group (128 patients). Patients exceeding the LT criteria were analyzed as subgroups. Disease-free survival (DFS) and overall survival (OS) after tumor recurrence were compared using the Kaplan-Meier method. Univariate and multivariate Cox analyses were used to compare OS between the SRL and non-SRL groups. Results The SRL group achieved better OS compared to the non-SRL group, while there was no significant difference in DFS. PD 116948 Subgroup (Milan criteria-based or Hangzhou criteria-based) analyses revealed that patients exceeding, rather than meeting, the Milan or Hangzhou criteria benefited from SRL (exceeding the Milan criteria P=0.002; exceeding the Hangzhou criteria P less then 0.001). There was no significant difference in OS between the SRL group and the non-SRL group that met the Milan or Hangzhou criteria. Conclusions SRL can improve survival outcomes in LT patients with HCC exceeding the Hangzhou criteria. 2020 Annals of Translational Medicine. All rights reserved.Adhesion is a postoperative complication that has plagued gynecologists for many years, as 60-90% of gynecological patients develop adhesions after abdominopelvic surgeries. Abdominopelvic adhesions could lead to chronic pelvic pain, infertility, intestinal obstruction, and complicated reoperations. Adhesions might also increase the risk of postoperative chemoradiotherapy failure and endanger patients' lives, especially after surgeries for gynecological malignant tumors. The aim of this consensus was to review the pathogenesis and clinical consequences of adhesions and to summarize various surgical procedures and preventive measures that can reduce the occurrence of adhesions after gynecological tumor surgeries based on a discussion among well-known domestic gynecology specialists. 2020 Annals of Translational Medicine. All rights reserved.Background Management of intrauterine adhesions (IUAs) is challenging, mainly because there is no ideal method to prevent its recurrence. Recurrence of moderate to severe IUAs after conventional treatments entails a poorer prognosis in these patients. This study aimed to assess the safety and effectiveness of a patented intrauterine stent as a barrier in the treatment of recurrent IUAs with poor prognosis. Methods This was a retrospective, observational study of 13 women with IUAs, admitted to the Third Xiangya Hospital of Central South University from June 2018 to September 2019. After conventional treatments, moderate to severe adhesions were still evident. Then a patented intrauterine stent was used as a barrier to prevent the reformation of adhesions after hysteroscopic adhesiolysis (HA). All cases received a second-look hysteroscopy after 2-3 menstrual cycles. American Fertility Society (AFS) scores were noted for all cases. Menstrual pattern, recurrence of adhesions, and reproductive outcomes were also he studied population, the recurrent rate of IUAs and pregnancy rate after the removal of the stent is still discouraging, although the improvement in menstruation is inspiring. 2020 Annals of Translational Medicine. All rights reserved.Background Intrauterine adhesion (IUA), also referred to as Asherman syndrome, is a complication with partial or complete adhesion of the uterine cavity due to fibrotic proliferation after endometrial and uterine wall injury of the newly pregnant uterus. Currently, all IUA research models are based on non-pregnant animals which are ill-suited in mimicking its pathogenesis. This study aimed to establish an animal IUA model caused by surgical abortion and curettage in pregnant rats that is more in line with clinical etiology, and to provide a more ideal animal model for further exploration of the pathogenesis and treatment for IUA. Methods Fifteen, 13-to-15-day pregnant Sprague-Dawley (SD) rats aged 10 weeks were selected. After incising and removing the embryos, we randomly selected one side of the uterine cavity as the study group (n=15) and scraped it with a curette; the contralateral side of the uterine cavity that underwent no special procedures was used for inclusion in the control group (n=15). Five rats were euthanized and dissected on the 3rd, 7th, and 14th day after surgery respectively. The changes in tissue morphology, the number of endometrial glands, the ratio of endometrial fibrotic area, and the expression level of the transforming growth factor beta (TGF-β) in the endometrium were compared between the 2 groups. Results The endometrial granular cell number in the study group on the 7th and 14th day postoperatively was 3.87±0.72 & 2.59±0.90 in each visual field (×100) respectively, which was significantly lower than that of the control group (6.48±0.96 & 7.53±1.10; P0.05). Conclusions The establishment of an animal model of IUA after surgical abortion and curettage in pregnant rats was successful and is thus feasible for further studies; the model may be a more effective mimic for the generation of human IUA. 2020 Annals of Translational Medicine. All rights reserved.
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