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Abstract The study aims to identify potential drug targets for endometrial cancer (EC) subtypes through a Mendelian randomization (MR) approach, assessing their clinical relevance. We utilized genetic instruments for 4,907 plasma proteins from the deCODE Genetics study dataset, and data with EC (n = 12,906) from a genome-wide study (GWAS) meta-analysis in European populations for MR analyses. Complementary analyses included protein-protein interactions (PPI) network analysis, therapeutic efficacy evaluation, differential gene expression assessment, and prognosis evaluation. The expression levels of key drug targets were quantitatively measured at both the transcriptional and translational stages utilizing reverse transcription quantitative PCR (RT-qPCR) and immunohistochemistry (IHC). Additionally, we analyzed various clinicopathological features. Five drug targets for EC (CBR3, GSTO1, HHIP, IGF2R, and MMP10), seven for endometrioid subtypes (ACAP2, CBR3, GSTO1, HHIP, IGF2R, MMP10, and TLR2), and seven for non-endometrioid subtypes (CST3, DNAJB14, FSTL5, GMPR2, IFI16, MAPK9, and NEO1) were identified. Among these, IGF2R (OR = 1.165; 95% CI 1.067–1.272; p = 1.046 × 10− 2) and CST3 (OR = 0.523; 95% CI 0.339–0.804; p = 7.010 × 10− 3) were highlighted as key drug targets with causal evidence both at transcriptional and translational levels. This study preliminarily confirms that IGF2R and CST3 may serve as novel targets for the treatment of EC, providing a foundational reference for innovative clinical approaches to this disease.

Objective: It is challenging to accurately distinguish atypical endometrial hyperplasia (AEH) and endometrial cancer (EC) under routine transvaginal ultrasonic (TVU) detection. Our research aims to use the few-shot learning (FSL) method to identify non-atypical endometrial hyperplasia (NAEH), AEH, and EC based on limited TVU images. Methods: The TVU images of pathologically confirmed NAEH, AEH, and EC patients (n = 33 per class) were split into the support set (SS, n = 3 per class) and the query set (QS, n = 30 per class). Next, we used dual pretrained ResNet50 V2 which pretrained on ImageNet first and then on extra collected TVU images to extract 1*64 eigenvectors from the TVU images in SS and QS. Then, the Euclidean distances were calculated between each TVU image in QS and nine TVU images of SS. Finally, the k-nearest neighbor (KNN) algorithm was used to diagnose the TVU images in QS. Results: The overall accuracy and macro precision of the proposed FSL model in QS were 0.878 and 0.882 respectively, superior to the automated machine learning models, traditional ResNet50 V2 model, junior sonographer, and senior sonographer. When identifying EC, the proposed FSL model achieved the highest precision of 0.964, the highest recall of 0.900, and the highest F1-score of 0.931. Conclusions: The proposed FSL model combining dual pretrained ResNet50 V2 eigenvectors extractor and KNN classifier presented well in identifying NAEH, AEH, and EC patients with limited TVU images, showing potential in the application of computer-aided disease diagnosis.

Objectives This study aimed to assess the factors influencing pregnant women’s participation in perinatal education and their demand for educational courses.Design A cross-sectional study.Setting Tertiary hospital in Suzhou, China, July–September 2022.Participants Pregnant women from a general grade A tertiary hospital in Suzhou were recruited via online survey invitations during the specified period.Measures A self-designed scale was used to evaluate pregnant women’s demand for perinatal education. Multiple response sets were employed for the assessment of multiple-choice items and analyses included frequency and cross-tabulation. Logistic regression analysis was conducted to assess the factors influencing pregnant women’s participation in perinatal education.Outcome The primary outcome measured was the demand for perinatal education among pregnant women.Results A majority (53.8%) of pregnant women expressed a preference for a mixed teaching mode combining online and offline formats. Logistic regression analysis showed that education level significantly influenced pregnant women’s participation in online learning. Specifically, women with higher education levels were more likely to participate actively in online courses. Additionally, compared with those with first-born children, pregnant women with second-born children participated less actively in online learning. Pregnant women in their second and third trimesters showed greater engagement in online learning compared with those in their first trimester.Conclusions These findings indicate that Chinese pregnant women’s preferences for perinatal education are influenced by their educational background, pregnancy history and the mode of teaching employed. The variability in educational needs underscores the importance of regularly updating course content based on participant feedback.

Ovarian cancer (OC) is the most lethal gynecological tumor, characterized by its insidious and frequently recurring metastatic progression. Owing to limited early screening methods, over 70% of OC cases are diagnosed at advanced stages, typically stage III or IV. Recently, N6-methyladenosine (m6A) modification has emerged as a hotspot of epigenetic research, representing a significant endogenous RNA modification in higher eukaryotes. Numerous studies have reported that m6A-related regulatory factors play pivotal roles in tumor development through diverse mechanisms. Moreover, recent studies have indicated the aberrant expression of multiple regulatory factors in OC. Therefore, this paper comprehensively reviews research advancements concerning m6A in OC, aiming to elucidate the regulatory mechanism of m6A-associated regulators on pivotal aspects, such as proliferation, invasion, metastasis, and drug resistance, in OC. Furthermore, it discusses the potential of m6A-associated regulators as early diagnostic markers and therapeutic targets, thus contributing to the diagnosis and treatment of OC.

Abstract Background Endometrial carcinoma (EC) is one of the world’s typical female reproductive tract malignancies, mostly occurring in postmenopausal women. Many reports have confirmed that long non-coding RNA SOX21 antisense RNA1 (lncRNA SOX21-AS1) is associated with the progressions of various cancer. However, the mechanism of SOX21-AS1 in EC remains unclear. Our study is intended to probe the mechanisms of SOX21-AS1 on EC progression. Methods The CCK-8 assay and colony formation detected cell proliferation. Cell migration and invasion were assessed by transwell analysis. Apoptosis was measured by flow cytometry assay. Bioinformatics software predicted target binding and confirmed using a luciferase reporter analysis. Results SOX21-AS1 expression was upregulated in EC tumor tissues and cells. High expression of SOX21-AS1 was associated with poor overall survival. Silencing of SOX21-AS1 restrained cell proliferation, migration, invasion, and increased apoptosis in HEC-1A and Ishikawa cells. Additionally, bioinformatics analysis demonstrated that SOX21-AS1 modulated RAF1 expression by competitively binding to miR-7-5p. Functionally, silencing of RAF1 reversed the functions of miR-7-5p inhibitor in the proliferation, invasion, and apoptosis of HEC-1A/sh-SOX21-AS1 and Ishikawa/sh-SOX21-AS1 cells. Conclusions SOX21-AS1 promoted the pathological development of EC by regulating the miR-7-5p/RAF1 pathway. This research may provide a novel target for EC therapy.

Abstract Background Mucinous epithelial ovarian cancer (mEOC) is a relatively uncommon subtype of ovarian cancer with special prognostic features, but there is insufficient research in this area. This study aimed to develop a nomogram for the cancer-specific survival (CSS) of mEOC based on Surveillance, Epidemiology, and End Results (SEER) database and externally validate it in National Union of Real World Gynecological Oncology Research and Patient Management (NUWA) platform from China. Methods Patients screened from SEER database were allocated into training and internal validation cohort in a ratio of 7: 3, with those from NUWA platform as an external validation cohort. Significant factors selected by Cox proportional hazard regression were applied to establish a nomogram for 3-year and 5-year CSS. The performance of nomogram was assessed by concordance index, calibration curves and Kaplan-Meier (K-M) curves. Results The training cohort (n = 572) and internal validation cohort (n = 246) were filtered out from SEER database. The external validation cohort contained 186 patients. Baseline age, tumor stage, histopathological grade, lymph node metastasis and residual disease after primary surgery were significant risk factors (p

Abstract Background To investigate the prognostic relevance of the time to interval debulking surgery (TTS) and the time to postoperative adjuvant chemotherapy (TTC) after the completion of neoadjuvant chemotherapy (NACT). Methods A retrospective real-word study included 658 patients with histologically confirmed advanced epithelial ovarian cancer who received NACT at seven tertiary hospitals in China from June 2008 to June 2020. TTS was defined as the time interval from the completion of NACT to the time of interval debulking surgery (IDS). TTC was defined as the time interval from the completion of NACT to the initiation of postoperative adjuvant chemotherapy (PACT). Results The median TTS and TTC were 25 (IQR, 20–29) and 40 (IQR, 33–49) days, respectively. Patients with TTS > 25 days were older (55 vs. 53 years, P = 0.012) and received more NACT cycles (median, 3 vs. 2, P = 0.002). Similar results were observed in patients with TTC > 40 days. In the multivariate analyses, TTS and TTC were not associated with PFS when stratified by median, quartile, or integrated as continuous variables (all P > 0.05). However, TTS and TTC were significantly associated with worse OS when stratified by median (P = 0.018 and 0.018, respectively), quartile (P = 0.169, 0.014, 0.027 and 0.012, 0.001, 0.033, respectively), or integrated as continuous variables (P = 0.018 and 0.011, respectively). Similarly, increasing TTS and TTC intervals were associated with a higher risk of death (P trend = 0.016 and 0.031, respectively) but not with recurrence (P trend = 0.103 and 0.381, respectively). Conclusion The delays of IDS and PACT after the completion of NACT have adverse impacts on OS but no impacts on PFS, which indicates that reducing delays of IDS and PACT might ameliorate the outcomes of ovarian cancer patients treated with NACT.

Abstract Background Uterine leiomyomata (UL) is a common gynecological disease in women. Studied on the relationship between single metabolites of urinary phytoestrogens and UL, especially for the combined effects of mixed metabolites on UL still are insufficient. Methods In this cross-sectional study, we included 1,579 participants from the National Health and Nutrition Examination Survey. Urinary phytoestrogens were assessed by measuring urinary excretion of daidzein, genistein, equol, O-desmethylangolensin, enterodiol and enterolactone. The outcome was defined as UL. Weighted logistic regression was used to analyze the association between single metabolites of urinary phytoestrogens and UL. Notably, we adopted the weighted quantile sum (WQS) regression, Bayesian kernel machine regression (BKMR), and quantile g-computation (qgcomp) models, to investigate the combined effects of six mixed metabolites on UL. Results The prevalence of UL was approximately 12.92%. After adjusting age, race/ethnicity, marital status, drinking status, body mass index, waist circumference, menopausal status, ovary removed status, use of female hormones, hormones/hormone modifiers, total energy, daidzein, genistein, O-desmethylangolensin, enterodiol, and enterolactone, the association of equol with UL was significant [Odds ratio (OR) = 1.92, 95% confidence interval (CI): 1.09–3.38]. In the WQS model, mixed metabolites of urinary phytoestrogen had a positive association with UL (OR = 1.68, 95%CI: 1.12–2.51), with the highest weighted chemical of equol. In the gpcomp model, equol had the largest positive weight, followed by genistein and enterodiol. In the BKMR model, equol and enterodiol have positive correlation on UL risk, while enterolactone has negative correlation. Conclusion Our results implied a positive association between the mixed metabolites of urinary phytoestrogen and UL. This study provides evidence that urinary phytoestrogen-metabolite mixture was closely related to the risk of female UL.

Background: Nausea and vomiting are common and unpleasant symptoms for pregnant women during cesarean section, which can lead to aspiration, a serious complication that can cause pneumonia. This study aimed to evaluate the effects of oral multi-vitamin carbohydrate beverage on maternal intraoperative nausea and vomiting by gastric ultrasound. Methods: This was a single-center, randomized controlled trial. According to their diet, pregnant women who were converted from vaginal delivery to cesarean section were divided into two groups: the observation group (multi-vitamin carbohydrate beverage) or the control group (semi-solid food). The cross-sectional area (CSA) of the gastric antrum was measured by ultrasound before cesarean section, and the occurrence of intraoperative nausea, vomiting, and aspiration was recorded in both groups. Results: The CSA of the gastric antrum at 1 h, 2 h, after eating, and before cesarean section in the observation group was significantly smaller than that in the control group. This suggests that an oral multi-vitamin carbohydrate beverage needs less gastric emptying time. The incidence of vomiting in the observation group was significantly lower than that in the control group. Moreover, the pH of the vomited fluid in the observation group was higher than that in the control group, indicating that oral multi-vitamin carbohydrate beverage may reduce the acidity of stomach contents, which can further reduce the risk and severity of vomiting. Conclusions: Oral multi-vitamin carbohydrate beverage can promote gastric emptying and reduce the incidence and harm of vomiting during urgent cesarean section. This dietary intervention may be a simple and effective way to improve maternal outcomes during cesarean section. Clinical Trial Registration: The study has been registered on https://classic.clinicaltrials.gov/ (registration number: NCT06333626).

Background: The tumor microenvironment and tumor immunity have become the focus of research on tumor diagnosis and treatment. Lymphocyte activation gene-3 (LAG-3, CD223) is a newly discovered immunosuppressive receptor that is abnormally expressed in various tumor microenvironments and plays an important role as an immune checkpoint in the tumor immune response. Objective: We developed a novel enzyme-linked immunosorbent assay kit, examined the levels of soluble LAG-3 (sLAG-3) in the serum of patients with cervical cancer, and identified new biomarkers for cervical cancer development. Methods: To investigate the potential biological function of sLAG-3, we generated and characterized 2 novel anti-LAG-3 monoclonal antibodies, namely 4F4 and 4E12. We performed western blotting, immunofluorescence, and immunohistochemistry using hybridoma technology and an enzyme-linked immunosorbent assay kit for detecting human sLAG-3 based on an improved double-antibody sandwich enzyme-linked immunosorbent assay method. The stability and sensitivity of these kits were also assessed. Results: We screened and characterized 2 novel monoclonal antibodies against human LAG-3. The enzyme-linked immunosorbent assay kit also includes a wide range of tests. Using this enzyme-linked immunosorbent assay system, we found that the expression level of sLAG-3 in the peripheral blood of patients with cervical cancer significantly decreased as the disease progressed ( P

The mortality rate of cervical cancer is the highest among female malignant tumors and seriously threatens women's lives and health. Persistent high-risk human papillomavirus (HPV) infection is the leading cause of cervical cancer, which provides the basis for immunotherapy. In recent years, owing to progress in targeted therapy and immunotherapy, the survival time of patients with cervical cancer has been significantly extended. However, effective treatments for advanced, recurrent, and metastatic cancers are lacking. “Tumor immunotherapy” has been described as a viable option for tumor therapy but the efficacy of immunotherapy for cervical cancer has only been demonstrated in phase I or II clinical trials. Immune checkpoint inhibitors (ICIs) have shown promising clinical results particularly for treating recurrent and advanced cervical cancer, however, they remain inadequate in some patients. Immune checkpoint is the target of immunotherapy. Therefore, the identification of novel therapeutic targets is essential. In this paper, the structure, expression, function, biological effect of immune inhibitory receptors (IRs) and related clinical studies were reviewed, in order to further explore the application potential of these immune checkpoints and apply them to the future clinical treatment of cervical cancer.

Abstract Background Ovarian cancer (OC) has high mortality and morbidity. Circular RNA (circRNA) can deeply impact the tumor occurrence and growth. The pathogenic activity of one particular circRNA, hsa_circ_0001445 (hcR1445), in OC remains unclear and was therefore analyzed in this study. Methods Human OC tissue specimens and cell lines (SKOV3, HO8910, and OVCAR8) were used to examine the levels of hcR1445 and the microRNA miR‐576‐5p using polymerase chain reaction. The 5‐ethynyl‐2′‐deoxyuridine, flow cytometry, cellular scratch test, CCK‐8, and Transwell migration assays were used to examine the biological activities of hcR1445 and miR‐576‐5p on cell apoptosis, invasion, migration, and proliferation in OC cells. Protein expression of WNT/β‐catenin and secreted frizzled‐related protein 1 (SFRP1) were tested using Western blot analysis. The potential interactions of miR‐576‐5p/SFRP1 and hcR1445/miR‐576‐5p were evaluated using a dual‐luciferase report assay. The effect of hcR1445 on OC growth and metastasis was further determined using an OC tumor xenograft model in vivo. Results hcR1445 level was declined in OC cells and tissues. hcR1445 reduced cellular invasion, proliferation, and migration by blocking the ability of miR‐576‐5p to upregulate SFRP1 expression and consequently prohibit WNT/β‐catenin signal transduction. hcR1445 upregulation suppressed OC growth, development, and intraperitoneal metastasis in vivo. Conclusion hcR1445 acts an antioncogene by targeting the miR‐576‐5p/SFRP1 axis and blocking OC progression and development. Thus, hcR1445 may be employed as an indicator or a possible therapeutic target in OC patients.

Abstract Cervical cancer (CC) is the most prevalent gynecological malignancy occurring in the cervix. Long non-coding RNAs (lncRNAs) can act as oncogenes or anti-oncogenes in CC development. Here, we investigated the functional role and detailed mechanism of lncRNA pyruvate dehydrogenase E1 subunit beta antisense (PDHB-AS) in CC. At first, we found that PDHB-AS was significantly down-regulated in CC cells. Besides, overexpression of PDHB-AS repressed CC cell malignant behaviors. HKF-derived exosomes carried miR-4536-5p to CC cells and thereby inhibited PDHB-AS expression. Moreover, PDHB-AS inactivated the Wnt/β-catenin pathway via impeding the nuclear translocation of β-catenin in CC cells. In addition, miR-582-5p could bind with both PDHB-AS and Dickkopf-1 (DKK1). PDHB-AS recruited poly(A) binding protein cytoplasmic 1 (PABPC1) to inhibit Wnt7b expression. PDHB-AS interacted with RNA-binding motif protein X-linked (RBMX) to regulate cisplatin resistance in CC. Finally, we conducted in vivo experiments to confirm that HKF promoted CC tumor growth whereas PDHB-AS suppressed CC tumor growth. Collectively, PDHB-AS plays a tumor-suppressive role in the progression of CC, which suggests the therapeutic potential of PDHB-AS for CC.

Abstract Background Preoperative neoadjuvant chemotherapy (NACT) has been widely used in developing countries for the treatment of patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB3 and IIA2 cervical cancer. However, the effectiveness of NACT and treatment options for NACT-insensitive patients have been concerning. This study will assess prognostic differences between NACT and primary surgery treatment (PST), determine factors associated with prognosis, and explore better adjuvant treatment modalities for NACT-insensitive patients. Methods This study analyzed clinical characteristics, pathological characteristics, treatment options, and follow-up information of 774 patients with FIGO stages IB3 and IIA2 cervical cancer from 28 centers from January 2016 to October 2019 who participated in a multicenter, prospective, randomized controlled trial. Results For patients undergoing NACT, the 5-year OS and PFS rate was 85.8 and 80.5% respectively. They were similar in the PST group. There was no significant difference in OS and PFS between clinical response (CR)/partial response (PR) groups and stable disease (SD)/progressive disease (PD) groups. Apart from deep cervical invasion (p = 0.046) affecting OS for patients undergoing NACT, no other clinical and pathological factors were associated with OS. 97.8% of NACT-insensitive patients opted for surgery. If these patients did not have intermediate- or high-risk factors, whether they had undergone postoperative adjuvant therapy was irrelevant to their prognosis, whereas for patients with intermediate- or high-risk factors, adjuvant chemotherapy resulted in better PFS (chemotherapy vs. no therapy, p

Salt‐inducible kinase 2 (SIK2; also known as serine/threonine‐protein kinase SIK2) is overexpressed in several cancers and has been implicated in cancer progression. However, the mechanisms by which SIK2 regulates cancer cell motility, migration and metastasis in ovarian cancer have not been fully discovered. Here, we identify that SIK2 promotes ovarian cancer cell motility, migration and metastasis in vitro and in vivo. Mechanistically, SIK2 regulated cancer cell motility and migration by myosin light chain kinase, smooth muscle (MYLK)‐meditated phosphorylation of myosin light chain 2 (MYL2). SIK2 directly phosphorylated MYLK at Ser343 and activated its downstream effector MYL2, promoting ovarian cancer cell motility and metastasis. In addition, we found that adipocytes induced SIK2 phosphorylation at Ser358 and MYLK phosphorylation at Ser343, enhancing ovarian cancer cell motility. Moreover, SIK2 protein expression was positively correlated with the expression of MYLK‐pS343 in ovarian cancer cell lines and tissues. The co‐expression of SIK2 and MYLK‐pS343 was associated with reduced median overall survival in human ovarian cancer samples. Taken together, SIK2 positively regulates ovarian cancer motility, migration and metastasis, suggesting that SIK2 is a potential candidate for ovarian cancer treatment.

Healing of full-thickness skin wounds remains a major challenge. Recently, human umbilical cord mesenchymal stem cells (hUC-MSCs) were shown to possess an extraordinary potential to promote skin repair in clinical settings. However, their low survival rate after transplantation limits their therapeutic efficiency in treating full-thickness skin wounds. Hydrogels are considered an ideal cell transplantation vector owing to their three-dimensional mesh structure, good biosafety, and biodegradation. The objective of this study was to investigate the skin wound healing effect of a fibrin hydrogel scaffold loaded with hUC-MSCs. We found that the fibrin hydrogel had a three-dimensional mesh structure and low cytotoxicity and could prolong the time of cell survival in the peri-wound area. The number of green fluorescent protein (GFP)-labeled hUC-MSCs was higher in the full-thickness skin wound of mice treated with hydrogel–hUC-MSCs than those of mice treated with cell monotherapy. In addition, the combination therapy between the hydrogel and hUC-MSCs speed up wound closure, its wound healing rate was significantly higher than those of phosphate-buffered saline (PBS) therapy, hydrogel monotherapy, and hUC-MSCs monotherapy. Furthermore, the results showed that the combination therapy between hydrogel and hUC-MSCs increased keratin 10 and keratin 14 immunofluorescence staining, and upregulated the relative gene expressions of epidermal growth factor (EGF), transforming growth factor-β1 (TGF-β1), and vascular endothelial growth factor A (VEGFA), promoting epithelial regeneration and angiogenesis. In conclusion, the fibrin hydrogel scaffold provides a relatively stable sterile environment for cell adhesion, proliferation, and migration, and prolongs cell survival at the wound site. The hydrogel–hUC-MSCs combination therapy promotes wound closure, re-epithelialization, and neovascularization. It exhibits a remarkable therapeutic effect, being more effective than the monotherapy with hUC-MSCs or hydrogel.

Methylenetetrahydrofolate dehydrogenase 2 (MTHFD2) is a bifunctional enzyme located in the mitochondria. MTHFD2 has been reported to be overexpressed in several malignant tumors and is implicated in cancer development. This study aimed to investigate the effect of MTHFD2 on ovarian cancer progression. The expression of MTHFD2 was detected by bioinformatic analysis, immunohistochemistry, RT‐qPCR (real‐time quantitative PCR analysis), and western blot analysis. The effects of MTHFD2 depletion on cell proliferation, migration, and invasion were determined through in vitro experiments. Cell cycle progression and apoptosis were accessed by flow cytometry. The related signaling pathway protein expression was determined by western blot analysis. We found that MTHFD2 is highly expressed in both ovarian cancer tissues and cell lines. MTHFD2 deletion suppressed cell proliferation and metastasis. Knockdown of MTHFD2 induces cell apoptosis and G2/M arrest, whereas the number of cells in S phase increased with MTHFD2 overexpression. Mechanically, our results indicate that an inhibitory effect of MTHFD2 knockdown may be mediated by the downregulation of cyclin B1/Cdc2 complex and the inhibitory effect on its activity. Additionally, MTHFD2 could regulate cell growth and aggressiveness via activation of STAT3 and the STAT3‐induced epithelial–mesenchymal transition signaling pathway. These findings indicate that MTHFD2 is overexpressed in ovarian cancer and regulates cell proliferation and metastasis, presenting an attractive therapeutic target.

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12957-023-03114-6.

Background: Intrapartum cesarean delivery has been the focus of many researchers. We derived and validated a model to predict cesarean for low-risk Chinese nulliparous undergoing induction of labor. Methods: We developed a risk model for cesarean by including variables in univariate and multivariable logistic regression using the development set (3841 pregnant women). The performance of the model was assessed for the receiver operating characteristic (ROC) curve, calibration and decision curve analysis (DCA). Additionally, we validated the model externally using an independent dataset (3421 pregnant women). Results: Multivariable logistic regression analysis showed that age, height, body mass index (BMI), weight change during pregnancy, gestational age, premature rupture of membranes (PROM), meconium-stained amniotic fluid and neonatal sex were independent factors affecting cesarean outcome. Two models were established, depending on whether the sex of the fetus was included. The area under the ROC curve of two models were 0.755 and 0.748, respectively. We verified externally, and the area under the ROC curve of two models were 0.758 and 0.758, respectively. The calibration plots demonstrated a good correlation. DCA demonstrated that two models had clinical application value. The online web servers were constructed based on the nomograms for convenient clinical use. Conclusions: These two models can be used as useful tools to assess the risk of cesarean for low-risk Chinese nulliparous undergoing induction of labor.

Abstract Background Ovarian cancer is the most lethal gynecologic malignancy worldwide. Olaparib, an inhibitor of poly (ADP-ribose) polymerase (PARP), is becoming widely used in ovarian cancer treatment. The overall survival of ovarian cancer has not been significantly changed over the past decades and ovarian cancer has become increasingly resistant to the Olaparib. Ubiquitin-conjugating enzyme E2S (UBE2S) has been proved to promote malignant behaviors in many cancers. However, the function of UBE2S in the development and Olaparib resistance of ovarian cancer are unclear. Materials and methods In this study, we detected the expression of UBE2S in normal fallopian tube (FT) and HGSOC tissues. A2780 and SKOV3 cells were stably transfected with PCMV-UBE2S, PCMV-UBE2S-C95S, UBE2S shRNAs, and negative controls. The CCK8 assay and clonogenic assay were conducted to analyze ovarian cancer proliferation and Olaparib resistance. The transwell assay was performed to determine the migration and invasion of ovarian cancer cells. The relative protein levels of the Wnt/β-catenin signaling pathway were tested using western blot. The ovarian cancer cells were treated with XAV-939 to investigate the role of Wnt/β-catenin signaling pathway in Olaparib resistance. Moreover, we repeated some above procedures in the xenograft model. Results The results demonstrated that UBE2S was highly upregulated in HGSOC and that high UBE2S expression was correlated with poor outcomes in HGSOC. UBE2S promoted ovarian cancer proliferation and drived the migration and invasion of ovarian cancer cells. UBE2S activated the Wnt/β-catenin signaling pathway in ovarian cancer resulting in Olaparib resistance in vitro and in vivo. Furthermore, UBE2S enhanced the proliferation and Olaparib resistance of ovarian cancer in its enzymatic activity dependent manner. Conclusions These data suggest a possible molecular mechanism of proliferation and metastasis of ovarian cancer and highlight the potential role of UBE2S as a therapeutic target in ovarian cancer.

Objective: To explore the genetic bias in a Chinese family suspected of having congenital nephrotic syndrome of the Finnish type (CNF). Case report: We developed a prenatal genetic diagnosis in a Chinese family with CNF. A single heterozygous mutation (c.3213delG) was found in the foetus IId and we presumed that it was an asymptomatic carrier of the normal phenotype. Additionally, two compound heterozygous variants (c.3213delG and c.3478C > T) were discovered in the foetus IIe, which were inherited from the mother and father, respectively. We performed further pathological examinations after medical abortion. Kidney histopathology and immunofluorescence results were similar to those reported in previous studies. Conclusion: Prenatal genetic diagnosis of CNF still requires further research to explore the pathogenicity of suspected mutations.

Abstract Long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) play critical roles in human diseases. We aimed to clarify the role of lncRNA X-inactive specific transcript (XIST)/miR-149-3p/forkhead box P3 (FOXP3) axis in ovarian cancer (OC) cell growth. XIST, miR-149-3p and FOXP3 expression in OC tissues and cell lines was assessed, and the predictive role of XIST in prognosis of OC patients was analyzed. The OC cell lines were screened and accordingly treated with silenced/overexpressed XIST plasmid or miR-149-3p mimic/inhibitor, and then the proliferation, invasion, migration, colony formation ability, apoptosis, and cell cycle distribution of OC cells were measured. Effect of altered XIST and miR-149-3p on tumor growth in vivo was observed. Online website prediction and dual luciferase reporter gene were implemented to detect the targeting relationship of lncRNA XIST, miR-149-3p, and FOXP3. XIST and FOXP3 were upregulated, whereas miR-149-3p was downregulated in OC tissues and cells. High XIST expression indicated a poor prognosis of OC. Inhibition of XIST or elevation of miR-149-3p repressed proliferation, invasion, migration, and colony formation ability, and promoted apoptosis and cell cycle arrest of HO-8910 cells. In SKOV3 cells upon treatment of overexpressed XIST or reduction of miR-149-3p, there exhibited an opposite tendency. Based on online website prediction, dual luciferase reporter gene, and RNA pull-down assays, we found that there was a negative relationship between XIST and miR-149-3p, and miR-149-3p downregulated FOXP3 expression. This study highlights that knockdown of XIST elevates miR-149-3p expression to suppress malignant behaviors of OC cells, thereby inhibiting OC development.

Abstract Background High-grade serous ovarian cancer (HGSOC) is a fatal form of ovarian cancer. Previous studies indicated some potential biomarkers for clinical evaluation of HGSOC prognosis. However, there is a lack of systematic analysis of different expression genes (DEGs) to screen and detect significant biomarkers of HGSOC. Methods TCGA database was conducted to analyze relevant genes expression in HGSOC. Outcomes of candidate genes expression, including overall survival (OS) and progression-free survival (PFS), were calculated by Cox regression analysis for hazard rates (HR). Histopathological investigation of the identified genes was carried out in 151 Chinese HGSOC patients to validate gene expression in different stages of HGSOC. Results Of all 57,331 genes that were analyzed, FAP was identified as the only novel gene that significantly contributed to both OS and PFS of HGSOC. In addition, FAP had a consistent expression profile between carcinoma-paracarcinoma and early-advanced stages of HGSOC. Immunological tests in paraffin section also confirmed that up-regulation of FAP was present in advanced stage HGSOC patients. Prediction of FAP network association suggested that FN1 could be a potential downstream gene which further influenced HGSOC survival. Conclusions High-level expression of FAP was associated with poor prognosis of HGSOC via FN1 pathway.

Abstract Background The aim of this study was to investigate the effect role and mechanism of miR-30b-3p on ovarian cancer cells biological function. Methods The expression of miR-30b-3p was detected in ovarian cancer cell lines and normal ovarian epithelial cell line by qRT-PCR. Mir-30b-3p mimic was transfected into OVCAR3 cells. Cell-counting kit-8 (CCK-8) assay was conducted to explore the effect of mir-30b-3p on the OVCAR3 cells’ proliferation. Cell cycle and apoptosis were detected by Flow cytometry. Cell invasion ability was detected by Transwell test. The regulation of putative target of miR-30b-3p was verified by double luciferase reporter assays and Western blot. Result We found that miR-30b-3p was downregulated in OVCAR3 cells. Overexpression of miR-30b-3p suppressed proliferation, promoted apoptosis, slowed cell cycle and inhibited migration and invasion of OVCAR3 cells. Bioinformatics analysis identified 3′-untranslated region (3′UTR) of Collagen triple helix repeat-containing 1 (CTHRC1) as the presumed binding site for miR-30b-3p. Detection of double luciferase reporter and Western-Blot result confirmed that CTHRC1 was the target gene of miR-30b-3p. Furthermore, E-cadherin, β-cadherin and Vimentin protein expression level were changed after transfection of miR-30b-3p. Conclusion miR-30b-3p function as an anti-cancer gene. Overexpression of miR-30b-3p can inhibit the biological function of ovarian cancer cells. MiR-30b-3p targets CTHRC1 gene plays an important role in epithelial–mesenchymal transformation (EMT), and supports miR-30b-3p as a potential biological indicator for ovarian cancer in the future.

The perception of duration becomes biased after repetitive duration adaptation; this is known as the duration aftereffect. The duration aftereffect exists in both the sub-second and supra-second ranges. However, it is unknown whether the properties and mechanisms of the adaptation aftereffect differ between sub-second and supra-second durations. In the present study, we addressed this question by investigating the color sensitivity of the duration aftereffect in the sub-second (Experiment 1) and supra-second (Experiment 2) ranges separately. We found that the duration aftereffect in the sub-second range could only partly transfer across different visual colors, whereas the duration aftereffect in the supra-second range could completely transfer across different visual colors. That is, the color-sensitivity of the duration aftereffect in the sub-second duration was stronger than that in the supra-second duration. These results imply that the mechanisms underlying the adaptation aftereffects of the sub-second and supra-second ranges are distinct.

Endometrial carcinoma (EC) is one of the common gynecological cancers with increasing incidence and revived mortality recently. Given the heterogeneity of tumors and the complexity of lncRNAs, a panel of lncRNA biomarkers might be more precise and stable for prognosis. In the present study, we developed a new lncRNA model to predict the prognosis of patients with EC. EC-associated differentially expressed long noncoding RNAs (lncRNAs) were identified from The Cancer Genome Atlas (TCGA). Univariate COX regression and least absolute shrinkage and selection operator (LASSO) model were selected to find the 8-independent prognostic lncRNAs of EC patient. Furthermore, the risk score of the 3-lncRNA signature for overall survival (OS) was identified as CTD-2377D24.6 expression × 0.206 + RP4-616B8.5 × 0.341 + RP11-389G6.3 × 0.343 by multivariate Cox regression analysis. According to the median cutoff value of this prognostic signature, the EC samples were divided into two groups, high-risk set (3-lncRNAs at high levels) and low-risk set (3-lncRNAs at low levels), and the Kaplan–Meier survival curves demonstrated that the low-risk set had a higher survival rate than the high-risk set. In addition, the 3-lncRNA signature was closely linked with histological subtype (p = 0.0001), advanced clinical stage (p = 0.011), and clinical grade (p < 0.0001) in EC patients. Our clinical samples also confirmed that RP4-616B8.5, RP11-389G6.3, and CTD-2377D24.6 levels were increased in tumor tissues by qRT-PCR and in situ hybridization. Intriguingly, the p-value of combined 3-lncRNAs was lower than that of each lncRNA, indicating that the 3-lncRNA signature also showed higher performance in EC tissue than paracancerous. Functional analysis revealed that cortactin might be involved in the mechanism of 3-lncRNA signatures. These findings provide the first hint that a panel of lncRNAs may play a critical role in the initiation and metastasis of EC, indicating a new signature for early diagnosis and therapeutic strategy of uterine corpus endometrial carcinoma.

Objective. At present, the clinical effect of music therapy combined with free position to assist delivery is rarely reported. Based on evidence-based nursing, this study is aimed at exploring the effect of the combination of music therapy and free position delivery on labor pain and maternal and fetal outcomes. Methods. A total of 440 primiparas with vaginal delivery in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Soochow University between July 2018 and July 2019 were selected. They were divided into music therapy, free position delivery group (n=201) and traditional delivery group (n=239). Subsequently, the two groups were compared in terms of the Chinese Perception of Labor Pain Questionnaire (PLPQ) score, bleeding amount at 2 hours after birth, perineal injury, labor stage duration, and 1 minute Apgar score. Results. The combination group had better results of the Chinese PLPQ score, postpartum hemorrhage, and perineum condition. However, compared with traditional delivery, a longer duration of the first stage and total stage of labor was found in the combination group. Music therapy combined with free position delivery required less medical intervention during delivery, and there was no significant difference in 1 minute Apgar score between the two groups. Conclusions. Music therapy combined with free position delivery, an intervention based on evidence-based nursing, can effectively reduce maternal labor pain, postpartum hemorrhage, soft birth canal injury, and medical intervention during labor. It is, therefore, a safe intervention to assist delivery.

Background: To investigate the associations of adjusting gestational weight gain rate (GWGr) with maternal and neonatal outcomes. Methods: We analyzed 6235 singleton pregnancies among women with normal pre-pregnancy body mass index at two medical centers in China during 2016~2018 to figure out whether pregnancy outcomes could be improved by adjusting GWGr timely when the first-trimester weight gain rate (GWGr-1) and/or the second-trimester weight gain rate (GWGr-2) were inappropriate. Results: When GWGr-1 was excessive, excessive GWGr during the second and third trimesters of pregnancy (late GWGr) was associated with a higher risk of cesarean section (CS), postpartum hemorrhage (PPH), obstructed and prolonged labor and large for gestational age (LGA), and inadequate late GWGr was associated with a lower prevalence of CS and hypertensive disorders of pregnancy (HDP). In pregnancies with inadequate GWGr-1, excessive late GWGr was related to a higher rate of CS, LGA and HDP. Among women with adequate GWGr-1, excessive GWGr in the third trimester (GWGr-3) was positively associated with CS, HDP, and obstruction and prolongation of labor if their GWGr-2 was excessive, and excessive GWGr-3 was associated with a higher risk of CS even though tFheir GWGr-2 was inadequate. Conclusions: Prompt control of GWGr, even during late pregnancy, was beneficial to improving pregnancy outcomes.

Endometrial cancer (EC)) is one of the most common malignant tumors of the female genital system, with an increasing incidence and mortality, worldwide. Although the therapeutic strategy of EC is still complicated and challenging, further understanding of carcinogenesis from a gene perspective would allow an effort to improve therapeutic precision in this complex malignancy. DNA methylation is the most widely studied epigenetic alteration in human tumors. Aberrant DNA methylation events, resulting in altered gene expression, are features of many tumor types. In this review, we provide an update on evidence about the roles of aberrant DNA methylation within some classical tumor suppressor genes and oncogenes in endometrial carcinogenesis, and report on recent advances in the understanding of the contribution of aberrant DNA methylation to EC, as well as opportunities and challenges of DNA methylation in EC management and prevention.

The Zimbardo Time Perspective Inventory (ZTPI) is one of the most well-known and widely used measures of time perspective. Various short versions were proposed to resolve the psychometric problems of the ZTPI. The present study conducted a systematic review to obtain 25 short versions, calculated the frequency of each item of the ZTPI in short versions, and hypothesized that the more frequent the item is, the more robust it becomes. The hypothesis was tested by assessing the structural validity and internal consistency of short forms with high, medium, and low frequent items in Chinese samples (575 children, 407 undergraduates, and 411 older adults). Structural validity and internal consistency analyses showed that the form with more frequent items had better psychometric properties; item frequencies were positively correlated with factor loadings. The results suggest that the systematic review is an effective approach to identify the robust items of the ZTPI. This approach is general and can be the basis to improve the psychometric properties of scales in social science.

Here, we reported a simple method for recognizing CA125 overexpressed serum samples using array-based fluorescent gold nanoclusters (AuNCs). The sensing array was fabricated by the combination of various CA125 aptamer functionalized AuNCs. The fluorescence of different aptamer-capped AuNCs was quenched to a different extent in the presence of CA125. By comprehensive analysis of these fluorescence changes, unique patterns were formed when CA125 was overexpressed in serum samples. This strategy is successfully used for discriminating CA125 overexpressed human serum samples, which have great importance for the diagnosis of ovarian cancer in the early stage.

The objective of the study is to analyze the association between early pregnancy body mass index (BMI), gestational weight gain (GWG), and maternal and neonatal outcomes. The retrospective cohort study was conducted at Quanzhou First Hospital Affiliated to Fujian Medical University from January 2018 to May 2021, with 552 women enrolled. Women were divided into the underweight group, normal weight group, overweight group, and obese group according to early pregnancy BMI. Univariate and multivariate logistic regression analyses were performed. The absolute risk of adverse maternal and neonatal outcomes in the early pregnancy BMI group was calculated to further analyze the association between GWG and adverse maternal and neonatal outcomes. Of the 552 women, 390 (70.65%) women had adverse maternal and neonatal outcomes. The result revealed that overweight was associated with increased risk of adverse maternal and neonatal outcomes (odds ratio (OR): 1.643, 95% confidence interval (CI): 1.006-2.684), maternal complications (OR: 1.937, 95% CI: 1.188-3.159), and large for gestational age (LGA) (OR: 1.905, 95% CI: 1.061-3.422). In the obese group, the risk of adverse maternal and neonatal outcomes (OR: 5.760, 95% CI: 1.997-16.786), maternal complications (OR: 3.112, 95% CI: 1.645-5.887), gestational diabetes mellitus (GDM) (OR: 2.943, 95% CI: 1.509-5.741), cesarean section (OR: 1.899, 95% CI: 1.002-3.599), and preterm delivery (OR: 4.752, 95% CI: 1.395-16.185) increased. Besides, there was an association between insufficient GWG and decreased risk of LGA (OR: 0.392, 95% CI: 0.187-0.826) and higher risk of preterm delivery (OR: 2.818, 95% CI: 1.171-6.784). This study demonstrates that BMI and GWG are related to maternal and neonatal outcomes. It is necessary to regularly monitor the weight of pregnant women during pregnancy. And regional guidelines for GWG also need to be explored.

The neural representation of the external events duration in working memory (WM) remains to be understood. It has been reported that there were different neural representations below and above 3 s/2 s for visual/auditory duration, respectively. However, these studies had limitations in experimental design, i.e., the interference of task difficulty was not assessed. Consequently, the results of these studies require verification. In the present study, we eliminated these limitations using an exploratory experiment in which the probe stimulus conditions were reset, while the other settings remained similar to those used in previous studies. In the exploratory experiment, we found that accuracy and reaction times were comparable among all the four duration conditions, suggesting that task difficulty was accurately matched. In the formal experiment, theta and alpha oscillations were examined using electroencephalogram recordings during the maintenance of the auditory duration in working memory, after removing the interference of task difficulty. Electroencephalogram results indicated that there were no significant differences in theta band power among different length of durations retained in working memory, whereas the alpha band power was significantly lower in the 3-s and 4-s duration conditions than in the 1-s and 2-s conditions. The findings suggest that different internal representations of auditory durations above and below the 2-s threshold are maintained in working memory. Also, our study provides evidence that the duration representation segmentation is associated with the length of the auditory duration retained in working memory, but not with task difficulty.

Objective: Cancer-associated fibroblasts (CAFs) were associated with tumor progression in the tumor microenvironment (TME). However, their immunosuppressive roles in protecting cancer cells from the attack by cytotoxic T lymphocytes (CTLs) are not fully clear. In this study, we investigated whether and how CAFs regulate tumor-infiltrating lymphocytes as well as their role in tumor immunosuppression.Methods: Eighty-three cases of ovarian cancer and 10 controls were analyzed for CAFs and CD8+ tumor-infiltrating lymphocytes by gene array and immunohistochemistry. We evaluated presenilin 1 (PS1) expression in CAFs, CTL penetration, tumor burden, dendritic cell function, and migration of tumor-infiltrating lymphocytes and their function in vivo and in vitro after silencing PS1. In addition, the pathway via which PS1 affects the TME was also evaluated.Results: PS1 was highly expressed in CAFs, and its silencing significantly promoted CD8+ CTL proliferation and penetration in multiple ovarian models (p < 0.05), resulting in tumor regression and growth inhibition. Interleukin (IL)-1β was identified as a major immune inhibitor in the TME, and it was significantly decreased after PS1 silencing (p < 0.05), which was regulated by the WNT/β-catenin pathway. It was also showed that high expression of IL-1β in CAFs inhibits CTL penetration significantly (p < 0.05).Conclusion: Highly expressed PS1 in CAFs plays a crucial role in regulating tumor-infiltrating lymphocyte populations in the TME via the WNT/β-catenin pathway. Targeting PS1 may retrieve functional CTLs in the TME and improve the efficacy of current immunotherapies.

Background: Some models predicting cesarean section (CS) have been proposed, with Tolcher, Levine, and Burke model well acknowledged. Tolcher model targets nulliparous women with term labor induction; Levine model targets women with term labor induction with intact membranes and an unfavorable cervix. Burke model targets term nulliparous woman with an uncomplicated pregnancy. Our objective was to assess the predictive performance of these three models, and to disclose the variables which may predict the risk of CS in Chinese population. Methods: A retrospective study was conducted on women with singleton, term, cephalic pregnancies at a tertiary academic center (2011–2017). A predicted probability for CS was calculated for women in the dataset by the algorithm of each model. The performance of the model was evaluated for discrimination. Univariate analysis was used to screen out the factors that may increase the risk of CS. Results: The three models predicted CS as following (expressed by an area under the receiver operating characteristic curve [AUC ROC]) (in the population defined/employed by each model): Tolcher model with AUC ROC of 0.659; Levine model with 0.697; and Burke model as 0.623. Different interventional measures or characteristics of labor were also evaluated; the nulliparous and multiparous were analyzed separately. Still, most of the results were unsatisfactory (AUC ROC

Abstract Maternal embryo leucine zipper kinase (MELK) is highly expressed in a variety of malignant tumors and involved in cell cycle regulation, cell proliferation, apoptosis, tumor formation etc However, the biological effects of MELK in cervical cancer are still uninvestigated. This study aimed to explore the expression of MELK in cervical cancer, as well as its effects on the proliferation, apoptosis, DNA damage repair on cervical cancer cell line in vitro and to provide novel ideas for further improving the clinical efficacy of cervical cancer. Immunohistochemistry, Western blot, RT‐qPCR, CCK8, and immunofluorescence techniques were used to detect the expression of MELK in cervical cancer tissues, paracancerous tissues, and cervical cancer cell lines. Several cervical cancer cell lines were treated with MELK knockdown by siRNA and MELK selective inhibitor OTSSP167. The effects on proliferation, apoptosis, and colony formation capacity, and tumor cell DNA damage repair‐related factor were detected in cell lines. Our data showed that the high expression rate of MELK in cervical cancer patients was 56.92%. MELK expression in cervical cancer samples was significantly higher than that in paraneoplastic tissues. Highly expressed MELK correlated with the cervical histopathological grading and greatly increased with the cervical histopathological grading, from normal cervix and cervical intraepithelial neoplasia to cervical cancer. Moreover, the abnormal expression of MELK was related to cervical cancer metastasis at early stage. The knockdown of MELK with siRNA and OTSSP167 had strong inhibition effects on the proliferation, apoptosis, and colony formation of cervical cancer cells. MELK knockdown could also aggravate the DNA damage of cervical cancer cells possibly by homologous recombination repair pathway. Therefore, MELK may be a predicting marker of poor prognosis of cervical cancer and may also be a new therapeutic target for cervical cancer, providing ideas for improving the therapeutic effect of cervical cancer.

Abstract The neural representation of auditory duration remains unknown. Here, we used electroencephalogram (EEG) recordings to investigate neural oscillations during the maintenance of auditory duration in working memory (WM). EEG analyses indicated that the auditory duration length was not associated with changes in the theta band amplitude, whereas the alpha band amplitudes during 3-s and 4-s auditory duration conditions were lower than during the 1-s and 2-s conditions. Moreover, the alpha band amplitude and accuracy were positively correlated in the 2-s duration condition. We also found that the neural representation of auditory duration is segmented, with a critical threshold point of approximately 2 s, which is shorter than that for visual duration (3 s). The results emphasised the involvement of the alpha band in auditory duration maintenance in WM. Our study’s findings indicate that different internal representations of auditory durations are maintained in WM below and above 2 s from the perspective of electrophysiology. Additionally, the critical threshold point is related to the sensory modality of duration.

Visual crowding is the difficulty experienced in identifying a target flanked by other objects within the peripheral visual field. Despite extensive research conducted on this topic, the precise relationship between attention and crowding is still debatable. One perspective suggests that crowding is a bottom-up and pre-attentive process, while another suggests that crowding is top-down and attentional. A third perspective proposes that crowding is a combination of bottom-up and top-down processes. To address this debate, the current study manipulated the attention and distance between targets and flankers, while simultaneously measuring event-related potentials, in human participants. Results indicated that, compared to uncrowded targets, crowded targets elicited more negative frontal N1 and P2 activity and a less negative occipital N1 activity, regardless of whether targets were attended or unattended, and a more positive occipital P2 activity when they were attended. Furthermore, the crowded minus uncrowded difference amplitude was more negative over the frontal region and more positive over the occipital region when the targets were attended, compared to when they were unattended during the N1 and P2 stages. This suggests that crowding, a concept that originates from Gestalt grouping, occurs automatically and can be modulated by attention.

In the Kappa effect, two visual stimuli are given, and their spatial distance affects their perceived temporal interval. The classical model assumes constant speed while a competing Bayesian model assumes a slow speed prior. The two models are based on different assumptions about the statistical structure of the environment. Here we introduce a new visual experiment to distinguish between these models. When fit to the data, both the two models replicated human response, but the slowness model makes better behavioral predictions than the speed constancy model, and the estimated constant speed is close to the absolute threshold of speed. Our findings suggest that the Kappa effect appears to be due to slow speeds, and also modulated by spatial variance.

Endometrial carcinoma (EC) is one of the most common gynecological malignant neoplasms, the prognosis of which is strongly related to the time of diagnosis, with an earlier diagnosis leading to a better prognosis. Therefore, effective diagnostic indicators and methods are needed to ensure early detection. The present study explored the following in EC: Circulating tumor cells (CTCs); the long noncoding RNAs (lncRNAs) RP4-616B8.5, RP11-389G6.3 and carboxy-terminal domain (CTD)-2377D24.6; and the methylation of cysteine dioxygenase type 1 (CDO1) and CUGBP Elav-like family member 4 (CELF4). In total, 85 patients, including 71 with EC, and 14 without EC (NO-EC) but with uterine fibroids or polyps, were included in the present study. In total, 46 patients with EC and 8 NO-EC patients underwent CTC detection. In the evaluation of the EC vs. NO-EC groups, the results showed that the CTC-positive rate of the EC group was 80.43% and that the area under the curve (AUC) value of CTCs was 0.8872 (P=0.0098). A total of 35 patients with EC and 14 NO-EC patients underwent detection of the RP4-616B8.5, RP11-389G6.3 and CTD-2377D24.6 lncRNAs. When the levels of the three lncRNAs RP4-616B8.5, RP11-389G6.3 and CTD-2377D24.6 were compared between the EC and NO-EC groups, they were higher in the EC group; the P-values were 0.0002, 0.0001 and <0.0001, respectively, and the AUC values were 0.8184, 0.8347 and 0.8265, respectively. In addition, a total of 35 patients with EC and 8 NO-EC patients underwent CDO1 and CELF4 DNA methylation analysis. The positive rates of the methylated genes CDO1 and CELF4 were 20% (7/35) and 5.71% (2/35), and the P-values of the comparisons between the EC and NO-EC groups were 0.1748 and 0.5004, respectively; the AUC values were 0.6000 and 0.5286. Furthermore, the combination of CTCs, and lncRNAs RP4-616B8.5, RP11-389G6.3 and CTD-2377D24.6 exhibited high performance in the detection of EC (AUC=0.9375). [ABSTRACT FROM AUTHOR]