Cystic adenomyoma of the uterus: Case report and literature review
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Lei Zhang
,
Zhaojun Guo
Abstract
Cystic adenomyosis is a rare type of adenomyosis. The main clinical manifestation of uterine cystic adenomyoma is severe dysmenorrhoea, and the condition can be diagnosed by relevant clinical examination. The preferred treatment, with a good prognosis, is lesion resection. The clinical data of a patient with uterine cystic adenomyoma recorded at the Third Hospital of Hebei Medical University are reported herein. A 39-year-old female patient presented with tolerable menstrual pain and aggravated dysmenorrhoea, which she had experienced for 4 years, and menorrhagia, which she had had for approximately 1 year. Ultrasound and tumour marker tests suggested abnormalities, and magnetic resonance imaging confirmed a diagnosis of uterine cystic adenomyoma. A hysteroscopy and intrauterine lesion electrocision were performed, and the results of postoperative pathology tests suggested that the endometriosis cysts had returned to normal after the postoperative intervention. The analysis of the clinical manifestations and diagnosis and treatment of uterine cystic adenomyoma can improve the understanding of the disease and reduce the rates of misdiagnosis and missed diagnoses to ensure early detection with timely diagnosis and treatment.
1 Introduction
Adenomyosis is a benign uterine disease characterised by gland and stromal tissue of the ectopic endometrium invading the myometrium with reactive fibrosis [1]. If the cystic cavity is filled with ectopic endometrial tissue and blood with a diameter of greater than 10 mm, the condition is referred to as cystic adenomyosis, an adenomyotic cyst, or cystic adenomyoma [2]. This is a rare type of adenomyosis with low incidence, and its typical clinical manifestations are dysmenorrhoea and menorrhagia, which are difficult to control. Asymptomatic cases are usually not diagnosed in routine gynaecological examinations; however, some patients with cystic adenomyosis complain of severe pain associated with menstruation [3]. In other cases, it may be found during the investigation of infertility or miscarriage. This disease has a negative impact on quality of life in terms of menstrual symptoms, fertility, and pregnancy outcomes, and patients are at high risk of miscarriage and obstetric complications [4]. Cystic adenomyoma is still a poorly understood disease. It is a cystic lesion that does not communicate with the uterine cavity. It is lined with a healthy endometrium, lies within the myometrium, and contains a bleeding fluid described as chocolate like. According to the literature, patients with symptomatic cystic adenomyoma present mainly with pain, especially dysmenorrhoea, sometimes accompanied by chronic pelvic pain and painful intercourse. Menorrhagia and menorrhagia are sometimes associated with cystic adenomyoma. Few cases of cystic adenomyoma have been reported in the literature. Similar disease entities have been reported using different nomenclature, making it difficult to estimate the prevalence of the disease. Most case reports show that the lesion site of uterine cystic adenomyosis is often located in the myometrial wall or subserosa. Due to the lack of specificity of clinical manifestations, it is easy to miss a diagnosis of uterine cystic adenomyosis or misdiagnose it before surgery, and since an early diagnosis is difficult, this condition has attracted much attention. This article presents a clinical case of cystic adenomyoma in a 39-year-old woman who reported menstrual abdominal pain and summarises the patient’s clinical manifestations, classification, pathogenesis, diagnosis, and treatment to provide a reference for clinicians to diagnose and treat this disorder.
2 Case description
2.1 History and pre-admission examination
The 39-year-old female patient was hospitalised on 23 February 2021 due to dysmenorrhoea, which she had experienced for 4 years, and aggravation of menstruation, with increased menstruation volume and length, which she had had for 1 year. The patient had had four pregnancies but only one birth, a male baby 13 years previously, who had been delivered by caesarean section. The section incision had healed poorly, and the patient had fat liquefaction, infection, incision dehiscence, and purulent secretion exudation in the abdominal incision. The incision finally healed after repeated dressing changes, anti-infection treatment, and secondary suture. The patient had undergone two artificial abortions and a laparoscopic right salpingectomy, due to an ectopic pregnancy. The patient’s menstrual abdominal pain was tolerable and had a visual analogue scale (VAS) score of 2 points, and the aggravated dysmenorrhoea symptoms had a VAS score of 9 points. Oral analgesics administered daily during menstruation relieved the symptoms of dysmenorrhoea, but they increased menstrual flow and prolonged menstruation.
Ultrasound examination of the patient 2 months prior to admission showed uterine cavity line separation, a 59 mm × 24 mm liquid dark area, poor sound transmission, dense weak echo points, and unilateral endometrial thickness of approximately 2.3 mm. An intrauterine fluid dark area (a haematocele) was considered and curettage was suggested, but the patient refused it. On 16 February 2021, the patient visited another hospital and underwent a gynaecological ultrasound, which suggested that the low-echo area in the uterine cavity had dimensions of approximately 2.6 cm × 3.5 cm × 2.4 cm. As a result of this intrauterine low-echo area (a possible haematocele), a curettage was performed. No blood was discharged during the operation, and only a small amount of endometrial tissue was scraped out. The pathological results indicated secretory changes in the endometrium, accompanied by decidual-like changes in the stroma.
After hospital admission, the patient underwent further clinical examinations to confirm the initial findings and make a diagnosis. Ultrasound and magnetic resonance imaging (MRI) imaging were performed to observe and locate the lesion, and the tumour markers carbohydrate antigen (CA125) and carbohydrate antigen 19-9 (CA199) were checked to further confirm and track the changes in the cystic adenomyosis. Finally, after the initial diagnosis, a hysteroscopy and intrauterine focal electrocision surgery were performed to remove the lesion, which was analysed using haematoxylin and eosin (HE) staining.
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Informed consent: Informed consent has been obtained from all individuals included in this study.
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Ethical approval: The research related to human use has been complied with all the relevant national regulations, institutional policies and in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
2.2 Ultrasound examination
The ultrasound images after admission revealed a cystic mass, 3.0 cm × 2.7 cm in size, which could be seen as a liquid dark area with a dotted linear strong echo and which appeared to be located in the upper part of the uterine cavity. It seemed to form a complete capsule with a thickness of approximately 0.2 cm. The anterior wall of the uterus was not clear, and the lower uterine segment interval was 0.5 cm. The thickness of a single endometrium was approximately 0.1 cm. These results are shown in Figure 1a and b.
Ultrasonic imaging and MRI of cystic adenomyoma. (a) High signal of lesion in the T1WI cross-sectional images (marked white arrow). (b) Slightly low signal of lesion in the T2WI sagittal images. (c and d) MRI of cystic adenomyoma.
2.3 MRI examination
The MRI examination after admission showed a circular mass shadow of approximately 2.73 cm × 3.04 cm × 3.61 cm in the endometrial cavity. There was a high signal in the T1-weighted image (WI) and a slightly lower signal in T2WI, and the upper margin of the lesion had a long narrow neck attached to the right anterior myometrium, as shown in Figure 1c and d.
2.4 Tumour marker evaluation
Blood samples were collected from the patient on 16 February 2021 at an outpatient review, and enzyme-linked immunosorbent assay results showed that the CA125 concentration was 16.2 U/mL and the CA199 concentration was 285.2 U/mL.
2.5 Operation description
The preliminary clinical diagnosis was cystic adenomyoma. Hysteroscopy and intrauterine focal electrocision were performed under intravenous anaesthesia. During the operation, a mass of approximately 3 cm × 3 cm × 4 cm was observed to protrude into the uterine cavity from the anterior wall of the uterus. This mass had a smooth surface and was covered in endometrial tissue, and the pedicle, which was approximately 2 cm in width, was attached to the right anterior wall of the uterus, close to the cornual region. Brown chocolate-like fluid exuded from the mass when stimulated with needle electrodes, and the cyst wall was approximately 0.5 cm thick. The hysteroscopy was then performed through the cyst cavity. After washing the cyst cavity, the cyst wall was seen to be smooth and white, and a dilated gland opening was visible near the myometrium cyst wall. A cut was made in the cyst wall using a ring electrode to flush out the region with the normal endometrial tissue while retaining part of the cyst wall to prevent the large area of endometrial defect from affecting postoperative menstruation. The results of postoperative pathology tests suggested the presence of an endometrial cyst as shown in Figure 2. Postoperative intervention comprised the administration of three courses of GnRH-a to prevent relapse. When tested on 2 April 2021, CA199 (21.5 U/mL) had decreased to normal levels, and on 3 July, when menstruation recovered, menstrual abdominal pain symptoms were relieved, and menstrual period and menstrual volume were normal. Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Pathologic examination of the lesion. (a and b) HE staining results of the pathologic lesion.
3 Discussion
Diffuse adenomyosis is the most common type, and localised adenomyosis, especially of the cystic uterine glands, is very rare. Cystic adenomyosis is a specific type of lesion that originates in the myometrium of the uterus and is filled with a chocolate-like viscous fluid. A summary of the cases that were found is given in Table 1 [4,5,6,7,8,9,10,11,12,13]. Cystic adenomyoma is characterised by the invasive presence of gland and stromal tissue of the ectopic endometrium with a thickness of greater than 2.5 cm in the myometrium. The main clinical manifestations are secondary progressive dysmenorrhoea, prolonged menstruation, menorrhagia, and uterine enlargement, combined with infertility [14]. Because of the atypical clinical manifestations and the rarity of the condition, patients with cystic adenomyosis are often misdiagnosed. These symptoms may be signs of other clinical conditions, such as subplasmalemmal fibroid degeneration.
Case summary of cystic adenomyosis reported in literatures
| Study (author, time) | Age | Location | Lesion size (cm) | Clinical symptoms | References |
|---|---|---|---|---|---|
| Protopapas et al. (2020) | 14 | Hypotense myometrium | 3.8 | Dysmenorrhoea | [4] |
| Takeuchi et al. (2010) | 30 | Adjacent myometrium | 3.5 | Serve dyspareunia | [5] |
| 29 | Adjacent myometrium | 3 | Serve dyspareunia | ||
| 27 | Adjacent myometrium | 4.2 | Serve dyspareunia | ||
| 20 | Adjacent myometrium | 2.8 | Serve dyspareunia | ||
| 30 | Adjacent myometrium | 3.4 | Serve dyspareunia | ||
| 28 | Adjacent myometrium | 2.5 | Serve dyspareunia | ||
| 23 | Adjacent myometrium | 2.8 | Serve dyspareunia | ||
| 20 | Adjacent myometrium | 3.4 | Serve dyspareunia | ||
| Zhou et al. (2020) | 45 | Posterior uterine isthmus | 9 | Serve dyspareunia | [6] |
| Branquinho et al. (2012) | 17 | Adjacent myometrium | 3.3 | Dyspareunia | [7] |
| Dadhwal et al. (2017) | 23 | Adjacent myometrium | 4 | Lower abdominal pain, dyspareunia | [8] |
| 16 | Adjacent myometrium | 3.5 | Lower abdominal pain, dyspareunia | ||
| Kim (2014) | 30 | Adjacent myometrium | 2 | Dyspareunia | [9] |
| Kriplani et al. (2011) | 16 | Adjacent myometrium | 4 | Serve dyspareunia | [10] |
| 18 | Adjacent myometrium | 5 | Serve dyspareunia | ||
| 18 | Adjacent myometrium | 4.5 | Serve dyspareunia | ||
| 24 | Adjacent myometrium | 4 | Serve dyspareunia | ||
| Pontrelli et al. (2015) | 27 | Uterine cavity | 8 | Dyspareunia | [11] |
| Mahey et al. (2023) | 20 | Left side anteroinferior | 3 | Lower abdominal pain | [12] |
| Nigam et al. (2021) | 30 | Adjacent myometrium | 4.8 | Severe abdominal pain | [13] |
The pathogenesis of cystic adenomyoma is unclear, but it may result from repeated endometrial damage and repair, high oestrogen levels, immunity, inflammation, and other factors [15]. The growth of the endometrial glands and stroma is limited due to the action of oestrogen and progesterone, which causes uniform or limited enlargement of the uterus, and this results in the formation of adenomyoma in the myometrium [16]. The patient in this study had previously undergone a uterine caesarean section, and the wound had healed poorly. She had a history of two abortions and an ectopic pregnancy, and she had had a laparoscopic right salpingectomy. Her history of infection and multiple uterine operations suggests probable disruption of the boundary between the endometrium and the myometrium, and the endometrium migration to the myometrium is a known high-risk factor for the development of the disease.
The surgical techniques described for treating cystic adenomyomas were developed from myomectomy techniques [3]. Individualised treatment plans should be formulated according to the patient’s age of onset of the disease, lesion location, size, and fertility requirements and should be aimed at relieving symptoms, removing lesions, protecting fertility function, and avoiding recurrence. Panhysterectomy and lesion resection may be opted for depending on the patient’s age and fertility requirements, and lesion resection is the preferred surgical method for treating young patients who may wish to have a child in the future.
There is no unified conclusion concerning the necessity and choice of maintenance treatment after surgery. Some scholars regard cystic adenomyoma to be a special type of adenomyosis [17]. They did not think that it needs maintenance and the patients can have a treatment efficiency; however, in this case, the postoperative pathology outcome was an endometrioma, and, due to the probable presence of residual ectopic endometrial tissue after surgery, the postoperative use of drugs to prevent recurrence was advocated. Since part of the cyst wall was preserved to replace the normal endometrium, three courses of GnRH-a were prescribed.
4 Conclusion
According to the current case and a review of the relevant literature, cases of cystic adenomyoma are clinically significant. For women with aggravated menstruation, severe dysmenorrhoea, isolated uterine cysts seen in ultrasound images, and elevated serum CA125, the possibility of cystic uterine adenomyomas should be considered to avoid clinical misdiagnosis and delays in the diagnosis of the condition. In such cases, MRI scans facilitate further differential diagnosis, and surgical treatment is the most effective treatment method. Future studies are required to gain insights into maintenance treatment after surgery.
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Funding information: Authors state no funding involved.
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Author contributions: L.Z., J.Z., ZJ.G., and XL.M. analysed and interpreted the patient data. L.Z. and J.L. wrote the manuscript. YC.P. and XL.M. were significant contributors to Organizing medical records. XL.M. revised the manuscript.
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Conflict of interest: Authors state no conflict of interest.
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Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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- Major ozonated autohemotherapy promoted functional recovery following spinal cord injury in adult rats via the inhibition of oxidative stress and inflammation
- Axodendritic targeting of TAU and MAP2 and microtubule polarization in iPSC-derived versus SH-SY5Y-derived human neurons
- Differential expression of phosphoinositide 3-kinase/protein kinase B and Toll-like receptor/nuclear factor kappa B signaling pathways in experimental obesity Wistar rat model
- The therapeutic potential of targeting Oncostatin M and the interleukin-6 family in retinal diseases: A comprehensive review
- BA inhibits LPS-stimulated inflammatory response and apoptosis in human middle ear epithelial cells by regulating the Nf-Kb/Iκbα axis
- Role of circRMRP and circRPL27 in chronic obstructive pulmonary disease
- Investigating the role of hyperexpressed HCN1 in inducing myocardial infarction through activation of the NF-κB signaling pathway
- Characterization of phenolic compounds and evaluation of anti-diabetic potential in Cannabis sativa L. seeds: In vivo, in vitro, and in silico studies
- Quantitative immunohistochemistry analysis of breast Ki67 based on artificial intelligence
- Ecology and Environmental Science
- Screening of different growth conditions of Bacillus subtilis isolated from membrane-less microbial fuel cell toward antimicrobial activity profiling
- Degradation of a mixture of 13 polycyclic aromatic hydrocarbons by commercial effective microorganisms
- Evaluation of the impact of two citrus plants on the variation of Panonychus citri (Acari: Tetranychidae) and beneficial phytoseiid mites
- Prediction of present and future distribution areas of Juniperus drupacea Labill and determination of ethnobotany properties in Antalya Province, Türkiye
- Population genetics of Todarodes pacificus (Cephalopoda: Ommastrephidae) in the northwest Pacific Ocean via GBS sequencing
- A comparative analysis of dendrometric, macromorphological, and micromorphological characteristics of Pistacia atlantica subsp. atlantica and Pistacia terebinthus in the middle Atlas region of Morocco
- Macrofungal sporocarp community in the lichen Scots pine forests
- Assessing the proximate compositions of indigenous forage species in Yemen’s pastoral rangelands
- Food Science
- Gut microbiota changes associated with low-carbohydrate diet intervention for obesity
- Reexamination of Aspergillus cristatus phylogeny in dark tea: Characteristics of the mitochondrial genome
- Differences in the flavonoid composition of the leaves, fruits, and branches of mulberry are distinguished based on a plant metabolomics approach
- Investigating the impact of wet rendering (solventless method) on PUFA-rich oil from catfish (Clarias magur) viscera
- Non-linear associations between cardiovascular metabolic indices and metabolic-associated fatty liver disease: A cross-sectional study in the US population (2017–2020)
- Knockdown of USP7 alleviates atherosclerosis in ApoE-deficient mice by regulating EZH2 expression
- Utility of dairy microbiome as a tool for authentication and traceability
- Agriculture
- Enhancing faba bean (Vicia faba L.) productivity through establishing the area-specific fertilizer rate recommendation in southwest Ethiopia
- Impact of novel herbicide based on synthetic auxins and ALS inhibitor on weed control
- Perspectives of pteridophytes microbiome for bioremediation in agricultural applications
- Fertilizer application parameters for drip-irrigated peanut based on the fertilizer effect function established from a “3414” field trial
- Improving the productivity and profitability of maize (Zea mays L.) using optimum blended inorganic fertilization
- Application of leaf multispectral analyzer in comparison to hyperspectral device to assess the diversity of spectral reflectance indices in wheat genotypes
- Animal Sciences
- Knockdown of ANP32E inhibits colorectal cancer cell growth and glycolysis by regulating the AKT/mTOR pathway
- Development of a detection chip for major pathogenic drug-resistant genes and drug targets in bovine respiratory system diseases
- Exploration of the genetic influence of MYOT and MB genes on the plumage coloration of Muscovy ducks
- Transcriptome analysis of adipose tissue in grazing cattle: Identifying key regulators of fat metabolism
- Comparison of nutritional value of the wild and cultivated spiny loaches at three growth stages
- Transcriptomic analysis of liver immune response in Chinese spiny frog (Quasipaa spinosa) infected with Proteus mirabilis
- Disruption of BCAA degradation is a critical characteristic of diabetic cardiomyopathy revealed by integrated transcriptome and metabolome analysis
- Plant Sciences
- Effect of long-term in-row branch covering on soil microorganisms in pear orchards
- Photosynthetic physiological characteristics, growth performance, and element concentrations reveal the calcicole–calcifuge behaviors of three Camellia species
- Transcriptome analysis reveals the mechanism of NaHCO3 promoting tobacco leaf maturation
- Bioinformatics, expression analysis, and functional verification of allene oxide synthase gene HvnAOS1 and HvnAOS2 in qingke
- Water, nitrogen, and phosphorus coupling improves gray jujube fruit quality and yield
- Improving grape fruit quality through soil conditioner: Insights from RNA-seq analysis of Cabernet Sauvignon roots
- Role of Embinin in the reabsorption of nucleus pulposus in lumbar disc herniation: Promotion of nucleus pulposus neovascularization and apoptosis of nucleus pulposus cells
- Revealing the effects of amino acid, organic acid, and phytohormones on the germination of tomato seeds under salinity stress
- Combined effects of nitrogen fertilizer and biochar on the growth, yield, and quality of pepper
- Comprehensive phytochemical and toxicological analysis of Chenopodium ambrosioides (L.) fractions
- Impact of “3414” fertilization on the yield and quality of greenhouse tomatoes
- Exploring the coupling mode of water and fertilizer for improving growth, fruit quality, and yield of the pear in the arid region
- Metagenomic analysis of endophytic bacteria in seed potato (Solanum tuberosum)
- Antibacterial, antifungal, and phytochemical properties of Salsola kali ethanolic extract
- Exploring the hepatoprotective properties of citronellol: In vitro and in silico studies on ethanol-induced damage in HepG2 cells
- Enhanced osmotic dehydration of watermelon rind using honey–sucrose solutions: A study on pre-treatment efficacy and mass transfer kinetics
- Effects of exogenous 2,4-epibrassinolide on photosynthetic traits of 53 cowpea varieties under NaCl stress
- Comparative transcriptome analysis of maize (Zea mays L.) seedlings in response to copper stress
- An optimization method for measuring the stomata in cassava (Manihot esculenta Crantz) under multiple abiotic stresses
- Fosinopril inhibits Ang II-induced VSMC proliferation, phenotype transformation, migration, and oxidative stress through the TGF-β1/Smad signaling pathway
- Antioxidant and antimicrobial activities of Salsola imbricata methanolic extract and its phytochemical characterization
- Bioengineering and Biotechnology
- Absorbable calcium and phosphorus bioactive membranes promote bone marrow mesenchymal stem cells osteogenic differentiation for bone regeneration
- New advances in protein engineering for industrial applications: Key takeaways
- An overview of the production and use of Bacillus thuringiensis toxin
- Research progress of nanoparticles in diagnosis and treatment of hepatocellular carcinoma
- Bioelectrochemical biosensors for water quality assessment and wastewater monitoring
- PEI/MMNs@LNA-542 nanoparticles alleviate ICU-acquired weakness through targeted autophagy inhibition and mitochondrial protection
- Unleashing of cytotoxic effects of thymoquinone-bovine serum albumin nanoparticles on A549 lung cancer cells
- Erratum
- Erratum to “Investigating the association between dietary patterns and glycemic control among children and adolescents with T1DM”
- Erratum to “Activation of hypermethylated P2RY1 mitigates gastric cancer by promoting apoptosis and inhibiting proliferation”
- Retraction
- Retraction to “MiR-223-3p regulates cell viability, migration, invasion, and apoptosis of non-small cell lung cancer cells by targeting RHOB”
- Retraction to “A data mining technique for detecting malignant mesothelioma cancer using multiple regression analysis”
- Special Issue on Advances in Neurodegenerative Disease Research and Treatment
- Transplantation of human neural stem cell prevents symptomatic motor behavior disability in a rat model of Parkinson’s disease
- Special Issue on Multi-omics
- Inflammasome complex genes with clinical relevance suggest potential as therapeutic targets for anti-tumor drugs in clear cell renal cell carcinoma
- Gastroesophageal varices in primary biliary cholangitis with anti-centromere antibody positivity: Early onset?
Artikel in diesem Heft
- Biomedical Sciences
- Constitutive and evoked release of ATP in adult mouse olfactory epithelium
- LARP1 knockdown inhibits cultured gastric carcinoma cell cycle progression and metastatic behavior
- PEGylated porcine–human recombinant uricase: A novel fusion protein with improved efficacy and safety for the treatment of hyperuricemia and renal complications
- Research progress on ocular complications caused by type 2 diabetes mellitus and the function of tears and blepharons
- The role and mechanism of esketamine in preventing and treating remifentanil-induced hyperalgesia based on the NMDA receptor–CaMKII pathway
- Brucella infection combined with Nocardia infection: A case report and literature review
- Detection of serum interleukin-18 level and neutrophil/lymphocyte ratio in patients with antineutrophil cytoplasmic antibody-associated vasculitis and its clinical significance
- Ang-1, Ang-2, and Tie2 are diagnostic biomarkers for Henoch-Schönlein purpura and pediatric-onset systemic lupus erythematous
- PTTG1 induces pancreatic cancer cell proliferation and promotes aerobic glycolysis by regulating c-myc
- Role of serum B-cell-activating factor and interleukin-17 as biomarkers in the classification of interstitial pneumonia with autoimmune features
- Effectiveness and safety of a mumps containing vaccine in preventing laboratory-confirmed mumps cases from 2002 to 2017: A meta-analysis
- Low levels of sex hormone-binding globulin predict an increased breast cancer risk and its underlying molecular mechanisms
- A case of Trousseau syndrome: Screening, detection and complication
- Application of the integrated airway humidification device enhances the humidification effect of the rabbit tracheotomy model
- Preparation of Cu2+/TA/HAP composite coating with anti-bacterial and osteogenic potential on 3D-printed porous Ti alloy scaffolds for orthopedic applications
- Aquaporin-8 promotes human dermal fibroblasts to counteract hydrogen peroxide-induced oxidative damage: A novel target for management of skin aging
- Current research and evidence gaps on placental development in iron deficiency anemia
- Single-nucleotide polymorphism rs2910829 in PDE4D is related to stroke susceptibility in Chinese populations: The results of a meta-analysis
- Pheochromocytoma-induced myocardial infarction: A case report
- Kaempferol regulates apoptosis and migration of neural stem cells to attenuate cerebral infarction by O‐GlcNAcylation of β-catenin
- Sirtuin 5 regulates acute myeloid leukemia cell viability and apoptosis by succinylation modification of glycine decarboxylase
- Apigenin 7-glucoside impedes hypoxia-induced malignant phenotypes of cervical cancer cells in a p16-dependent manner
- KAT2A changes the function of endometrial stromal cells via regulating the succinylation of ENO1
- Current state of research on copper complexes in the treatment of breast cancer
- Exploring antioxidant strategies in the pathogenesis of ALS
- Helicobacter pylori causes gastric dysbacteriosis in chronic gastritis patients
- IL-33/soluble ST2 axis is associated with radiation-induced cardiac injury
- The predictive value of serum NLR, SII, and OPNI for lymph node metastasis in breast cancer patients with internal mammary lymph nodes after thoracoscopic surgery
- Carrying SNP rs17506395 (T > G) in TP63 gene and CCR5Δ32 mutation associated with the occurrence of breast cancer in Burkina Faso
- P2X7 receptor: A receptor closely linked with sepsis-associated encephalopathy
- Probiotics for inflammatory bowel disease: Is there sufficient evidence?
- Identification of KDM4C as a gene conferring drug resistance in multiple myeloma
- Microbial perspective on the skin–gut axis and atopic dermatitis
- Thymosin α1 combined with XELOX improves immune function and reduces serum tumor markers in colorectal cancer patients after radical surgery
- Highly specific vaginal microbiome signature for gynecological cancers
- Sample size estimation for AQP4-IgG seropositive optic neuritis: Retinal damage detection by optical coherence tomography
- The effects of SDF-1 combined application with VEGF on femoral distraction osteogenesis in rats
- Fabrication and characterization of gold nanoparticles using alginate: In vitro and in vivo assessment of its administration effects with swimming exercise on diabetic rats
- Mitigating digestive disorders: Action mechanisms of Mediterranean herbal active compounds
- Distribution of CYP2D6 and CYP2C19 gene polymorphisms in Han and Uygur populations with breast cancer in Xinjiang, China
- VSP-2 attenuates secretion of inflammatory cytokines induced by LPS in BV2 cells by mediating the PPARγ/NF-κB signaling pathway
- Factors influencing spontaneous hypothermia after emergency trauma and the construction of a predictive model
- Long-term administration of morphine specifically alters the level of protein expression in different brain regions and affects the redox state
- Application of metagenomic next-generation sequencing technology in the etiological diagnosis of peritoneal dialysis-associated peritonitis
- Clinical diagnosis, prevention, and treatment of neurodyspepsia syndrome using intelligent medicine
- Case report: Successful bronchoscopic interventional treatment of endobronchial leiomyomas
- Preliminary investigation into the genetic etiology of short stature in children through whole exon sequencing of the core family
- Cystic adenomyoma of the uterus: Case report and literature review
- Mesoporous silica nanoparticles as a drug delivery mechanism
- Dynamic changes in autophagy activity in different degrees of pulmonary fibrosis in mice
- Vitamin D deficiency and inflammatory markers in type 2 diabetes: Big data insights
- Lactate-induced IGF1R protein lactylation promotes proliferation and metabolic reprogramming of lung cancer cells
- Meta-analysis on the efficacy of allogeneic hematopoietic stem cell transplantation to treat malignant lymphoma
- Mitochondrial DNA drives neuroinflammation through the cGAS-IFN signaling pathway in the spinal cord of neuropathic pain mice
- Application value of artificial intelligence algorithm-based magnetic resonance multi-sequence imaging in staging diagnosis of cervical cancer
- Embedded monitoring system and teaching of artificial intelligence online drug component recognition
- Investigation into the association of FNDC1 and ADAMTS12 gene expression with plumage coloration in Muscovy ducks
- Yak meat content in feed and its impact on the growth of rats
- A rare case of Richter transformation with breast involvement: A case report and literature review
- First report of Nocardia wallacei infection in an immunocompetent patient in Zhejiang province
- Rhodococcus equi and Brucella pulmonary mass in immunocompetent: A case report and literature review
- Downregulation of RIP3 ameliorates the left ventricular mechanics and function after myocardial infarction via modulating NF-κB/NLRP3 pathway
- Evaluation of the role of some non-enzymatic antioxidants among Iraqi patients with non-alcoholic fatty liver disease
- The role of Phafin proteins in cell signaling pathways and diseases
- Ten-year anemia as initial manifestation of Castleman disease in the abdominal cavity: A case report
- Coexistence of hereditary spherocytosis with SPTB P.Trp1150 gene variant and Gilbert syndrome: A case report and literature review
- Utilization of convolutional neural networks to analyze microscopic images for high-throughput screening of mesenchymal stem cells
- Exploratory evaluation supported by experimental and modeling approaches of Inula viscosa root extract as a potent corrosion inhibitor for mild steel in a 1 M HCl solution
- Imaging manifestations of ductal adenoma of the breast: A case report
- Gut microbiota and sleep: Interaction mechanisms and therapeutic prospects
- Isomangiferin promotes the migration and osteogenic differentiation of rat bone marrow mesenchymal stem cells
- Prognostic value and microenvironmental crosstalk of exosome-related signatures in human epidermal growth factor receptor 2 positive breast cancer
- Circular RNAs as potential biomarkers for male severe sepsis
- Knockdown of Stanniocalcin-1 inhibits growth and glycolysis in oral squamous cell carcinoma cells
- The expression and biological role of complement C1s in esophageal squamous cell carcinoma
- A novel GNAS mutation in pseudohypoparathyroidism type 1a with articular flexion deformity: A case report
- Predictive value of serum magnesium levels for prognosis in patients with non-small cell lung cancer undergoing EGFR-TKI therapy
- HSPB1 alleviates acute-on-chronic liver failure via the P53/Bax pathway
- IgG4-related disease complicated by PLA2R-associated membranous nephropathy: A case report
- Baculovirus-mediated endostatin and angiostatin activation of autophagy through the AMPK/AKT/mTOR pathway inhibits angiogenesis in hepatocellular carcinoma
- Metformin mitigates osteoarthritis progression by modulating the PI3K/AKT/mTOR signaling pathway and enhancing chondrocyte autophagy
- Evaluation of the activity of antimicrobial peptides against bacterial vaginosis
- Atypical presentation of γ/δ mycosis fungoides with an unusual phenotype and SOCS1 mutation
- Analysis of the microecological mechanism of diabetic kidney disease based on the theory of “gut–kidney axis”: A systematic review
- Omega-3 fatty acids prevent gestational diabetes mellitus via modulation of lipid metabolism
- Refractory hypertension complicated with Turner syndrome: A case report
- Interaction of ncRNAs and the PI3K/AKT/mTOR pathway: Implications for osteosarcoma
- Association of low attenuation area scores with pulmonary function and clinical prognosis in patients with chronic obstructive pulmonary disease
- Long non-coding RNAs in bone formation: Key regulators and therapeutic prospects
- The deubiquitinating enzyme USP35 regulates the stability of NRF2 protein
- Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as potential diagnostic markers for rebleeding in patients with esophagogastric variceal bleeding
- G protein-coupled receptor 1 participating in the mechanism of mediating gestational diabetes mellitus by phosphorylating the AKT pathway
- LL37-mtDNA regulates viability, apoptosis, inflammation, and autophagy in lipopolysaccharide-treated RLE-6TN cells by targeting Hsp90aa1
- The analgesic effect of paeoniflorin: A focused review
- Chemical composition’s effect on Solanum nigrum Linn.’s antioxidant capacity and erythrocyte protection: Bioactive components and molecular docking analysis
- Knockdown of HCK promotes HREC cell viability and inner blood–retinal barrier integrity by regulating the AMPK signaling pathway
- The role of rapamycin in the PINK1/Parkin signaling pathway in mitophagy in podocytes
- Laryngeal non-Hodgkin lymphoma: Report of four cases and review of the literature
- Clinical value of macrogenome next-generation sequencing on infections
- Overview of dendritic cells and related pathways in autoimmune uveitis
- TAK-242 alleviates diabetic cardiomyopathy via inhibiting pyroptosis and TLR4/CaMKII/NLRP3 pathway
- Hypomethylation in promoters of PGC-1α involved in exercise-driven skeletal muscular alterations in old age
- Profile and antimicrobial susceptibility patterns of bacteria isolated from effluents of Kolladiba and Debark hospitals
- The expression and clinical significance of syncytin-1 in serum exosomes of hepatocellular carcinoma patients
- A histomorphometric study to evaluate the therapeutic effects of biosynthesized silver nanoparticles on the kidneys infected with Plasmodium chabaudi
- PGRMC1 and PAQR4 are promising molecular targets for a rare subtype of ovarian cancer
- Analysis of MDA, SOD, TAOC, MNCV, SNCV, and TSS scores in patients with diabetes peripheral neuropathy
- SLIT3 deficiency promotes non-small cell lung cancer progression by modulating UBE2C/WNT signaling
- The relationship between TMCO1 and CALR in the pathological characteristics of prostate cancer and its effect on the metastasis of prostate cancer cells
- Heterogeneous nuclear ribonucleoprotein K is a potential target for enhancing the chemosensitivity of nasopharyngeal carcinoma
- PHB2 alleviates retinal pigment epithelium cell fibrosis by suppressing the AGE–RAGE pathway
- Anti-γ-aminobutyric acid-B receptor autoimmune encephalitis with syncope as the initial symptom: Case report and literature review
- Comparative analysis of chloroplast genome of Lonicera japonica cv. Damaohua
- Human umbilical cord mesenchymal stem cells regulate glutathione metabolism depending on the ERK–Nrf2–HO-1 signal pathway to repair phosphoramide mustard-induced ovarian cancer cells
- Electroacupuncture on GB acupoints improves osteoporosis via the estradiol–PI3K–Akt signaling pathway
- Renalase protects against podocyte injury by inhibiting oxidative stress and apoptosis in diabetic nephropathy
- Review: Dicranostigma leptopodum: A peculiar plant of Papaveraceae
- Combination effect of flavonoids attenuates lung cancer cell proliferation by inhibiting the STAT3 and FAK signaling pathway
- Renal microangiopathy and immune complex glomerulonephritis induced by anti-tumour agents: A case report
- Correlation analysis of AVPR1a and AVPR2 with abnormal water and sodium and potassium metabolism in rats
- Gastrointestinal health anti-diarrheal mixture relieves spleen deficiency-induced diarrhea through regulating gut microbiota
- Myriad factors and pathways influencing tumor radiotherapy resistance
- Exploring the effects of culture conditions on Yapsin (YPS) gene expression in Nakaseomyces glabratus
- Screening of prognostic core genes based on cell–cell interaction in the peripheral blood of patients with sepsis
- Coagulation factor II thrombin receptor as a promising biomarker in breast cancer management
- Ileocecal mucinous carcinoma misdiagnosed as incarcerated hernia: A case report
- Methyltransferase like 13 promotes malignant behaviors of bladder cancer cells through targeting PI3K/ATK signaling pathway
- The debate between electricity and heat, efficacy and safety of irreversible electroporation and radiofrequency ablation in the treatment of liver cancer: A meta-analysis
- ZAG promotes colorectal cancer cell proliferation and epithelial–mesenchymal transition by promoting lipid synthesis
- Baicalein inhibits NLRP3 inflammasome activation and mitigates placental inflammation and oxidative stress in gestational diabetes mellitus
- Impact of SWCNT-conjugated senna leaf extract on breast cancer cells: A potential apoptotic therapeutic strategy
- MFAP5 inhibits the malignant progression of endometrial cancer cells in vitro
- Major ozonated autohemotherapy promoted functional recovery following spinal cord injury in adult rats via the inhibition of oxidative stress and inflammation
- Axodendritic targeting of TAU and MAP2 and microtubule polarization in iPSC-derived versus SH-SY5Y-derived human neurons
- Differential expression of phosphoinositide 3-kinase/protein kinase B and Toll-like receptor/nuclear factor kappa B signaling pathways in experimental obesity Wistar rat model
- The therapeutic potential of targeting Oncostatin M and the interleukin-6 family in retinal diseases: A comprehensive review
- BA inhibits LPS-stimulated inflammatory response and apoptosis in human middle ear epithelial cells by regulating the Nf-Kb/Iκbα axis
- Role of circRMRP and circRPL27 in chronic obstructive pulmonary disease
- Investigating the role of hyperexpressed HCN1 in inducing myocardial infarction through activation of the NF-κB signaling pathway
- Characterization of phenolic compounds and evaluation of anti-diabetic potential in Cannabis sativa L. seeds: In vivo, in vitro, and in silico studies
- Quantitative immunohistochemistry analysis of breast Ki67 based on artificial intelligence
- Ecology and Environmental Science
- Screening of different growth conditions of Bacillus subtilis isolated from membrane-less microbial fuel cell toward antimicrobial activity profiling
- Degradation of a mixture of 13 polycyclic aromatic hydrocarbons by commercial effective microorganisms
- Evaluation of the impact of two citrus plants on the variation of Panonychus citri (Acari: Tetranychidae) and beneficial phytoseiid mites
- Prediction of present and future distribution areas of Juniperus drupacea Labill and determination of ethnobotany properties in Antalya Province, Türkiye
- Population genetics of Todarodes pacificus (Cephalopoda: Ommastrephidae) in the northwest Pacific Ocean via GBS sequencing
- A comparative analysis of dendrometric, macromorphological, and micromorphological characteristics of Pistacia atlantica subsp. atlantica and Pistacia terebinthus in the middle Atlas region of Morocco
- Macrofungal sporocarp community in the lichen Scots pine forests
- Assessing the proximate compositions of indigenous forage species in Yemen’s pastoral rangelands
- Food Science
- Gut microbiota changes associated with low-carbohydrate diet intervention for obesity
- Reexamination of Aspergillus cristatus phylogeny in dark tea: Characteristics of the mitochondrial genome
- Differences in the flavonoid composition of the leaves, fruits, and branches of mulberry are distinguished based on a plant metabolomics approach
- Investigating the impact of wet rendering (solventless method) on PUFA-rich oil from catfish (Clarias magur) viscera
- Non-linear associations between cardiovascular metabolic indices and metabolic-associated fatty liver disease: A cross-sectional study in the US population (2017–2020)
- Knockdown of USP7 alleviates atherosclerosis in ApoE-deficient mice by regulating EZH2 expression
- Utility of dairy microbiome as a tool for authentication and traceability
- Agriculture
- Enhancing faba bean (Vicia faba L.) productivity through establishing the area-specific fertilizer rate recommendation in southwest Ethiopia
- Impact of novel herbicide based on synthetic auxins and ALS inhibitor on weed control
- Perspectives of pteridophytes microbiome for bioremediation in agricultural applications
- Fertilizer application parameters for drip-irrigated peanut based on the fertilizer effect function established from a “3414” field trial
- Improving the productivity and profitability of maize (Zea mays L.) using optimum blended inorganic fertilization
- Application of leaf multispectral analyzer in comparison to hyperspectral device to assess the diversity of spectral reflectance indices in wheat genotypes
- Animal Sciences
- Knockdown of ANP32E inhibits colorectal cancer cell growth and glycolysis by regulating the AKT/mTOR pathway
- Development of a detection chip for major pathogenic drug-resistant genes and drug targets in bovine respiratory system diseases
- Exploration of the genetic influence of MYOT and MB genes on the plumage coloration of Muscovy ducks
- Transcriptome analysis of adipose tissue in grazing cattle: Identifying key regulators of fat metabolism
- Comparison of nutritional value of the wild and cultivated spiny loaches at three growth stages
- Transcriptomic analysis of liver immune response in Chinese spiny frog (Quasipaa spinosa) infected with Proteus mirabilis
- Disruption of BCAA degradation is a critical characteristic of diabetic cardiomyopathy revealed by integrated transcriptome and metabolome analysis
- Plant Sciences
- Effect of long-term in-row branch covering on soil microorganisms in pear orchards
- Photosynthetic physiological characteristics, growth performance, and element concentrations reveal the calcicole–calcifuge behaviors of three Camellia species
- Transcriptome analysis reveals the mechanism of NaHCO3 promoting tobacco leaf maturation
- Bioinformatics, expression analysis, and functional verification of allene oxide synthase gene HvnAOS1 and HvnAOS2 in qingke
- Water, nitrogen, and phosphorus coupling improves gray jujube fruit quality and yield
- Improving grape fruit quality through soil conditioner: Insights from RNA-seq analysis of Cabernet Sauvignon roots
- Role of Embinin in the reabsorption of nucleus pulposus in lumbar disc herniation: Promotion of nucleus pulposus neovascularization and apoptosis of nucleus pulposus cells
- Revealing the effects of amino acid, organic acid, and phytohormones on the germination of tomato seeds under salinity stress
- Combined effects of nitrogen fertilizer and biochar on the growth, yield, and quality of pepper
- Comprehensive phytochemical and toxicological analysis of Chenopodium ambrosioides (L.) fractions
- Impact of “3414” fertilization on the yield and quality of greenhouse tomatoes
- Exploring the coupling mode of water and fertilizer for improving growth, fruit quality, and yield of the pear in the arid region
- Metagenomic analysis of endophytic bacteria in seed potato (Solanum tuberosum)
- Antibacterial, antifungal, and phytochemical properties of Salsola kali ethanolic extract
- Exploring the hepatoprotective properties of citronellol: In vitro and in silico studies on ethanol-induced damage in HepG2 cells
- Enhanced osmotic dehydration of watermelon rind using honey–sucrose solutions: A study on pre-treatment efficacy and mass transfer kinetics
- Effects of exogenous 2,4-epibrassinolide on photosynthetic traits of 53 cowpea varieties under NaCl stress
- Comparative transcriptome analysis of maize (Zea mays L.) seedlings in response to copper stress
- An optimization method for measuring the stomata in cassava (Manihot esculenta Crantz) under multiple abiotic stresses
- Fosinopril inhibits Ang II-induced VSMC proliferation, phenotype transformation, migration, and oxidative stress through the TGF-β1/Smad signaling pathway
- Antioxidant and antimicrobial activities of Salsola imbricata methanolic extract and its phytochemical characterization
- Bioengineering and Biotechnology
- Absorbable calcium and phosphorus bioactive membranes promote bone marrow mesenchymal stem cells osteogenic differentiation for bone regeneration
- New advances in protein engineering for industrial applications: Key takeaways
- An overview of the production and use of Bacillus thuringiensis toxin
- Research progress of nanoparticles in diagnosis and treatment of hepatocellular carcinoma
- Bioelectrochemical biosensors for water quality assessment and wastewater monitoring
- PEI/MMNs@LNA-542 nanoparticles alleviate ICU-acquired weakness through targeted autophagy inhibition and mitochondrial protection
- Unleashing of cytotoxic effects of thymoquinone-bovine serum albumin nanoparticles on A549 lung cancer cells
- Erratum
- Erratum to “Investigating the association between dietary patterns and glycemic control among children and adolescents with T1DM”
- Erratum to “Activation of hypermethylated P2RY1 mitigates gastric cancer by promoting apoptosis and inhibiting proliferation”
- Retraction
- Retraction to “MiR-223-3p regulates cell viability, migration, invasion, and apoptosis of non-small cell lung cancer cells by targeting RHOB”
- Retraction to “A data mining technique for detecting malignant mesothelioma cancer using multiple regression analysis”
- Special Issue on Advances in Neurodegenerative Disease Research and Treatment
- Transplantation of human neural stem cell prevents symptomatic motor behavior disability in a rat model of Parkinson’s disease
- Special Issue on Multi-omics
- Inflammasome complex genes with clinical relevance suggest potential as therapeutic targets for anti-tumor drugs in clear cell renal cell carcinoma
- Gastroesophageal varices in primary biliary cholangitis with anti-centromere antibody positivity: Early onset?
