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Primary pleomorphic liposarcoma involving bilateral ovaries: Case report and literature review

  • Huan Chen , Jing Luo , Ke Zhang and Puxiang Chen EMAIL logo
Published/Copyright: March 21, 2025
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From the journal Open Life Sciences Volume 20 Issue 1

Abstract

Pleomorphic liposarcomas (PLPSs) commonly occur in the extremities or retroperitoneum. However, cases of primary PLPSs in the female reproductive system are rare, with only one reported case in the ovary. Herein, we describe the case of a patient with primary PLPS involving bilateral ovaries. She presented with a 2-month history of abdominal pain, and underwent total hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and excision of surface lesions on the bladder and rectum. Intraoperatively, nitrogen mustard (2%) was used to rinse the abdominal cavity. One week postoperatively, she was administered the first cycle of postoperative cisplatin chemotherapy for intraperitoneal heat infusion chemotherapy plus intravenous liposomal paclitaxel. Postoperative histopathological examination revealed primary PLPS involving both ovaries. Therefore, a doxorubicin liposomal chemotherapy regimen was administered according to the soft tissue sarcoma NCCN guidelines. The patient’s CA-125 levels decreased from 987 to 9.8 U/mL; however, after two chemotherapy sessions, she declined further treatment. The patient was still being followed-up and had no signs of recurrence at the time of writing this report. PLPS tends to be misdiagnosed and underdiagnosed due to its complex pathology and the lack of specific molecular markers. The disease is infrequent in the female reproductive system, and there is no consensus on its diagnostic and therapeutic guidelines. Herein, we summarized the findings of published case reports of PLPSs in organs of the female reproductive system to raise awareness of the disease and discussed its diagnosis, clinical treatment, and prognosis.

Keywords: ovarian cancer; pleomorphic liposarcoma; ovary; case report; sarcoma

1 Introduction

Soft tissue sarcoma (STS) is a malignant neoplasm that can occur anywhere in the body, including adipose, muscular, and fibrous tissues, as well as blood vessels [1]. Liposarcomas (LPSs) account for approximately 20% of all sarcomas [2]. According to the 2020 WHO classification, LPSs are classified into six types: well-differentiated and not otherwise specified LPSs (lipoma-like, inflammatory, and sclerosing), dedifferentiated LPS, myxoid LPS, pleomorphic LPS (PLPS), epithelioid LPS, and myxoid PLPS [3]. PLPS is a rare aggressive variant that accounts for only 5% of cases [4]. The extremities are the most common sites for PLPS (60%), followed by the chest and abdominal walls (15%), the retroperitoneum (5%), and other anatomical sites (20% in total). The local recurrence rate of PLPS is 30–45%, its metastatic rate is 28–43%, and the reported disease-specific mortality ranges from 28 to 35%. PLPSs metastasize most commonly to the lungs (75% of cases) and liver (25% of cases). An increased tumor size, a high mitotic rate, truncal and deep locations, and vascular invasion are associated with a poor prognosis [5]. Few case reports have focused on PLPS occurring in the female reproductive system. The pathogenesis, presentation, surgical treatment, and postoperative features of this disease remain unclear. Herein we present the case of a patient with PLPS involving both ovaries, who was treated with hyperthermic intraperitoneal chemotherapy. To our knowledge, this is the first reported case in medical literature.

2 Case representation

A 55-year-old postmenopausal woman (para 1) was referred to our hospital with a 2-month history of abdominal pain and unintentional weight loss of approximately 10 kg. She had a 16-year history of schizophrenia and was treated with antipsychotropic medications for several years. Her family history was significant for symptomatic uterine fibroid in her mother and two elder sisters, and her father had died of pancreatic cancer.

On admission, her vital parameters were within normal limits. A physical examination revealed a medium-textured lower abdominal mass extending two fingerbreadths above the umbilicus; the rest of the examination revealed no abnormalities. B-ultrasound showed a multilocular, mixed, solid, and cystic mass (Figure 1a), consistent with an ovarian origin tumor. Computed tomography (CT) scan revealed a 133 mm × 229 mm mass spanning the pelvic and abdominal cavities and closely adherent to the uterus, the upper bladder wall, and the anterior rectal wall, with unclear demarcations. There were no signs of pelvic effusion or lymphadenopathy in the abdominopelvic cavity (Figure 1b). CT of other parts of the body revealed no sign of oncological involvement. However, the patient’s CA-125 levels were elevated at 987 U/mL, while her HE4 levels were within normal limits. Fibrogastroscopy findings were indicative of chronic gastritis.

Figure 1 B-ultrasound and CT image of the patient. (a) B-ultrasound showed a multilocular, mixed solid, and cystic mass. (b)–(d) CT scan revealed a 133 mm × 229 mm mass located in the pelvic and abdominal cavity; it was closely adhered to the uterus, the upper bladder wall, and the anterior rectal wall, with unclear demarcation. The mass was solid and cystic, with septations and obvious enhancement; there were no signs of pelvic effusion, and no swollen lymph nodes were observed in the abdominopelvic cavity.
Figure 1

B-ultrasound and CT image of the patient. (a) B-ultrasound showed a multilocular, mixed solid, and cystic mass. (b)–(d) CT scan revealed a 133 mm × 229 mm mass located in the pelvic and abdominal cavity; it was closely adhered to the uterus, the upper bladder wall, and the anterior rectal wall, with unclear demarcation. The mass was solid and cystic, with septations and obvious enhancement; there were no signs of pelvic effusion, and no swollen lymph nodes were observed in the abdominopelvic cavity.

We suspected she had a clinically advanced ovarian cancer (OC) due to the pelvic mass on pelvic CT and ultrasound, along with the significant increase in CA125 levels. The patient then underwent an exploratory laparotomy. Intraoperatively, approximately 1,000 mL of yellowish ascitic fluid was found in the abdominal cavity; no abnormalities were observed in the liver, gallbladder, spleen, kidneys, stomach, diaphragm, and small intestine. The mass was (20 cm) mixed cystic and solid, brittle; the solid part of the mass had tofu brain-like changes, with evidence of invasion of the lower part of the descending colon, the entire length of the sigmoid colon, and the plasma membrane of the upper part of the rectum; the right fallopian tube was invaded by the mass and structurally destroyed; the peritoneum over the right pelvic wall was also invaded and thickened. The uterus was in a posterior position; the size and texture of the uterus were grossly normal; however, its surface had multiple miliary nodules. The right ovary appeared only slightly enlarged with a smooth outer surface. The peritoneal covering of the bladder was invaded by the mass, with diffuse thickening and an obvious metastatic mass measuring 6 cm × 5 cm. The ischiorectal fossa had multiple metastatic miliary nodules, while no nodules were observed in the paracolic grooves. A frozen-section biopsy revealed the mass malignancy. The patient was diagnosed with stage Ⅲc OC intraoperatively; consequently, the surgeon performed a total hysterectomy, left salpingo-oophorectomy, and omentectomy. Furthermore, both the bladder and rectal surface lesions were all meticulously excised. Lymph node dissection was not performed due to considerations of late staging and the implications on quality of life. During the operation, nitrogen mustard (2%) was used to rinse the abdominal cavity. The patient had an uneventful recovery. One week postoperatively, hyperthermic intraperitoneal cisplatin (110 mg) chemotherapy plus intravenous liposomal paclitaxel (175 mg/m2) chemotherapy were administered once while awaiting the pathology results. After this cycle of chemotherapy, the patient’s CA-125 level reduced to 21.1 U/mL. One month later, the pathology suggests the presence of PLPS in both ovaries, as well as the bladder and rectal surface lesions; however, the omentum and ascitic fluid were free of tumor cells. The chemotherapy regimen was then changed to liposomal doxorubicin (2 mg/kg). The patient’s CA-125 level dropped further to 9.8 U/mL after the second chemotherapy. The patient had no complaints during chemotherapy sessions; however, for personal reasons, she declined further treatment. At the time of writing this report, the patient had been under periodic follow-up examinations and had had no signs of recurrence for 22 months. Further CT scans revealed no abnormalities, and her CA125 level was 7.52 U/mL.

The gross specimen of the left ovarian mass was approximately 20 cm × 14 cm × 8 cm in size. It appeared multilocular and exhibited a combination of cystic, solid, and partly solid areas with a tofu brain-like texture. The mass was friable and contained yellow mucus-like material inside the capsule. The right ovary had the same features as the left one upon dissection.

The pathological findings of both ovaries revealed rounded, irregular, and signet-ring adipoblasts, as well as typical pleomorphic adipoblasts with large and deeply stained nuclei, along with multivacuolar interstitial changes in lipogenic origin areas, without normal ovarian tissues (Figure 2). The non-lipogenic areas contained atypical multinucleated giant cells of various shapes with eosinophilic or vacuolated cytoplasms. In addition, malignant neoplastic components were found in both the bladder and rectal surface lesions.

Figure 2 Pathology image of the patient. (a) HE showed rounded, irregular, and signet-ring adipoblasts, as well as typical pleomorphic adipoblasts with large nuclei and deeply stained nuclei (red arrow). (b) Multivacuolar changes in the interstitium were seen in areas of lipogenic origin; atypical multinucleated giant cells of various shapes with eosinophilic or vacuolated cytoplasm are seen in non-lipogenic areas (green arrow).
Figure 2

Pathology image of the patient. (a) HE showed rounded, irregular, and signet-ring adipoblasts, as well as typical pleomorphic adipoblasts with large nuclei and deeply stained nuclei (red arrow). (b) Multivacuolar changes in the interstitium were seen in areas of lipogenic origin; atypical multinucleated giant cells of various shapes with eosinophilic or vacuolated cytoplasm are seen in non-lipogenic areas (green arrow).

Immunohistochemistry showed positive staining for P53 (70%+), vimentin, Ki-67 (80%+), and CD99, and partial staining for CDK4. The results were negative for S100 and MDM2.

Next-generation sequencing analysis results revealed five somatic mutations, including TP53 p.S241F, ARAF p.V143F, APC p.T185Ffs*4, EPHB1 p.D848E, and ABL2 p.P986L. The tumor mutational burden was 3.84 mutations/Mb. A microsatellite instability analysis revealed microsatellite stability. No germline variants were found; however, the following genes were fused AKAP8L-BRD4(EX2:EX2), FBXL7-FAM105B(EX1:EX3), and CYP7B1-UCKL1(EX1:EX2).

  1. Informed consent: Informed consent has been obtained from all individuals included in this study.

  2. 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 Ethics Committee of the Second Xiangya Hospital affiliated to Central South University.

3 Discussion

The gold standard for diagnosing PLPS is the presence of polymorphic lipoblasts [6]. However, polymorphic lipoblasts need to be distinguished from the “homogeneous lipoblastoid differentiation” cell types seen in dedifferentiated LPSs. Differentiating PLPSs from other high-grade sarcomas or high-grade carcinomas may be difficult due to the complex morphology of these tumors. PLPS tumors exhibit variable distribution of pleomorphic lipoblasts in different regions, and identifying them poses a challenge. Moreover, the tumor morphologies vary between cell-rich pleomorphic sarcomatoid, epithelioid, muco-fibrosarcomatoid, and scattered foci of coagulomatous necrosis [7]. Ultrasound PLPS features exhibit a mixed hyperechoic and hypoechoic pattern reminiscent of gyri [8]; the ultrasound images of our patient had such an appearance. The molecular features of PLPSs include 13q14.2-5 (containing RB1) deletions in 50% of patients, TP53 mutations, and NF1 deletions [5,6]. Our patient had mutations in other genes in addition to the TP53 mutation. However, the p53 mutation is not seen in other LPS subtypes and is considered to be the cause of chemoresistance in PLPS [9].

According to the STS NCCN guidelines [10], a wide surgical resection with negative tumor margins is a potentially curative strategy for non-metastatic primary retroperitoneal or intraperitoneal sarcomas (R0 resection/R1 resection recommendation). After surgery, adjuvant systemic therapy, including radiation and chemotherapy, should be considered for all patients with metastatic disease risks based on intraoperative or clinicopathological findings. However, the expert panel discouraged adjuvant radiation therapy (RT) for retroperitoneal/intra-abdominal STSs except for highly selected cases, in which local recurrence would cause undue morbidity. A previous study showed that R1 resection was associated with a two-fold higher risk of recurrence, while adjuvant chemotherapy appeared to improve the relapse-free survival (RFS) in patients with STSs of the extremities. Postoperative doxorubicin-based chemotherapy significantly improved recurrence-free survival and overall survival in female patients with R1 resection. Although the mass was excised to the extent that it was invisible to the naked eye intraoperatively, we could not guarantee that there would be no microscopic residue and believe that the resection only reached R1. Therefore, we administered postoperative adjuvant chemotherapy to the patient and changed the regime according to the routine pathology. However, the evidence regarding whether chemotherapy is beneficial for overall patient survival is conflicting [10]. Moreover, due to its low incidence, there is no evidence on chemotherapy being beneficial for survival in women with PLPS in the female reproductive system.

Only a few cases of PLPS originating in the female reproductive system have been reported. The pathogenesis, surgical treatment, and postoperative features of PLPS remain unclear. A search of the PubMed, Embase, WOS, and CNKI databases yielded six cases of PLPS in the uterus [11–16], two in the cervix [17,18], one in the perineal corpus [19], one in the fallopian tube [20], and one in the ovary [21]. Table 1 summarizes all published PLPS cases in the female reproductive system: the patients age ranged from 24 to 70 years, with a median age of 50.8 years; the presenting symptoms included abdominal pain, dysuria, urinary retention, anorexia, increasing abdominal girth, vaginal bleeding, uterine mass, and a perineal lump. Most patients underwent surgical resections, radical/total hysterectomy along with bilateral adnexectomy, with or without lymphadenectomy. Adjuvant therapy included chemotherapy, RT, and targeted therapy. Most patients tested positive for S-100 and vimentin; however, our patient was only positive for vimentin. Negative expressions of MDM2 and CDK4 have been proposed as markers for PLPS from well-differentiated LPSs and dedifferentiated LPSs [22]; however, CDK4 was partially positive and MDM2 was negative in our case.

Table 1

The clinical character of all primary PLPS originated from female genital system

References Year Site Age symptom Size Surgery IHC NGS Adjuvant therapy Recurrence Follow up
Valenciaga [11] 2021 Uterus 70 Acute abdominal pain 7.0 × 6.0 × 2.1 cm(uterine anterior) 8.0 × 6.5 × 4.0 cm(uterine posterior) TAH + BSO(first) right PH(recurrence) CD10 cyclin-D1 IQGAP-NTRK3 C(doxorubicin) + T(olaratumab), T(Entrectinib live recurrence), R(neck recurrence) 15 m (liver), 18 m (neck) 49 m
Schoolmeester [12] 2016 Uterus 70 Dysuria and urinary retention 9.0 × 8.0 × 7.5 cm RH + BSO + PLND S-100 TP53, PTEN, RB1, FAT1, TERT C(gemcitabine + docetaxel) Died, One circle, chemotherapy
McDonald [13] 2011 Uterus 49 Uterine mass 10.5 cm TAH + BSO + appendectomy S-100, MDM2 Not, Report none no 12 m
Fadare [14] 2011 Uterus 62 Acute abdominal pain 7 × 6.3 × 4.5 cm TAH + BSO + reimplantation of a resected left ureter with stent placement Not report Not Report C(gemcitabine + taxotere) after resction of recurrent lesion 2 m anterior abdominal wall Lost
Nodule of anterior abdominal wall resection(recurrence)
Levine [15] 2003 Uterus 62 Lower abdominal pain, anorexia, and increasing abdominal girth 15 cm RH + BSO + PLND paraaortic lymph node dissection, and omentectomy S-100 vimentin ER Not Report R after recurrence 9 m multiple pelvic nodules Not report
Sośnik [16] 2006 Uterus 71 Vaginal bleed ing 10.8 × 12.9 × 6.0 cm TAH + BSO S-100 Not Report R No 96 m
Tandon [17] 2017 Cervix 24 None 6 cm None S-100 TP53,ALK C(cisplatin + Etoposide) No report died shortly
Obafunwa [18] 1990 Cervix 45 Not available 9 cm Not available Not available Not available Not available 6 m Not available
Gondos [19] 1982 Perineum 31 Perineal lump 6 × 5 × 4 cm TPE + perineum + vulva + posterolateral vagina resection(first) Not report Not report C(Adriamycin)after recurrence 8 m 14 m
Resection of left vagina(recurrence)
Wang [20] 2017 Fallopian Tube 47 Dull pain in the left lower quadrants of the abdomen 10 × 10 × 9 cm TAH + BSO Ki-67 Not report C(Ifosfamide + epirubicin) 10 m Left lower quadrants of the abdomen 11 m
Gao [21] 2013 Left ovary 28 Lower abdominal pain 10 cm Left salpingo-oopherectomy S-100 vimentin Not report C No 96 m

TPE: Total pelvic exenteration; RH, radical hysterectomy; TAH, total hysterectomy; BSO, bilateral salpingo-oopherectomy; PLND, pelvic lymph node dissection; PH: partial hepatectomy; C, chemotherapy; R, radiotherapy; T: Targeted therapy; IHC: Immunohistochemistry; NGS: Next generation sequencing.

No standard treatments exist for LPSs occurring at rare sites, including those in the female reproductive system. Among the treatment modalities mentioned in the 11 reported cases we retrieved, one patient underwent surgery, chemotherapy, radiotherapy, and targeted therapy; another one received only surgical treatment; two patients received surgery and radiotherapy; five patients received surgery and chemotherapy; one patient received only chemotherapy; however, we could not ascertain the treatment information for the other patient. Overall, surgery combined with adjuvant therapy seems to be the mainstream treatment approach, and patients who received chemotherapy alone have a poor prognosis. Although adjuvant RT following surgery is discouraged for retroperitoneal or intra-abdominal sarcomas, two of the patients in the published case reports received adjuvant radiotherapy. Most of the women in the reports received chemotherapy, but only three underwent the preferred chemotherapy regimen based on the NCCN guidelines for STS (adriamycin, ifosfamide, and epirubicin); the remaining patients received other recommended NCCN chemotherapy regimens for recurrent OC (such as cisplatin and etoposide, gemcitabine and docetaxel, or gemcitabine and taxotere). In the case of our patient, the first chemotherapy regimen was based on the NCCN guidelines for OC [23], while awaiting the results of the pathological examination. Once the pathology results were consistent with PLPS, the chemotherapy regimen was replaced with doxorubicin. The evidence showing that postoperative chemotherapy improves the RFS of patients is based on patients with STSs of the extremities [10]. Therefore, whether postoperative chemotherapy is beneficial for patients with PLPS of organs of the female reproductive system remains unclear. Doxorubicin alone or in combination with ifosfamide is the preferred choice for most STSs; however, different LPS subtypes have different sensitivities to chemotherapeutic agents [24], and most studies have been conducted with patients with PLPSs at frequently occurring sites. Therefore, whether these drugs are effective for PLPS in rare sites is unknown. Our patient was free from relapses 22 months after stopping the treatment. Therefore, we speculate that intraperitoneal heat-perfusion chemotherapy may be equally effective in ovarian malignancies of mesenchymal origin, with some clinical implications. For advanced PLPS, eribulin and trabectedin have shown promising activity in comparison to conventional therapy (doxorubicin- and gemcitabine-based regimes) [25].

In conclusion, prospective studies with relatively large samples are needed to determine whether the surgical approach and postoperative treatment for PLPSs originating in the female reproductive system should be managed according to STS or corresponding malignant tumor guidelines for the female reproductive system.

# This author contributed equally to this work.

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Acknowledgements

The authors would like to express their heartfelt thanks to all the people who have ever helped them in this article.

  1. Funding information: This research was funded by Zhuzhou City’s 2024 socialized funding project.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and consented to its submission to the journal, reviewed all the results and approved the final version of the manuscript. Huan Chen: conceptualization, writing – original draft; Jing Luo: writing – original draft, investigation; Ke Zhang: data acquisition; Puxiang Chen: writing – review & editing, supervision.

  3. Conflict of interest: Authors state no conflict of interest.

  4. 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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Received: 2024-08-28
Revised: 2024-12-21
Accepted: 2025-01-31
Published Online: 2025-03-21

© 2025 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  38. Stigmasterol alleviates endplate chondrocyte degeneration through inducing mitophagy by enhancing PINK1 mRNA acetylation via the ESR1/NAT10 axis
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  45. Transfer RNA-derived fragment tRF-36 modulates varicose vein progression via human vascular smooth muscle cell Notch signaling
  46. RTA-408 attenuates the hepatic ischemia reperfusion injury in mice possibly by activating the Nrf2/HO-1 signaling pathway
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  61. Metagenomic next-generation sequencing of alveolar lavage fluid improves the detection of pulmonary infection
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  66. Modulating the tumor microenvironment: The role of traditional Chinese medicine in improving lung cancer treatment
  67. Alterations of metabolites related to microbiota–gut–brain axis in plasma of colon cancer, esophageal cancer, stomach cancer, and lung cancer patients
  68. Research on individualized drug sensitivity detection technology based on bio-3D printing technology for precision treatment of gastrointestinal stromal tumors
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  72. Diagnosis of secondary tuberculosis infection in an asymptomatic elderly with cancer using next-generation sequencing: Case report
  73. Hesperidin and its zinc(ii) complex enhance osteoblast differentiation and bone formation: In vitro and in vivo evaluations
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  75. Anti-arthritic, immunomodulatory, and inflammatory regulation by the benzimidazole derivative BMZ-AD: Insights from an FCA-induced rat model
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  78. Evaluation and application analysis of animal models of PIPNP based on data mining
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  80. Fabrication of zinc oxide nanoparticles using Ruellia tuberosa leaf extract induces apoptosis through P53 and STAT3 signalling pathways in prostate cancer cells
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  87. Electroacupuncture alleviates sciatic nerve injury in sciatica rats by regulating BDNF and NGF levels, myelin sheath degradation, and autophagy
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  94. SATB2 promotes humeral fracture healing in rats by activating the PI3K/AKT pathway
  95. Overexpression of the ferroptosis-related gene, NFS1, corresponds to gastric cancer growth and tumor immune infiltration
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  102. Pulmonary cryptococcosis with headache as the first presentation: A case report
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  107. Experimental study on salmon demineralized bone matrix loaded with recombinant human bone morphogenetic protein-2: In vitro and in vivo study
  108. A case of IgA nephropathy treated with a combination of telitacicept and half-dose glucocorticoids
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  111. Combination of immunotherapy and whole-brain radiotherapy on prognosis of patients with multiple brain metastases: A retrospective cohort study
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  113. Research progress on the impact of curcumin on immune responses in breast cancer
  114. Biogenic Cu/Ni nanotherapeutics from Descurainia sophia (L.) Webb ex Prantl seeds for the treatment of lung cancer
  115. Dapagliflozin attenuates atrial fibrosis via the HMGB1/RAGE pathway in atrial fibrillation rats
  116. Glycitein alleviates inflammation and apoptosis in keratinocytes via ROS-associated PI3K–Akt signalling pathway
  117. ADH5 inhibits proliferation but promotes EMT in non-small cell lung cancer cell through activating Smad2/Smad3
  118. Apoptotic efficacies of AgNPs formulated by Syzygium aromaticum leaf extract on 32D-FLT3-ITD human leukemia cell line with PI3K/AKT/mTOR signaling pathway
  119. Novel cuproptosis-related genes C1QBP and PFKP identified as prognostic and therapeutic targets in lung adenocarcinoma
  120. Bee venom promotes exosome secretion and alters miRNA cargo in T cells
  121. Treatment of pure red cell aplasia in a chronic kidney disease patient with roxadustat: A case report
  122. Comparative bioinformatics analysis of the Wnt pathway in breast cancer: Selection of novel biomarker panels associated with ER status
  123. Kynurenine facilitates renal cell carcinoma progression by suppressing M2 macrophage pyroptosis through inhibition of CASP1 cleavage
  124. RFX5 promotes the growth, motility, and inhibits apoptosis of gastric adenocarcinoma cells through the SIRT1/AMPK axis
  125. ALKBH5 exacerbates early cardiac damage after radiotherapy for breast cancer via m6A demethylation of TLR4
  126. Phytochemicals of Roman chamomile: Antioxidant, anti-aging, and whitening activities of distillation residues
  127. Circadian gene Cry1 inhibits the tumorigenicity of hepatocellular carcinoma by the BAX/BCL2-mediated apoptosis pathway
  128. The TNFR-RIPK1/RIPK3 signalling pathway mediates the effect of lanthanum on necroptosis of nerve cells
  129. Longitudinal monitoring of autoantibody dynamics in patients with early-stage non-small-cell lung cancer undergoing surgery
  130. The potential role of rutin, a flavonoid, in the management of cancer through modulation of cell signaling pathways
  131. Construction of pectinase gene engineering microbe and its application in tobacco sheets
  132. Construction of a microbial abundance prognostic scoring model based on intratumoral microbial data for predicting the prognosis of lung squamous cell carcinoma
  133. Sepsis complicated by haemophagocytic lymphohistiocytosis triggered by methicillin-resistant Staphylococcus aureus and human herpesvirus 8 in an immunocompromised elderly patient: A case report
  134. Sarcopenia in liver transplantation: A comprehensive bibliometric study of current research trends and future directions
  135. Advances in cancer immunotherapy and future directions in personalized medicine
  136. Can coronavirus disease 2019 affect male fertility or cause spontaneous abortion? A two-sample Mendelian randomization analysis
  137. Heat stroke associated with novel leukaemia inhibitory factor receptor gene variant in a Chinese infant
  138. PSME2 exacerbates ulcerative colitis by disrupting intestinal barrier function and promoting autophagy-dependent inflammation
  139. Hyperosmolar hyperglycemic state with severe hypernatremia coexisting with central diabetes insipidus: A case report and literature review
  140. Efficacy and mechanism of escin in improving the tissue microenvironment of blood vessel walls via anti-inflammatory and anticoagulant effects: Implications for clinical practice
  141. Merkel cell carcinoma: Clinicopathological analysis of three patients and literature review
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  143. Lipoxin A4 improves myocardial ischemia/reperfusion injury through the Notch1-Nrf2 signaling pathway
  144. High levels of EPHB2 expression predict a poor prognosis and promote tumor progression in endometrial cancer
  145. Knockdown of SHP-2 delays renal tubular epithelial cell injury in diabetic nephropathy by inhibiting NLRP3 inflammasome-mediated pyroptosis
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  147. Concomitant gastric carcinoma and primary hepatic angiosarcoma in a patient: A case report
  148. Ecology and Environmental Science
  149. Optimization and comparative study of Bacillus consortia for cellulolytic potential and cellulase enzyme activity
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  151. Epidemiological characteristics and risk factors analysis of multidrug-resistant tuberculosis among tuberculosis population in Huzhou City, Eastern China
  152. Indices of human impacts on landscapes: How do they reflect the proportions of natural habitats?
  153. Genetic analysis of the Siberian flying squirrel population in the northern Changbai Mountains, Northeast China: Insights into population status and conservation
  154. Diversity and environmental drivers of Suillus communities in Pinus sylvestris var. mongolica forests of Inner Mongolia
  155. Global assessment of the fate of nitrogen deposition in forest ecosystems: Insights from 15N tracer studies
  156. Fungal and bacterial pathogenic co-infections mainly lead to the assembly of microbial community in tobacco stems
  157. Influencing of coal industry related airborne particulate matter on ocular surface tear film injury and inflammatory factor expression in Sprague-Dawley rats
  158. Temperature-dependent development, predation, and life table of Sphaerophoria macrogaster (Thomson) (Diptera: Syrphidae) feeding on Myzus persicae (Sulzer) (Homoptera: Aphididae)
  159. Eleonora’s falcon trophic interactions with insects within its breeding range: A systematic review
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  162. Variation in flower frost tolerance among seven apple cultivars and transcriptome response patterns in two contrastingly frost-tolerant selected cultivars
  163. Heritability of durable resistance to stripe rust in bread wheat (Triticum aestivum L.)
  164. Molecular mechanism of follicular development in laying hens based on the regulation of water metabolism
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  167. Plant Sciences
  168. Hairpin in a haystack: In silico identification and characterization of plant-conserved microRNA in Rafflesiaceae
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  174. Effects of Piriformospora indica and arbuscular mycorrhizal fungus on growth and physiology of Moringa oleifera under low-temperature stress
  175. Effects of different sources of potassium fertiliser on yield, fruit quality and nutrient absorption in “Harward” kiwifruit (Actinidia deliciosa)
  176. Comparative efficiency and residue levels of spraying programs against powdery mildew in grape varieties
  177. The DREB7 transcription factor enhances salt tolerance in soybean plants under salt stress
  178. Using plant electrical signals of water hyacinth (Eichhornia crassipes) for water pollution monitoring
  179. Food Science
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  181. Review on role of honey in disease prevention and treatment through modulation of biological activities
  182. Computational analysis of polymorphic residues in maltose and maltotriose transporters of a wild Saccharomyces cerevisiae strain
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  184. Liupao tea aqueous extract alleviates dextran sulfate sodium-induced ulcerative colitis in rats by modulating the gut microbiota
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  186. Polyphenolic spectrum of cornelian cherry fruits and their health-promoting effect
  187. Optimizing the encapsulation of the refined extract of squash peels for functional food applications: A sustainable approach to reduce food waste
  188. Advancements in curcuminoid formulations: An update on bioavailability enhancement strategies curcuminoid bioavailability and formulations
  189. Impact of saline sprouting on antioxidant properties and bioactive compounds in chia seeds
  190. The dilemma of food genetics and improvement
  191. Bioengineering and Biotechnology
  192. Impact of hyaluronic acid-modified hafnium metalorganic frameworks containing rhynchophylline on Alzheimer’s disease
  193. Emerging patterns in nanoparticle-based therapeutic approaches for rheumatoid arthritis: A comprehensive bibliometric and visual analysis spanning two decades
  194. Application of CRISPR/Cas gene editing for infectious disease control in poultry
  195. Preparation of hafnium nitride-coated titanium implants by magnetron sputtering technology and evaluation of their antibacterial properties and biocompatibility
  196. Preparation and characterization of lemongrass oil nanoemulsion: Antimicrobial, antibiofilm, antioxidant, and anticancer activities
  197. Corrigendum
  198. Corrigendum to “Utilization of convolutional neural networks to analyze microscopic images for high-throughput screening of mesenchymal stem cells”
  199. Corrigendum to “Effects of Ire1 gene on virulence and pathogenicity of Candida albicans”
  200. Retraction
  201. Retraction of “Down-regulation of miR-539 indicates poor prognosis in patients with pancreatic cancer”
https://doi.org/10.1515/biol-2025-1068
Keywords for this article
ovarian cancer; pleomorphic liposarcoma; ovary; case report; sarcoma
Creative Commons
BY 4.0

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  4. Comparative analysis of inflammatory biomarkers for the diagnosis of neonatal sepsis: IL-6, IL-8, SAA, CRP, and PCT
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  35. Clusterin activates the heat shock response via the PI3K/Akt pathway to protect cardiomyocytes from high-temperature-induced apoptosis
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  37. Low-pressure exposure influences the development of HAPE
  38. Stigmasterol alleviates endplate chondrocyte degeneration through inducing mitophagy by enhancing PINK1 mRNA acetylation via the ESR1/NAT10 axis
  39. AKAP12, mediated by transcription factor 21, inhibits cell proliferation, metastasis, and glycolysis in lung squamous cell carcinoma
  40. Association between PAX9 or MSX1 gene polymorphism and tooth agenesis risk: A meta-analysis
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  42. Case of nasopharyngeal tuberculosis complicated with cervical lymph node and pulmonary tuberculosis
  43. p-Cymene inhibits pro-fibrotic and inflammatory mediators to prevent hepatic dysfunction
  44. GFPT2 promotes paclitaxel resistance in epithelial ovarian cancer cells via activating NF-κB signaling pathway
  45. Transfer RNA-derived fragment tRF-36 modulates varicose vein progression via human vascular smooth muscle cell Notch signaling
  46. RTA-408 attenuates the hepatic ischemia reperfusion injury in mice possibly by activating the Nrf2/HO-1 signaling pathway
  47. Decreased serum TIMP4 levels in patients with rheumatoid arthritis
  48. Sirt1 protects lupus nephritis by inhibiting the NLRP3 signaling pathway in human glomerular mesangial cells
  49. Sodium butyrate aids brain injury repair in neonatal rats
  50. Interaction of MTHFR polymorphism with PAX1 methylation in cervical cancer
  51. Convallatoxin inhibits proliferation and angiogenesis of glioma cells via regulating JAK/STAT3 pathway
  52. The effect of the PKR inhibitor, 2-aminopurine, on the replication of influenza A virus, and segment 8 mRNA splicing
  53. Effects of Ire1 gene on virulence and pathogenicity of Candida albicans
  54. Small cell lung cancer with small intestinal metastasis: Case report and literature review
  55. GRB14: A prognostic biomarker driving tumor progression in gastric cancer through the PI3K/AKT signaling pathway by interacting with COBLL1
  56. 15-Lipoxygenase-2 deficiency induces foam cell formation that can be restored by salidroside through the inhibition of arachidonic acid effects
  57. FTO alleviated the diabetic nephropathy progression by regulating the N6-methyladenosine levels of DACT1
  58. Clinical relevance of inflammatory markers in the evaluation of severity of ulcerative colitis: A retrospective study
  59. Zinc valproic acid complex promotes osteoblast differentiation and exhibits anti-osteoporotic potential
  60. Primary pulmonary synovial sarcoma in the bronchial cavity: A case report
  61. Metagenomic next-generation sequencing of alveolar lavage fluid improves the detection of pulmonary infection
  62. Uterine tumor resembling ovarian sex cord tumor with extensive rhabdoid differentiation: A case report
  63. Genomic analysis of a novel ST11(PR34365) Clostridioides difficile strain isolated from the human fecal of a CDI patient in Guizhou, China
  64. Effects of tiered cardiac rehabilitation on CRP, TNF-α, and physical endurance in older adults with coronary heart disease
  65. Changes in T-lymphocyte subpopulations in patients with colorectal cancer before and after acupoint catgut embedding acupuncture observation
  66. Modulating the tumor microenvironment: The role of traditional Chinese medicine in improving lung cancer treatment
  67. Alterations of metabolites related to microbiota–gut–brain axis in plasma of colon cancer, esophageal cancer, stomach cancer, and lung cancer patients
  68. Research on individualized drug sensitivity detection technology based on bio-3D printing technology for precision treatment of gastrointestinal stromal tumors
  69. CEBPB promotes ulcerative colitis-associated colorectal cancer by stimulating tumor growth and activating the NF-κB/STAT3 signaling pathway
  70. Oncolytic bacteria: A revolutionary approach to cancer therapy
  71. A de novo meningioma with rapid growth: A possible malignancy imposter?
  72. Diagnosis of secondary tuberculosis infection in an asymptomatic elderly with cancer using next-generation sequencing: Case report
  73. Hesperidin and its zinc(ii) complex enhance osteoblast differentiation and bone formation: In vitro and in vivo evaluations
  74. Research progress on the regulation of autophagy in cardiovascular diseases by chemokines
  75. Anti-arthritic, immunomodulatory, and inflammatory regulation by the benzimidazole derivative BMZ-AD: Insights from an FCA-induced rat model
  76. Immunoassay for pyruvate kinase M1/2 as an Alzheimer’s biomarker in CSF
  77. The role of HDAC11 in age-related hearing loss: Mechanisms and therapeutic implications
  78. Evaluation and application analysis of animal models of PIPNP based on data mining
  79. Therapeutic approaches for liver fibrosis/cirrhosis by targeting pyroptosis
  80. Fabrication of zinc oxide nanoparticles using Ruellia tuberosa leaf extract induces apoptosis through P53 and STAT3 signalling pathways in prostate cancer cells
  81. Haplo-hematopoietic stem cell transplantation and immunoradiotherapy for severe aplastic anemia complicated with nasopharyngeal carcinoma: A case report
  82. Modulation of the KEAP1-NRF2 pathway by Erianin: A novel approach to reduce psoriasiform inflammation and inflammatory signaling
  83. The expression of epidermal growth factor receptor 2 and its relationship with tumor-infiltrating lymphocytes and clinical pathological features in breast cancer patients
  84. Innovations in MALDI-TOF Mass Spectrometry: Bridging modern diagnostics and historical insights
  85. BAP1 complexes with YY1 and RBBP7 and its downstream targets in ccRCC cells
  86. Hypereosinophilic syndrome with elevated IgG4 and T-cell clonality: A report of two cases
  87. Electroacupuncture alleviates sciatic nerve injury in sciatica rats by regulating BDNF and NGF levels, myelin sheath degradation, and autophagy
  88. Polydatin prevents cholesterol gallstone formation by regulating cholesterol metabolism via PPAR-γ signaling
  89. RNF144A and RNF144B: Important molecules for health
  90. Analysis of the detection rate and related factors of thyroid nodules in the healthy population
  91. Artesunate inhibits hepatocellular carcinoma cell migration and invasion through OGA-mediated O-GlcNAcylation of ZEB1
  92. Endovascular management of post-pancreatectomy hemorrhage caused by a hepatic artery pseudoaneurysm: Case report and review of the literature
  93. Efficacy and safety of anti-PD-1/PD-L1 antibodies in patients with relapsed refractory diffuse large B-cell lymphoma: A meta-analysis
  94. SATB2 promotes humeral fracture healing in rats by activating the PI3K/AKT pathway
  95. Overexpression of the ferroptosis-related gene, NFS1, corresponds to gastric cancer growth and tumor immune infiltration
  96. Understanding risk factors and prognosis in diabetic foot ulcers
  97. Atractylenolide I alleviates the experimental allergic response in mice by suppressing TLR4/NF-kB/NLRP3 signalling
  98. FBXO31 inhibits the stemness characteristics of CD147 (+) melanoma stem cells
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  100. Inhibiting CXCR6 promotes senescence of activated hepatic stellate cells with limited proinflammatory SASP to attenuate hepatic fibrosis
  101. Cadmium toxicity, health risk and its remediation using low-cost biochar adsorbents
  102. Pulmonary cryptococcosis with headache as the first presentation: A case report
  103. Solitary pulmonary metastasis with cystic airspaces in colon cancer: A rare case report
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  105. Morphometric analysis and immunobiological investigation of Indigofera oblongifolia on the infected lung with Plasmodium chabaudi
  106. The NuA4/TIP60 histone-modifying complex and Hr78 modulate the Lobe2 mutant eye phenotype
  107. Experimental study on salmon demineralized bone matrix loaded with recombinant human bone morphogenetic protein-2: In vitro and in vivo study
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  109. Analgesic and toxicological evaluation of cannabidiol-rich Moroccan Cannabis sativa L. (Khardala variety) extract: Evidence from an in vivo and in silico study
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  111. Combination of immunotherapy and whole-brain radiotherapy on prognosis of patients with multiple brain metastases: A retrospective cohort study
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  115. Dapagliflozin attenuates atrial fibrosis via the HMGB1/RAGE pathway in atrial fibrillation rats
  116. Glycitein alleviates inflammation and apoptosis in keratinocytes via ROS-associated PI3K–Akt signalling pathway
  117. ADH5 inhibits proliferation but promotes EMT in non-small cell lung cancer cell through activating Smad2/Smad3
  118. Apoptotic efficacies of AgNPs formulated by Syzygium aromaticum leaf extract on 32D-FLT3-ITD human leukemia cell line with PI3K/AKT/mTOR signaling pathway
  119. Novel cuproptosis-related genes C1QBP and PFKP identified as prognostic and therapeutic targets in lung adenocarcinoma
  120. Bee venom promotes exosome secretion and alters miRNA cargo in T cells
  121. Treatment of pure red cell aplasia in a chronic kidney disease patient with roxadustat: A case report
  122. Comparative bioinformatics analysis of the Wnt pathway in breast cancer: Selection of novel biomarker panels associated with ER status
  123. Kynurenine facilitates renal cell carcinoma progression by suppressing M2 macrophage pyroptosis through inhibition of CASP1 cleavage
  124. RFX5 promotes the growth, motility, and inhibits apoptosis of gastric adenocarcinoma cells through the SIRT1/AMPK axis
  125. ALKBH5 exacerbates early cardiac damage after radiotherapy for breast cancer via m6A demethylation of TLR4
  126. Phytochemicals of Roman chamomile: Antioxidant, anti-aging, and whitening activities of distillation residues
  127. Circadian gene Cry1 inhibits the tumorigenicity of hepatocellular carcinoma by the BAX/BCL2-mediated apoptosis pathway
  128. The TNFR-RIPK1/RIPK3 signalling pathway mediates the effect of lanthanum on necroptosis of nerve cells
  129. Longitudinal monitoring of autoantibody dynamics in patients with early-stage non-small-cell lung cancer undergoing surgery
  130. The potential role of rutin, a flavonoid, in the management of cancer through modulation of cell signaling pathways
  131. Construction of pectinase gene engineering microbe and its application in tobacco sheets
  132. Construction of a microbial abundance prognostic scoring model based on intratumoral microbial data for predicting the prognosis of lung squamous cell carcinoma
  133. Sepsis complicated by haemophagocytic lymphohistiocytosis triggered by methicillin-resistant Staphylococcus aureus and human herpesvirus 8 in an immunocompromised elderly patient: A case report
  134. Sarcopenia in liver transplantation: A comprehensive bibliometric study of current research trends and future directions
  135. Advances in cancer immunotherapy and future directions in personalized medicine
  136. Can coronavirus disease 2019 affect male fertility or cause spontaneous abortion? A two-sample Mendelian randomization analysis
  137. Heat stroke associated with novel leukaemia inhibitory factor receptor gene variant in a Chinese infant
  138. PSME2 exacerbates ulcerative colitis by disrupting intestinal barrier function and promoting autophagy-dependent inflammation
  139. Hyperosmolar hyperglycemic state with severe hypernatremia coexisting with central diabetes insipidus: A case report and literature review
  140. Efficacy and mechanism of escin in improving the tissue microenvironment of blood vessel walls via anti-inflammatory and anticoagulant effects: Implications for clinical practice
  141. Merkel cell carcinoma: Clinicopathological analysis of three patients and literature review
  142. Genetic variants in VWF exon 26 and their implications for type 1 Von Willebrand disease in a Saudi Arabian population
  143. Lipoxin A4 improves myocardial ischemia/reperfusion injury through the Notch1-Nrf2 signaling pathway
  144. High levels of EPHB2 expression predict a poor prognosis and promote tumor progression in endometrial cancer
  145. Knockdown of SHP-2 delays renal tubular epithelial cell injury in diabetic nephropathy by inhibiting NLRP3 inflammasome-mediated pyroptosis
  146. Exploring the toxicity mechanisms and detoxification methods of Rhizoma Paridis
  147. Concomitant gastric carcinoma and primary hepatic angiosarcoma in a patient: A case report
  148. Ecology and Environmental Science
  149. Optimization and comparative study of Bacillus consortia for cellulolytic potential and cellulase enzyme activity
  150. The complete mitochondrial genome analysis of Haemaphysalis hystricis Supino, 1897 (Ixodida: Ixodidae) and its phylogenetic implications
  151. Epidemiological characteristics and risk factors analysis of multidrug-resistant tuberculosis among tuberculosis population in Huzhou City, Eastern China
  152. Indices of human impacts on landscapes: How do they reflect the proportions of natural habitats?
  153. Genetic analysis of the Siberian flying squirrel population in the northern Changbai Mountains, Northeast China: Insights into population status and conservation
  154. Diversity and environmental drivers of Suillus communities in Pinus sylvestris var. mongolica forests of Inner Mongolia
  155. Global assessment of the fate of nitrogen deposition in forest ecosystems: Insights from 15N tracer studies
  156. Fungal and bacterial pathogenic co-infections mainly lead to the assembly of microbial community in tobacco stems
  157. Influencing of coal industry related airborne particulate matter on ocular surface tear film injury and inflammatory factor expression in Sprague-Dawley rats
  158. Temperature-dependent development, predation, and life table of Sphaerophoria macrogaster (Thomson) (Diptera: Syrphidae) feeding on Myzus persicae (Sulzer) (Homoptera: Aphididae)
  159. Eleonora’s falcon trophic interactions with insects within its breeding range: A systematic review
  160. Agriculture
  161. Integrated analysis of transcriptome, sRNAome, and degradome involved in the drought-response of maize Zhengdan958
  162. Variation in flower frost tolerance among seven apple cultivars and transcriptome response patterns in two contrastingly frost-tolerant selected cultivars
  163. Heritability of durable resistance to stripe rust in bread wheat (Triticum aestivum L.)
  164. Molecular mechanism of follicular development in laying hens based on the regulation of water metabolism
  165. Animal Science
  166. Effect of sex ratio on the life history traits of an important invasive species, Spodoptera frugiperda
  167. Plant Sciences
  168. Hairpin in a haystack: In silico identification and characterization of plant-conserved microRNA in Rafflesiaceae
  169. Widely targeted metabolomics of different tissues in Rubus corchorifolius
  170. The complete chloroplast genome of Gerbera piloselloides (L.) Cass., 1820 (Carduoideae, Asteraceae) and its phylogenetic analysis
  171. Field trial to correlate mineral solubilization activity of Pseudomonas aeruginosa and biochemical content of groundnut plants
  172. Correlation analysis between semen routine parameters and sperm DNA fragmentation index in patients with semen non-liquefaction: A retrospective study
  173. Plasticity of the anatomical traits of Rhododendron L. (Ericaceae) leaves and its implications in adaptation to the plateau environment
  174. Effects of Piriformospora indica and arbuscular mycorrhizal fungus on growth and physiology of Moringa oleifera under low-temperature stress
  175. Effects of different sources of potassium fertiliser on yield, fruit quality and nutrient absorption in “Harward” kiwifruit (Actinidia deliciosa)
  176. Comparative efficiency and residue levels of spraying programs against powdery mildew in grape varieties
  177. The DREB7 transcription factor enhances salt tolerance in soybean plants under salt stress
  178. Using plant electrical signals of water hyacinth (Eichhornia crassipes) for water pollution monitoring
  179. Food Science
  180. Phytochemical analysis of Stachys iva: Discovering the optimal extract conditions and its bioactive compounds
  181. Review on role of honey in disease prevention and treatment through modulation of biological activities
  182. Computational analysis of polymorphic residues in maltose and maltotriose transporters of a wild Saccharomyces cerevisiae strain
  183. Optimization of phenolic compound extraction from Tunisian squash by-products: A sustainable approach for antioxidant and antibacterial applications
  184. Liupao tea aqueous extract alleviates dextran sulfate sodium-induced ulcerative colitis in rats by modulating the gut microbiota
  185. Toxicological qualities and detoxification trends of fruit by-products for valorization: A review
  186. Polyphenolic spectrum of cornelian cherry fruits and their health-promoting effect
  187. Optimizing the encapsulation of the refined extract of squash peels for functional food applications: A sustainable approach to reduce food waste
  188. Advancements in curcuminoid formulations: An update on bioavailability enhancement strategies curcuminoid bioavailability and formulations
  189. Impact of saline sprouting on antioxidant properties and bioactive compounds in chia seeds
  190. The dilemma of food genetics and improvement
  191. Bioengineering and Biotechnology
  192. Impact of hyaluronic acid-modified hafnium metalorganic frameworks containing rhynchophylline on Alzheimer’s disease
  193. Emerging patterns in nanoparticle-based therapeutic approaches for rheumatoid arthritis: A comprehensive bibliometric and visual analysis spanning two decades
  194. Application of CRISPR/Cas gene editing for infectious disease control in poultry
  195. Preparation of hafnium nitride-coated titanium implants by magnetron sputtering technology and evaluation of their antibacterial properties and biocompatibility
  196. Preparation and characterization of lemongrass oil nanoemulsion: Antimicrobial, antibiofilm, antioxidant, and anticancer activities
  197. Corrigendum
  198. Corrigendum to “Utilization of convolutional neural networks to analyze microscopic images for high-throughput screening of mesenchymal stem cells”
  199. Corrigendum to “Effects of Ire1 gene on virulence and pathogenicity of Candida albicans”
  200. Retraction
  201. Retraction of “Down-regulation of miR-539 indicates poor prognosis in patients with pancreatic cancer”
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