Hubei Provincial Women and Children's Hospital

Since its discovery, cell-free mitochondrial DNA (cf-mtDNA) has emerged as a promising non-invasive molecular marker for disease diagnosis and prognosis. However, the biological origins of cf-mtDNA remain incompletely understood, which limits its clinical applications. This review comprehensively summarizes the molecular characteristics, release mechanisms, and diagnostic applications of cf-mtDNA. By discussing standardization of cf-mtDNA detection methods, this review aims to provide theoretical foundations for clinical translation of this emerging biomarker.

Intrahepatic cholestasis of pregnancy (ICP) is an idiopathic disease that can lead to adverse pregnancy outcomes. However, the underlying mechanisms that lead to these adverse outcomes remain unclear. The objective of this study is to elucidate the specific mechanisms by which ICP results in adverse pregnancy outcomes by conducting a detailed analysis of the compositional and functional changes of various cell populations in ICP placentas compared to normal placentas using single-cell sequencing. Our findings may provide new targets to prevent and treat fetal complications associated with ICP. Human placental tissues were collected for the following experiments. Masson staining was performed to assess collagen deposition and immunofluorescence was used to visualize the localization of fibrosis-related proteins, in order to confirm the presence and extent of placental fibrosis in ICP group compared with the control group. Single-cell sequencing was performed on placental tissues from both groups to evaluate changes in the compositional proportion and functional Features of macrophages in ICP compared to normal controls. Moreover, an ICP cell model established by TCA was utilized to detect the expression of transcription factor STAT5A, gene COL4A2, and the pro-fibrotic TGFβ1 pathway. Meanwhile other experiments such as siRNA transfection, chromatin immunoprecipitation-quantitative PCR(CHIP-qPCR) and dual-luciferase assays were also conducted to investigate the binding of STAT5A to COL4A2 in M2 macrophages. Masson staining and Immunofluorescence suggested the presence of fibrosis in the ICP placentas. Single-cell sequencing indicated changes in the proportions and functions of M2 macrophages in ICP placentas. Meanwhile, in the M2 macrophage model of ICP, the expression of pro-fibrotic signaling pathways was upregulated, with STAT5A being activated and COL4A2 expression increasing. siRNA transfection suggested that knockdown of STAT5A significantly reduced the mRNA and protein levels of COL4A2. CHIP-qPCR and Dual-luciferase assays indicated that STAT5A increased the activity of the COL4A2 cis-acting enhancer. M2 macrophages can induce villous basement membrane thickening and stromal collagen deposition through the activation of STAT5A and the upregulation of COL4A2 expression. This process is amplified by TGF-β1 autocrine signaling, which forms a self-reinforcing fibrotic cycle that decreases the placental function of material exchange through capillary compression and increased diffusion resistance, ultimately contributing to adverse fetal outcomes.

ABSTRACTAspirin, widely used during pregnancy to prevent complications, may adversely affect fetal development. This study investigates prenatal aspirin exposure (PAE) on ovarian reserve in female offspring. Pregnant mice received aspirin (5, 10, and 20 mg/kg·d) from gestational days 918. Morphological and functional analyses of ovaries across prenatal to postnatal stages revealed PAE (20 mg/kg·d) reduced primordial and antral follicle counts, increased follicular atresia, and impaired ovulation in adulthood. Transcriptomics identified sustained downregulation of Usp9x as a potential mediator, which correlated with suppression of the HIF1α/NOBOX signaling axis. Mechanistically, our data suggest that aspirin exposure is associated with increased HDAC1 activity and enrichment of HDAC1 at the Usp9x promoter, accompanied by a reduction of H3K27ac marks, thereby potentially epigenetically silencing Usp9x expression. This enhanced HIF1α ubiquitination and degradation, ultimately attenuating NOBOX‐mediated transcriptional regulation of downstream follicular genes. Using in vitro fetal ovarian cultures and NIH3T3 cells, we confirmed aspirin's disruption of primordial follicle assembly via the USP9X‐HIF1α‐NOBOX pathway. Crucially, HDAC1 knockdown or pharmacological inhibition rescued USP9X expression and restored follicular development. Our findings indicate that PAE reduces ovarian reserve through HDAC1‐linked epigenetic silencing of Usp9x, exacerbating HIF1α/NOBOX pathway dysfunction, thereby informing aspirin's gestational safety and future interventions for fetal‐origin ovarian disorders.

The initial electrocardiogram (ECG) of a 5-month-old infant with complex congenital heart disease (pulmonary valvular stenosis, ventricular septal defects, and patent ductus arteriosus) revealed a regular wide QRS tachycardia at 169 bpm, initially suggestive of ventricular tachycardia (VT) or supraventricular tachycardia (SVT) with aberrant conduction. However, a subsequent ECG obtained during spontaneous heart rate deceleration to 143 bpm showed narrow QRS complexes with discernible sinus P waves and a markedly prolonged PR interval (300 ms). These findings establish the diagnosis of sinus rhythm with biatrial enlargement and first-degree atrioventricular (AV) block. Comparative analysis of these ECGs revealed that the initial tracing did not represent a true wide QRS complex but rather a “pseudo-wide QRS complex” tachycardia. This phenomenon occurs when profound PR prolongation results in concealed sinus P waves overlapping the terminal portion of the preceding QRS complex, thereby mimicking a wide QRS complex. The significant PR interval prolongation, reflecting first-degree AV block, is likely attributable to underlying anatomical abnormalities leading to atrial enlargement and consequent impaired AV nodal conduction. This case report highlights the critical importance of meticulously identifying concealed sinus P waves within wide QRS rhythms to prevent misdiagnosis and inappropriate interventions.

Background: The study aims to observe the impact of psychological intervention on the psychological resilience, coping strategies, and quality of life of cancer patients during their rehabilitation period, in order to provide scientific reference for the nursing of many cancer patients in clinical practice and improve the overall benefit level of patients. Aim: To observe the influence of psychological intervention on resilience, coping style and quality of life of 100 tumor patients (50 in the control group and 50 in the study group, with a mean age of 38.15 ± 3.15 years in the control group and 38.32 ± 3.21 years in the study group) during rehabilitation, so as to provide scientific reference for the nursing of many tumor patients and improve the overall benefit level of patients. Methods: 100 tumor patients who were admitted to our hospital from January 2022 to December 2023 were randomly divided into two groups. 50 patients in the control group were treated with conventional nursing mode, and 50 patients in the research group were given psychological intervention. The patients’ fear of recurrence [Fear of Progression Questionnaire-Short Form (FoP-Q-SF)], quality of life [European Organization for Research and Treatment of Cancer (EORTC QOL-C30)], psychological resilience [Connor-Davidson resilience scale (CD-RISC)], medical coping style [Medical Coping Modes Questionnaire (MCMQ)], self-perceived burden [Self-perceived burden Scale (SPBS)], and post-traumatic stress status [The PTSD Cheeklist-17 (PCL-17)] were compared between the two groups. Results: After the intervention, the scores of FoP-Q-SF and PCL-17 in both groups decreased, and the scores in the research group were lower than those in the control group, with statistical significance (P < 0.05); After the intervention, the scores of EORTC QOL-C30 and CD-RISC in the two groups increased, and the scores in the research group were higher than those in the control group, with statistical significance (P < 0.05); After the intervention, the scores of coping dimension in MCMQ scale in the two groups increased, while the scores of avoidance and yield dimensions decreased before the intervention (P < 0.05), and the scores of coping dimension in the research group were higher than those in the control group, while the scores of avoidance and yield dimensions were lower than those in the control group, with statistical significance (P < 0.05); After the intervention, the self-perceived burden of the research group was better than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion: Choosing a psychological intervention model during the rehabilitation of oncology patients facilitates the reduction of patients’ fear of relapse, improves quality of life, improves psychological resilience, helps patients to establish a positive mode of coping with the disease, reduces the burden of self-feeling, and relieves patients’ post-traumatic stress, and it is recommended that a large-scale psychological intervention model be encouraged among clinical oncology patients with a view to increasing the overall level of benefit for the patients and improving the quality of life during the survivorship period.