Papillary proliferation of the endometrium (PPE) is subdivided based on the complexity of the papillae and the proliferation of lesions, and the complex group is considered to have an increased risk of concurrent/subsequent endometrial neoplasia. However, the current subdivision criteria fail to prove the equivalence of the quantity of simple papillae and structural complexity. In this study, we divided PPE of 207 cases from 2014 to 2022 into 3 groups according to structural complexity and proliferation degrees: Group 1 equaled to the simple PPE with a simple papillary structure and typical localized proliferation; group 2 had the simple structure similar to group 1 but occupy over 50% of the endometrial polyp or > 2 lesions in the surface of nonpolypoid endometrium; group 3 had the truly complex branching papillae despite of its proportion. Group 3 was implicated with significantly more concurrent endometrial neoplasia (EAH and carcinoma) compared with groups 1 and 2 (P < 0.01), while no difference was found between groups 1 and 2. In 128 cases with no concurrent endometrial abnormalities in the initial biopsy or curettage specimens, 4 cases presented endometrial neoplasia (3 carcinoma and 1 atypical hyperplasia) in the subsequent specimens, all of which presented PPE of group 3 but not group 1 or 2 in the prior tissues (P < 0.01). The immunochemistry of 83 cases showed similar expressions of ER, PTEN, ARID1A, PTEN, p16, β-catenin, and p53 between PPE and the surrounding normal endometrium. Nearly 100% of PPE cases lost expressions of PR. A total of 2/83 cases showing PAX2 expression were all in the group 3 and correlated with endometrial neoplasia (2/17, 11.76%, P < 0.05). 76/83 (91.57%) of PPE lesions had KRAS mutations, and the distributions of which were similar among 3 groups. The frequency of mucinous metaplasia was significantly higher in the PPE lesions with KRAS mutations (72/74, 97.30%, P < 0.01). Group 3 showed higher frequency of single KRAS mutations compared with the combination of groups 1 and 2 (P < 0.01). Finally, the concordance of KRAS mutation profiles between PPE and endometrial neoplasia was significantly higher in group 3 than either group 1 or 2 (P < 0.01), while no difference was found between group 1 and 2. Thus, a new 2-tier subdivision system only emphasizing the complexity of papillae is recommended, which might precisely predict the risk of endometrial neoplasia and neoplasia-related molecular characteristics.
This study explores the nexus among the Japanese trade in services to world trade and the economic development. Assuming that the relationship is linear, short-run Granger causality indicates that the export position negatively Granger causes the Japanese GDP relative to the world; the relative GDP exerts positive effects on the import position, and the export Granger causes the import position with negative effects while Granger causality runs from the later to the former with positive effects, and; the relative GDP positively Granger causes the Japanese import position. In the long-run, Wald tests show that the co-integration relationship Granger causes both the relative GDP and the import position in services, and; both export and import positions Granger cause the relative GDP, and both the relative GDP and the export position Granger cause the Japanese import position, all with positive effects. The export position in services seems to be exogenous to the model system, probably because of the policy interference of export facilitation.
The annually increasing incidence of endometrial cancer in younger women has created a growing demand for fertility preservation. However, the diverse therapeutic efficacy among patients under the same histological subtype and the same tumor grade suggests the potential interference of the innate molecular characteristics. The molecular classification has now been applied in clinical practice and might help to stratify the endometrial cancer patients and individualize the therapy, but the candidates for the fertility-spared treatment are most likely to be subdivided in the subgroup lacking the specific signature. KRAS mutation has been linked to the malignant transition of the endometrium, while its role in molecular classification and fertility preservation is vague. Here, we mainly review the advance of molecular classification and the role of KRAS in endometrial cancer, as well as their correlation with fertility-preservation treatment.
The perspective of this research is to explore how much India's protectionism in the services exports has been. This study used the annual data from UNTCAD and United Nations Statistics Division for the period of 1980-2018 and presented a new method to measure the degree of a country's export policy interference. The results show that India has had revealed comparative advantages in the services export for most years during the sample period, while she has adopted strong export promotion policies. After 1996, India's policy interference in the services exports suddenly strengthened. This research concluded that India has attempted to improve the services export comparative advantages by export promotion policies.
Coronavirus disease 2019 (COVID-19) swept across the world and posed a serious threat to human health. Health and elderly care enterprises are committed to continuously improving people's health. With the rapid development of the digital economy, many enterprises have established digital product-service ecosystems after combining “Internet +,” big data, cloud computing, and the big health industry. This paper uses the case study method to analyze the overseas market value mining mode of health and elderly care enterprises through in-depth research on leading health and elderly care enterprises. This study explores the value mining mode of the leading enterprise's global big health market using a cluster analysis and Bayesian model with the support of data on geographical characteristics, users' sleep habits, and national big health. This paper theoretically summarizes the successful cases of health and elderly care enterprises through digital transformation, which provides a useful reference for the intelligent transformation of the health and elderly care industry.
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