Uterine fibroids are benign tumors that originate from smooth muscle cells of the uterus.It is the most common gynecological disorder,affecting up to 80%of women of reproductive age.Uterine fibroids can cause various ...Uterine fibroids are benign tumors that originate from smooth muscle cells of the uterus.It is the most common gynecological disorder,affecting up to 80%of women of reproductive age.Uterine fibroids can cause various symptoms such as abnormal uterine bleeding,pelvic pain,infertility,and pregnancy complications.The treatment options for uterine fibroids include medical therapy,surgical intervention,and minimally invasive techniques.AIM To compare ovarian function of women with uterine fibroids who did or did not undergo uterine artery embolization(UAE).METHODS This prospective cohort study enrolled 87 women with symptomatic uterine fibroids who underwent UAE,and 87 women with the same symptoms who did not undergo UAE but received conservative management or other treatments.The two groups were matched for age,body mass index,parity,and baseline characteristics of uterine fibroids.The primary outcome was ovarian function that was evaluated by serum levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),and anti-Müllerian hormone(AMH),as well as ovarian reserve tests,such as antral follicle count(AFC)and ovarian volume(OV).The secondary outcome was fertility that was evaluated based on the menstrual cycle,ovulation,conception,pregnancy,and delivery.The participants were followed-up for 36 months and assessed at 1,3,6,12,24,and 36 months after treatment.RESULTS The study found that the most common minor complication of UAE was postembolization syndrome in 73.6% of women,resolving within a week.No significant differences were observed between the UAE group and the control group in serum levels of reproductive hormones(FSH,LH,E2,AMH)and ovarian reserve indicators(AFC,OV)at any point up to 36 months post-treatment.Additionally,there were no significant differences in conception,pregnancy,or delivery rates,with the average time to conception and gestational age at delivery being similar between the two groups.Birth weights were also comparable.Finally,there was no significant correlation between ovarian function,fertility indicators,and the type or amount of embolic agent used or the change in fibroids posttreatment.CONCLUSION UAE resulted in significantly positive pregnancy outcomes,no adverse events post-treatment,and is a safe and effective treatment for uterine fibroids that preserves ovarian function and fertility.展开更多
Anti-cancer therapy often causes premature ovarian insufficiency and infertility as the ovarian follicle reserve is extremely sensitive to chemotherapy drugs,such as cisplatin.Various fertility preservation methods ha...Anti-cancer therapy often causes premature ovarian insufficiency and infertility as the ovarian follicle reserve is extremely sensitive to chemotherapy drugs,such as cisplatin.Various fertility preservation methods have been explored for women,especially prepubertal girls undergoing radiotherapy and chemotherapy due to cancer.In recent years,mesenchymal stem cell-derived exosomes(MSC-exos)have been reported to play an important role in tissue repair and the treatment of various diseases.In the current study,we observed that human umbilical cord-derived MSC-exos(hucMSC-exos)after short-term culture improved follicular survival and development while receiving cisplatin treatment.Moreover,intravenous injection of hucMSC-exos improved ovarian function and ameliorated inflammatory environment within the ovary.The underlying mechanism of hucMSC-exos on fertility preservation was associated with the down-regulation of p53-related apoptosis and their anti-inflammatory function.Based on these findings,we propose that hucMSC-exos may be a potential approach to improve fertility in women diagnosed with cancer.展开更多
Chitooligosaccharide-zinc(COS·Zn)is a powerful anti-oxidant and anti-aging scavenger,whose anti-oxidative ability immensely exceeds vitamin C.Therefore,this study was aimed to investigate the protective effects o...Chitooligosaccharide-zinc(COS·Zn)is a powerful anti-oxidant and anti-aging scavenger,whose anti-oxidative ability immensely exceeds vitamin C.Therefore,this study was aimed to investigate the protective effects of COS·Zn against premature ovarian failure(POF)and potential mechanisms.Female KM adult mice were divided into the following groups:a treatment group(150 mg·kg^(−1)·d^(−1) COS·Zn),a treatment group(300 mg·kg^(−1)·d^(−1) COS·Zn),a prevention group,two control groups and two CY/BUS groups.COS·Zn(150,300 mg·kg^(−1)·d^(−1))and COS·Zn(300 mg·kg^(−1)·d^(−1))were therapeutically and preventatively administered to POF mice in the treatment and prevention studies,respectively.All the groups were administered for 21 days.Fewer primary and secondary follicles were observed in the COS·Zn-treated groups(including the treatment and prevention groups)than those of the control groups.Meanwhile,the ovarian index and the levels of FSH and LH notably increased in the treatment and prevention groups compared with those in the CY/BUS group.The levels of MVH,OCT4 and PCNA in the treatment group(300·kg^(−1)·d^(−1) COS·Zn)and MVH in the prevention group remarkably increased compared with those in the CY/BUS groups.Meanwhile,the levels of P53 and P16 protein were down-regulated in the treatment and prevention groups compared with those in the CY/BUS groups.Additionally,the amounts of Sestrin2(SESN2)and SOD2 protein were obviously higher in the treatment group(150 mg·kg^(−1)·d^(−1) COS·Zn)than those in the CY/BUS groups.Similarly,the amounts of NRF2 and SESN2 protein were up-regulated in the prevention group.Besides,an increased GSH level was observed in the two treatment groups,compared with that in the CY/BUS groups,and the same trend was also present in the prevention group.Taken together,COS·Zn improves the ovarian and follicular development through regulating the SESN2/NRF2 signaling pathway.These results suggest the role of COS·Zn as a novel agent for the treatment and prevention of POF.展开更多
Objective:To study the effects of acupuncture combined with Jianpi Bushen Decoction on ovarian function and metabolic disorders in patients with polycystic ovary syndrome(PCOS).Methods:A total of 100 PCOS patients adm...Objective:To study the effects of acupuncture combined with Jianpi Bushen Decoction on ovarian function and metabolic disorders in patients with polycystic ovary syndrome(PCOS).Methods:A total of 100 PCOS patients admitted in our hospital from October 2018-January 2020 were selected,and the patients were divided into the Jianpi Bushen Decoction group and the combined group with 50 patients each according to a completely random method.The patients in the Jianpi Bushen Decoction group were given Jianpi Bushen Decoction;the combined group was given acupuncture on the basis of the Jianpi Bushen Decoction group.Detection of follicle stimulating hormone(FSH),testosterone(T),pituitary prolactin(PRL),estradiol(E2),fasting insulin(FIN),fasting blood glucose(FBG),insulin resistance index(HOMA-IR),triglyceride Ester(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),endometrial thickness,ovarian volume,number of ovarian sinus follicles,C-reactive protein(CRP),procalcitonin(PCT).Statistical treatment is effective.Results:After treatment,FSH,T,PRL,FIN,FBG,HOMA-IR,TG,TC and LDL-C were lower in Jianpi Bushen Decoction group,and E2 and HDL-C levels were higher than Jianpi Bushen Decoction group(P<0.05).The endometrial thickness of the combined group was higher than that of Jianpi Bushen Decoction group,and the ovarian volume and the number of ovarian sinus follicles were lower than that of Jianpi Bushen Decoction group(P<0.05).The levels of CRP and PCT in the combination group were lower than those in the Jianpi Bushen Decoction group(P<0.05).The total effective rate of patients in combination group was higher than that in Jianpi Bushen Decoction group(P<0.05).Conclusion:Acupuncture combined with Jianpi Bushen Decoction has significant therapeutic effects on patients with PCOS,effectively improves patients'ovarian function,improves endocrine and metabolic disorders,and reduces inflammatory reactions,which deserves clinical promotion.展开更多
Objective:To investigate the quantitative influence of engineering parameters(diameter,bending angle)of minimally invasive surgical instruments and single-port laparoscopic surgery on biomarkers of ovarian reserve fun...Objective:To investigate the quantitative influence of engineering parameters(diameter,bending angle)of minimally invasive surgical instruments and single-port laparoscopic surgery on biomarkers of ovarian reserve function,and establish a multi-parameter coupled mathematical prediction model,providing a theoretical basis for precision instrument design and operation optimization.Methods:A total of 45 reproductive-age patients undergoing single-port laparoscopic ovarian cystectomy were selected.Through orthogonal experimental design,the instrument diameter(3/5/8 mm)and bending angle(30°/60°/90°)were divided into 9 groups,with5 cases in each group.Changes in serum AMH(anti-müllerian hormone),FSH(follicle-stimulating hormone),INHB(inhibin B)and ultrasonic AFC(antral follicle count)indexes were measured before surgery and on the 2nd to 3rd day of the first menstrual period after surgery.Enhanced CT images and laparoscopic images of ovarian force distribution were obtained.Finite element analysis(FEA)of the single-port instrument-ovarian tissue model was performed using ABAQUS software to calculate stress distribution in the ovarian cortex.Oscillatory shear experiments were used to determine the characteristics of viscoelastic property changes in the linear viscoelastic range of ovarian tissue.Results:The rate of decrease in AMH was lower in the 3 mm diameter-30°angle group(P<0.05);the peak Von Mises stress in the D3-θ30 group was lower than that in the other groups(P<0.05);the optimal parameter combination was a diameter of 3.13 mm and an angle of 21.72°,with the model calculating an AMH attenuation of 20%.Ovarian tissue changed with the frequency of the oscillatory shear test.In the low-frequency region(<1 Hz):G'>G''(elasticity-dominated);in the high-frequency region(>5 Hz):G''>G'(viscosity-dominated);the crossover point was at 5 Hz,where G'=G''=5 kPa.Before ovarian dissection:G'was relatively high and G''was relatively low,with elasticity dominating.During dissection:G'decreased and G''increased,with instrument stress causing damage.After dissection:G'further decreased and G''continued to rise,resulting in irreversible damage to the ovarian stroma.Conclusion:The engineering parameters of minimally invasive instruments significantly affect the ovarian reserve function index AMH and the peak Von Mises stress of the ovary through mechanical stress transmission.Using an instrument with a diameter of 3.13 mm and a bending angle of 21.72°can more effectively reduce the impact of single-port laparoscopic surgery on AMH decline.展开更多
Background:Prior research has established that exposure to low temperatures adversely affects ovarian function,yet the precise mechanisms remain to be elucidated.Methods:Thirty experimental rats,each demonstrating two...Background:Prior research has established that exposure to low temperatures adversely affects ovarian function,yet the precise mechanisms remain to be elucidated.Methods:Thirty experimental rats,each demonstrating two regular estrous cycles,were assorted randomly into three distinct groups:a control group,a cold exposure group,and a group treated with 4-phenylbutyric acid(4-PBA).To mimic the conditions of cold exposure,rats in the cold exposure and 4-PBA groups were subjected to immersion in ice water for 21 days.After 7 days of exposure to ice water,the 4-PBA group received intraperitoneal injections of a 20 mg/mL solution of 4-PBA at a dose of 100 mg/kg/day for 14 days.Estrous cycles were monitored via analysis of vaginal secretion smears.Serum hormone levels were measured using enzyme-linked immunosorbent assay(ELISA)kits.Ovarian morphology and the ultrastructure of granulosa cells(GCs)were evaluated using hematoxylin and eosin(HE)staining,and transmission electron microscopy(TEM),respectively.Apoptotic levels in GCs were quantified using a terminal deoxyribonucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)kit.Expression of apoptotic markers,endoplasmic reticulum stress(ERS)indicators,and molecules associated with relevant pathways were assessed through immunohistochemistry,western blot,and quantitative realtime polymerase chain reaction(qRT-PCR).Results:Dysregulation of the estrous cycle was notable in rats exposed to cold.The cold exposure group exhibited significantly reduced levels of estradiol(E2)and progesterone(P)compared to controls,alongside an increase in follicular atresia and a reduction in the count of developing follicles.After cold exposure,enhanced apoptosis and ERS were evident,with activation of the protein kinase RNA-like endoplasmic reticulum kinase(PERK)/eukaryotic translation initiation factor 2α(eIF2α)/activating transcription factor 4(ATF4)signaling pathway in ovarian.Notable changes were also observed in the ultrastructure of ovarian GCs,where both apoptosis and ERS levels were increased.Conversely,treatment with 4-PBA alleviated disturbances in the estrous cycle and hormonal imbalances,improved ovarian morphology,and alleviated apoptosis and ERS,effectively inhibiting the PERK/eIF2α/ATF4 pathway.Additionally,4-PBA treatment significantly improved the ultrastructure of GCs and alleviated apoptosis and ERS in these cells within the cold exposure group.Conclusion:These findings suggest that ERS plays a significant role in ovarian dysfunction induced by cold exposure,primarily through promoting apoptosis.展开更多
Premature ovarian insufficiency(POI)is characterized by irreversible loss of ovarian function before 40 years of age and affects 3.7%of women worldwide(Golezar et al.,2019;Huang et al.,2021).Raised serum follicle-stim...Premature ovarian insufficiency(POI)is characterized by irreversible loss of ovarian function before 40 years of age and affects 3.7%of women worldwide(Golezar et al.,2019;Huang et al.,2021).Raised serum follicle-stimulating hormone(FSH)levels,menstrual disturbance,and estrogen deficiency are the main symptoms of POl(European Society for Human Reproduction et al.,2016).Besides infertility,patients have an increased risk of long-term complications due to the early deficiency of ovarian steroids,such as osteoporosis,cardiovascular disease,and metabolic disorders(lshizuka,2021).Due to the lack of biomarkers for prediction or early diagnosis,most patients are not diagnosed until the failure stage(serum levels of FSH above 25 IU/L and amenorrhea),missing opportunities for intervention.Therefore,developing sensitive biomarkers for diminished ovarian reserves is paramount for timely treatment to improve reproductive outcomes and prevent long-term complications.展开更多
In most organs of mammals, cyclic remodelling of tissues after morphogenesis is minimal; however, reproductive tissues of female animals including endometrium, mammary gland, ovarian follicle and corpus luteum undergo...In most organs of mammals, cyclic remodelling of tissues after morphogenesis is minimal; however, reproductive tissues of female animals including endometrium, mammary gland, ovarian follicle and corpus luteum undergo growth, maturation and involution at various stages in the reproductive cycle or lifespan of the animal. Reconstruction of the extracellular matrix (ECM) is required for the dynamic tissue reorganization characteristic of these tissues. The ECM consists of proteinaceous and nonproteinaceous molecules that provide the tissue-specific, extracellular architecture to which cells attach. Furthermore, interaction of cellular receptors with proteins of the ECM can regulate cellular structure, second messenger generation and gene expression. Mainte-展开更多
Follicle-stimulating hormone(FSH), as the main indicator of ovarian function, plays an important role in the clinical activities of gynecologic endocrinology. Although anti-Miillerian hormone and antral follicle count...Follicle-stimulating hormone(FSH), as the main indicator of ovarian function, plays an important role in the clinical activities of gynecologic endocrinology. Although anti-Miillerian hormone and antral follicle count are also the indictors evaluating ovarian function, many clinicians are still relentless in their decision to impose the death penalty of ovaries when high FSH levels(especially more than 40 IU/L) are observed.We recently encountered four patients whose FSH levels were inconsistent with actual fertility because all patients had successfully conceived after treatment. In our study, we found the culprit(macro-FSH) of false-positive FSH levels by applying the polyethylene glycol protein precipitation technique. The biological functions of macro-FSH were further evaluated by using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis. This study suggests that ovarian reserve function should be comprehensively assessed in clinic, and the causes of serum test indicators inconsistent with clinic should be identified.展开更多
BACKGROUND Decreased ovarian reserve function is an ovarian hypofunction disease that occurs in women before 40 years of age,leading to a decline in fertility and perimeno-pausal symptoms,such as irregular menstruatio...BACKGROUND Decreased ovarian reserve function is an ovarian hypofunction disease that occurs in women before 40 years of age,leading to a decline in fertility and perimeno-pausal symptoms,such as irregular menstruation,amenorrhea,infertility,de-creased libido,and autonomic nervous dysfunction.Fenmatong(FMT)is a com-pound mixture of estradiol tablets and estradiol didroxyprogesterone tablets,which can improve ovarian reserve function by supplementation of exogenous estrogen.However,this treatment has also been shown to cause breast pain,gastrointestinal discomfort,irregular vaginal bleeding,and changes in sexual desire.In severe cases,FMT can promote the development of breast cancer,endometrial cancer,and venous embolic disease.AIM To observe the effects of Kuntai capsules and FMT on endocrine indexes and uterine artery blood circulation in patients with decreased ovarian reserve func-tion.METHODS Patients(130)with decreased ovarian reserve function,who were treated in our hospital from May 2018 to May 2020,were divided into two groups:The FMT group,in which patients were treated with FMT,and the observation group,in which patients were treated with Kuntai capsules.Chinese medicine symptom scores,uterine artery blood flow parameters,ovarian ultrasound test indexes,pictorial blood loss assessment chart(PBAC)scores,and hormone levels were recorded,and total effective rates were calculated for both groups.RESULTS The total effective rate in the observation group was higher than that in the FMT group(P<0.05).After treatment,primary symptoms,including low menstrual volume,delayed menstruation,red color and thick consistency of menses,di-zziness,palpitation,weakness at the waist and knee,insomnia and excessive dreaming,irritability,and dryness and astringency of the pudendal canal in the observation group decreased,and scores for primary and secondary symptoms in the observation group were significantly lower than those in the FMT group(P<0.05).The systolic peak flow rate(PSV),end-diastolic flow rate(EDV),ovarian diameter,sinus follicle count,and resistance index(RI)of the uterine arteries in the observation group and FMT group increased after treatment.Notably,the PSV,EDV,ovarian diameter,and antral follicle count in the observation group were higher than those in the FMT group,whereas the RI in the observation group was lower than that in the FMT group(P<0.05).The PBAC scores in the observation and FMT groups increased after treatment,with that in the ob-servation group becoming significantly higher than that in the FMT group(P<0.05).After treatment,estradiol(E2)and anti-Mullerian hormone(AMH)levels increased,whereas follicle-stimulating hormone(FSH)levels decreased in the observation group and FMT group;E2 and AMH levels became significantly higher and FSH levels became significantly lower in the observation group than in the FMT group(P<0.05).CONCLUSION Compared with FMT,Kuntai capsules promoted uterine artery blood circulation,improved menstruation,relieved symptoms,regulated endocrine function,and improved curative effects.展开更多
Background: The ovarian tumors with functioning stroma are defined by the morphological presence of endocrine active cells in stroma, and the clinical, biochemical or pathological evidence of endocrine function. Case ...Background: The ovarian tumors with functioning stroma are defined by the morphological presence of endocrine active cells in stroma, and the clinical, biochemical or pathological evidence of endocrine function. Case Report: The ovarian endometrioid adenocarcinoma with functioning stroma accompanied with endometrial endometrioid adenocarcinoma was found in 64-year-old post-menopausal woman complaining abnormal genital bleeding and mammary distention. Her preoperative serum 17?-estradiol level was high (53.2 pg/ml) while human chorionic gonadotropin (hCG) level was within normal limit. Her right ovary with 8.8 × 5.3 cm in size and tan-yellow in color mostly consisted of solid tumor. Histologically, tumor was composed of estrogen receptor (ER)- and progesterone receptor (PgR)-positive, and androgen receptor (AR)-negative cancerous endometrial cells with aggregates of vacuolated foamy stromal cells resembling luteinized cells. These stromal cells contained lipid droplets, and was immunopositive for α-inhibin and 17?-estradiol. After surgery, serum 17?-estradiol level decreased and became normal (14.2 pg/ml). These findings indicate the production of steroid hormone (17?-estradiol) from the foamy stromal cells and may be correlated with the clinical symptoms. Furthermore, ER- and PgR-positive endometrial endometrioid adenocarcinoma developed synchronously. However, ovary and uterus were totally immunonegative for human chorionic gonadotropin (hCG). Four other cases from the literature including ours are reviewed. Conclusion: Cancer cells were positive for ER and PgR in both ovary and uterus responded to steroid hormone produced by foamy stromal cells, which played a role in proliferation and progression of ovarian and endometrial endometrioid adenocarcinoma, respectively.展开更多
目的探究卵巢储备功能低下(decline in ovarian reserbe,DOR)患者的中医体质、中医证型分布特点及吴克明教授临床治疗的用药规律。方法遵循流行病学调查方法,采用《中医体质分类与判定表》对DOR患者进行打分和体质分类,参考《中医妇科...目的探究卵巢储备功能低下(decline in ovarian reserbe,DOR)患者的中医体质、中医证型分布特点及吴克明教授临床治疗的用药规律。方法遵循流行病学调查方法,采用《中医体质分类与判定表》对DOR患者进行打分和体质分类,参考《中医妇科常见病诊疗指南》及《中医妇科学》中“不孕症”“月经病”等证候分类,进行辨证分型,并收集吴克明教授门诊治疗DOR的中药处方信息。采用中医传承辅助平台(V2.5)进行挖掘分析相关用药规律。结果在所收集124例DOR患者的体质信息中,阳虚质36例,占29.03%;血瘀质19例,占15.32%;平和质16例,占12.9%;而气郁质、阴虚质、气虚质等占较少比例。中医证型分类中肾虚血瘀证共48例、脾肾阳虚证27例、肝郁肾虚证22例、气血两虚证14例、肝肾阴虚证13例。使用中医传承辅助平台对124例门诊处方进行数据挖掘,得出核心组方为:肉苁蓉、菟丝子、淫羊藿、枸杞子、覆盆子、黄精、当归、山萸肉、熟地黄、牡丹皮、香附。结论通过中医辅助平台对临床收集124例DOR患者的体质类型及其中药处方进行分析,阳虚质、血瘀质和肾虚血瘀证、脾肾阳虚证患者占比最多,而核心组方药物主要为肉苁蓉、菟丝子、淫羊藿、当归等,其中肉苁蓉、菟丝子、淫羊藿补肾精温肾阳,当归养血活血调经,初步揭示了吴克明教授在补肾养血活血法指导下临床治疗DOR的用药规律,并为不同体质类型、中医证型分类下DOR的临床治疗提供一定参考依据。展开更多
基金Supported by Key Project of Medical Science Research in Hebei Province,China,No.20160005.
文摘Uterine fibroids are benign tumors that originate from smooth muscle cells of the uterus.It is the most common gynecological disorder,affecting up to 80%of women of reproductive age.Uterine fibroids can cause various symptoms such as abnormal uterine bleeding,pelvic pain,infertility,and pregnancy complications.The treatment options for uterine fibroids include medical therapy,surgical intervention,and minimally invasive techniques.AIM To compare ovarian function of women with uterine fibroids who did or did not undergo uterine artery embolization(UAE).METHODS This prospective cohort study enrolled 87 women with symptomatic uterine fibroids who underwent UAE,and 87 women with the same symptoms who did not undergo UAE but received conservative management or other treatments.The two groups were matched for age,body mass index,parity,and baseline characteristics of uterine fibroids.The primary outcome was ovarian function that was evaluated by serum levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),and anti-Müllerian hormone(AMH),as well as ovarian reserve tests,such as antral follicle count(AFC)and ovarian volume(OV).The secondary outcome was fertility that was evaluated based on the menstrual cycle,ovulation,conception,pregnancy,and delivery.The participants were followed-up for 36 months and assessed at 1,3,6,12,24,and 36 months after treatment.RESULTS The study found that the most common minor complication of UAE was postembolization syndrome in 73.6% of women,resolving within a week.No significant differences were observed between the UAE group and the control group in serum levels of reproductive hormones(FSH,LH,E2,AMH)and ovarian reserve indicators(AFC,OV)at any point up to 36 months post-treatment.Additionally,there were no significant differences in conception,pregnancy,or delivery rates,with the average time to conception and gestational age at delivery being similar between the two groups.Birth weights were also comparable.Finally,there was no significant correlation between ovarian function,fertility indicators,and the type or amount of embolic agent used or the change in fibroids posttreatment.CONCLUSION UAE resulted in significantly positive pregnancy outcomes,no adverse events post-treatment,and is a safe and effective treatment for uterine fibroids that preserves ovarian function and fertility.
基金supported by the National Key Research and Development Program of China(Grant Nos.2018YFC1003703 and 2018YFC1004203)the National Natural Science Foundation of China(Grant No.31871513).
文摘Anti-cancer therapy often causes premature ovarian insufficiency and infertility as the ovarian follicle reserve is extremely sensitive to chemotherapy drugs,such as cisplatin.Various fertility preservation methods have been explored for women,especially prepubertal girls undergoing radiotherapy and chemotherapy due to cancer.In recent years,mesenchymal stem cell-derived exosomes(MSC-exos)have been reported to play an important role in tissue repair and the treatment of various diseases.In the current study,we observed that human umbilical cord-derived MSC-exos(hucMSC-exos)after short-term culture improved follicular survival and development while receiving cisplatin treatment.Moreover,intravenous injection of hucMSC-exos improved ovarian function and ameliorated inflammatory environment within the ovary.The underlying mechanism of hucMSC-exos on fertility preservation was associated with the down-regulation of p53-related apoptosis and their anti-inflammatory function.Based on these findings,we propose that hucMSC-exos may be a potential approach to improve fertility in women diagnosed with cancer.
基金supported by the Natural Science Foundation of Jiangxi,China(No.20192BAB215009)the National Natural Science Foundation of China(Nos.31460307,81671455 and 81771583)+1 种基金the Key Project of Jiangxi Province Natural Science Youth Fund(No.20202ACB216003)the Young Teacher Research and Training Foundation of Nanchang University Medical Department(No.PY201814).
文摘Chitooligosaccharide-zinc(COS·Zn)is a powerful anti-oxidant and anti-aging scavenger,whose anti-oxidative ability immensely exceeds vitamin C.Therefore,this study was aimed to investigate the protective effects of COS·Zn against premature ovarian failure(POF)and potential mechanisms.Female KM adult mice were divided into the following groups:a treatment group(150 mg·kg^(−1)·d^(−1) COS·Zn),a treatment group(300 mg·kg^(−1)·d^(−1) COS·Zn),a prevention group,two control groups and two CY/BUS groups.COS·Zn(150,300 mg·kg^(−1)·d^(−1))and COS·Zn(300 mg·kg^(−1)·d^(−1))were therapeutically and preventatively administered to POF mice in the treatment and prevention studies,respectively.All the groups were administered for 21 days.Fewer primary and secondary follicles were observed in the COS·Zn-treated groups(including the treatment and prevention groups)than those of the control groups.Meanwhile,the ovarian index and the levels of FSH and LH notably increased in the treatment and prevention groups compared with those in the CY/BUS group.The levels of MVH,OCT4 and PCNA in the treatment group(300·kg^(−1)·d^(−1) COS·Zn)and MVH in the prevention group remarkably increased compared with those in the CY/BUS groups.Meanwhile,the levels of P53 and P16 protein were down-regulated in the treatment and prevention groups compared with those in the CY/BUS groups.Additionally,the amounts of Sestrin2(SESN2)and SOD2 protein were obviously higher in the treatment group(150 mg·kg^(−1)·d^(−1) COS·Zn)than those in the CY/BUS groups.Similarly,the amounts of NRF2 and SESN2 protein were up-regulated in the prevention group.Besides,an increased GSH level was observed in the two treatment groups,compared with that in the CY/BUS groups,and the same trend was also present in the prevention group.Taken together,COS·Zn improves the ovarian and follicular development through regulating the SESN2/NRF2 signaling pathway.These results suggest the role of COS·Zn as a novel agent for the treatment and prevention of POF.
基金Scientific research project of Guangdong Provincial Bureau of Traditional Chinese Medicine(No.20191265)。
文摘Objective:To study the effects of acupuncture combined with Jianpi Bushen Decoction on ovarian function and metabolic disorders in patients with polycystic ovary syndrome(PCOS).Methods:A total of 100 PCOS patients admitted in our hospital from October 2018-January 2020 were selected,and the patients were divided into the Jianpi Bushen Decoction group and the combined group with 50 patients each according to a completely random method.The patients in the Jianpi Bushen Decoction group were given Jianpi Bushen Decoction;the combined group was given acupuncture on the basis of the Jianpi Bushen Decoction group.Detection of follicle stimulating hormone(FSH),testosterone(T),pituitary prolactin(PRL),estradiol(E2),fasting insulin(FIN),fasting blood glucose(FBG),insulin resistance index(HOMA-IR),triglyceride Ester(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),endometrial thickness,ovarian volume,number of ovarian sinus follicles,C-reactive protein(CRP),procalcitonin(PCT).Statistical treatment is effective.Results:After treatment,FSH,T,PRL,FIN,FBG,HOMA-IR,TG,TC and LDL-C were lower in Jianpi Bushen Decoction group,and E2 and HDL-C levels were higher than Jianpi Bushen Decoction group(P<0.05).The endometrial thickness of the combined group was higher than that of Jianpi Bushen Decoction group,and the ovarian volume and the number of ovarian sinus follicles were lower than that of Jianpi Bushen Decoction group(P<0.05).The levels of CRP and PCT in the combination group were lower than those in the Jianpi Bushen Decoction group(P<0.05).The total effective rate of patients in combination group was higher than that in Jianpi Bushen Decoction group(P<0.05).Conclusion:Acupuncture combined with Jianpi Bushen Decoction has significant therapeutic effects on patients with PCOS,effectively improves patients'ovarian function,improves endocrine and metabolic disorders,and reduces inflammatory reactions,which deserves clinical promotion.
文摘Objective:To investigate the quantitative influence of engineering parameters(diameter,bending angle)of minimally invasive surgical instruments and single-port laparoscopic surgery on biomarkers of ovarian reserve function,and establish a multi-parameter coupled mathematical prediction model,providing a theoretical basis for precision instrument design and operation optimization.Methods:A total of 45 reproductive-age patients undergoing single-port laparoscopic ovarian cystectomy were selected.Through orthogonal experimental design,the instrument diameter(3/5/8 mm)and bending angle(30°/60°/90°)were divided into 9 groups,with5 cases in each group.Changes in serum AMH(anti-müllerian hormone),FSH(follicle-stimulating hormone),INHB(inhibin B)and ultrasonic AFC(antral follicle count)indexes were measured before surgery and on the 2nd to 3rd day of the first menstrual period after surgery.Enhanced CT images and laparoscopic images of ovarian force distribution were obtained.Finite element analysis(FEA)of the single-port instrument-ovarian tissue model was performed using ABAQUS software to calculate stress distribution in the ovarian cortex.Oscillatory shear experiments were used to determine the characteristics of viscoelastic property changes in the linear viscoelastic range of ovarian tissue.Results:The rate of decrease in AMH was lower in the 3 mm diameter-30°angle group(P<0.05);the peak Von Mises stress in the D3-θ30 group was lower than that in the other groups(P<0.05);the optimal parameter combination was a diameter of 3.13 mm and an angle of 21.72°,with the model calculating an AMH attenuation of 20%.Ovarian tissue changed with the frequency of the oscillatory shear test.In the low-frequency region(<1 Hz):G'>G''(elasticity-dominated);in the high-frequency region(>5 Hz):G''>G'(viscosity-dominated);the crossover point was at 5 Hz,where G'=G''=5 kPa.Before ovarian dissection:G'was relatively high and G''was relatively low,with elasticity dominating.During dissection:G'decreased and G''increased,with instrument stress causing damage.After dissection:G'further decreased and G''continued to rise,resulting in irreversible damage to the ovarian stroma.Conclusion:The engineering parameters of minimally invasive instruments significantly affect the ovarian reserve function index AMH and the peak Von Mises stress of the ovary through mechanical stress transmission.Using an instrument with a diameter of 3.13 mm and a bending angle of 21.72°can more effectively reduce the impact of single-port laparoscopic surgery on AMH decline.
基金supported by the National Natural Science Foundation of China(Nos.82174426,82104740)the Natural Science Foundation of Hebei Province of China(No.H2021423020)the Innovation Funding Program for doctoral students in Hebei Province(No.CXZZBS2022098).
文摘Background:Prior research has established that exposure to low temperatures adversely affects ovarian function,yet the precise mechanisms remain to be elucidated.Methods:Thirty experimental rats,each demonstrating two regular estrous cycles,were assorted randomly into three distinct groups:a control group,a cold exposure group,and a group treated with 4-phenylbutyric acid(4-PBA).To mimic the conditions of cold exposure,rats in the cold exposure and 4-PBA groups were subjected to immersion in ice water for 21 days.After 7 days of exposure to ice water,the 4-PBA group received intraperitoneal injections of a 20 mg/mL solution of 4-PBA at a dose of 100 mg/kg/day for 14 days.Estrous cycles were monitored via analysis of vaginal secretion smears.Serum hormone levels were measured using enzyme-linked immunosorbent assay(ELISA)kits.Ovarian morphology and the ultrastructure of granulosa cells(GCs)were evaluated using hematoxylin and eosin(HE)staining,and transmission electron microscopy(TEM),respectively.Apoptotic levels in GCs were quantified using a terminal deoxyribonucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)kit.Expression of apoptotic markers,endoplasmic reticulum stress(ERS)indicators,and molecules associated with relevant pathways were assessed through immunohistochemistry,western blot,and quantitative realtime polymerase chain reaction(qRT-PCR).Results:Dysregulation of the estrous cycle was notable in rats exposed to cold.The cold exposure group exhibited significantly reduced levels of estradiol(E2)and progesterone(P)compared to controls,alongside an increase in follicular atresia and a reduction in the count of developing follicles.After cold exposure,enhanced apoptosis and ERS were evident,with activation of the protein kinase RNA-like endoplasmic reticulum kinase(PERK)/eukaryotic translation initiation factor 2α(eIF2α)/activating transcription factor 4(ATF4)signaling pathway in ovarian.Notable changes were also observed in the ultrastructure of ovarian GCs,where both apoptosis and ERS levels were increased.Conversely,treatment with 4-PBA alleviated disturbances in the estrous cycle and hormonal imbalances,improved ovarian morphology,and alleviated apoptosis and ERS,effectively inhibiting the PERK/eIF2α/ATF4 pathway.Additionally,4-PBA treatment significantly improved the ultrastructure of GCs and alleviated apoptosis and ERS in these cells within the cold exposure group.Conclusion:These findings suggest that ERS plays a significant role in ovarian dysfunction induced by cold exposure,primarily through promoting apoptosis.
基金supported by the National Key Research&Developmental Program of China(2022YFC2703800,2022YFC2703000)the National Natural Science Foundation of China(82125014,82371646,32070847)+1 种基金Basic Science Center Program of NSFC(31988101)the Natural Science Foundation of Shandong Province(ZR202105250005,ZR2022YQ69,tsqn202211371).
文摘Premature ovarian insufficiency(POI)is characterized by irreversible loss of ovarian function before 40 years of age and affects 3.7%of women worldwide(Golezar et al.,2019;Huang et al.,2021).Raised serum follicle-stimulating hormone(FSH)levels,menstrual disturbance,and estrogen deficiency are the main symptoms of POl(European Society for Human Reproduction et al.,2016).Besides infertility,patients have an increased risk of long-term complications due to the early deficiency of ovarian steroids,such as osteoporosis,cardiovascular disease,and metabolic disorders(lshizuka,2021).Due to the lack of biomarkers for prediction or early diagnosis,most patients are not diagnosed until the failure stage(serum levels of FSH above 25 IU/L and amenorrhea),missing opportunities for intervention.Therefore,developing sensitive biomarkers for diminished ovarian reserves is paramount for timely treatment to improve reproductive outcomes and prevent long-term complications.
基金This work was supported by the National Natural Science Foundation of China (Grant No. 39970106)the Knowledge Innovation Project of the Chinese Academy of Sciences.
文摘In most organs of mammals, cyclic remodelling of tissues after morphogenesis is minimal; however, reproductive tissues of female animals including endometrium, mammary gland, ovarian follicle and corpus luteum undergo growth, maturation and involution at various stages in the reproductive cycle or lifespan of the animal. Reconstruction of the extracellular matrix (ECM) is required for the dynamic tissue reorganization characteristic of these tissues. The ECM consists of proteinaceous and nonproteinaceous molecules that provide the tissue-specific, extracellular architecture to which cells attach. Furthermore, interaction of cellular receptors with proteins of the ECM can regulate cellular structure, second messenger generation and gene expression. Mainte-
基金supported by the National Natural Science Foundation of China(No.81471438 to Yingli Shi).
文摘Follicle-stimulating hormone(FSH), as the main indicator of ovarian function, plays an important role in the clinical activities of gynecologic endocrinology. Although anti-Miillerian hormone and antral follicle count are also the indictors evaluating ovarian function, many clinicians are still relentless in their decision to impose the death penalty of ovaries when high FSH levels(especially more than 40 IU/L) are observed.We recently encountered four patients whose FSH levels were inconsistent with actual fertility because all patients had successfully conceived after treatment. In our study, we found the culprit(macro-FSH) of false-positive FSH levels by applying the polyethylene glycol protein precipitation technique. The biological functions of macro-FSH were further evaluated by using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis. This study suggests that ovarian reserve function should be comprehensively assessed in clinic, and the causes of serum test indicators inconsistent with clinic should be identified.
文摘BACKGROUND Decreased ovarian reserve function is an ovarian hypofunction disease that occurs in women before 40 years of age,leading to a decline in fertility and perimeno-pausal symptoms,such as irregular menstruation,amenorrhea,infertility,de-creased libido,and autonomic nervous dysfunction.Fenmatong(FMT)is a com-pound mixture of estradiol tablets and estradiol didroxyprogesterone tablets,which can improve ovarian reserve function by supplementation of exogenous estrogen.However,this treatment has also been shown to cause breast pain,gastrointestinal discomfort,irregular vaginal bleeding,and changes in sexual desire.In severe cases,FMT can promote the development of breast cancer,endometrial cancer,and venous embolic disease.AIM To observe the effects of Kuntai capsules and FMT on endocrine indexes and uterine artery blood circulation in patients with decreased ovarian reserve func-tion.METHODS Patients(130)with decreased ovarian reserve function,who were treated in our hospital from May 2018 to May 2020,were divided into two groups:The FMT group,in which patients were treated with FMT,and the observation group,in which patients were treated with Kuntai capsules.Chinese medicine symptom scores,uterine artery blood flow parameters,ovarian ultrasound test indexes,pictorial blood loss assessment chart(PBAC)scores,and hormone levels were recorded,and total effective rates were calculated for both groups.RESULTS The total effective rate in the observation group was higher than that in the FMT group(P<0.05).After treatment,primary symptoms,including low menstrual volume,delayed menstruation,red color and thick consistency of menses,di-zziness,palpitation,weakness at the waist and knee,insomnia and excessive dreaming,irritability,and dryness and astringency of the pudendal canal in the observation group decreased,and scores for primary and secondary symptoms in the observation group were significantly lower than those in the FMT group(P<0.05).The systolic peak flow rate(PSV),end-diastolic flow rate(EDV),ovarian diameter,sinus follicle count,and resistance index(RI)of the uterine arteries in the observation group and FMT group increased after treatment.Notably,the PSV,EDV,ovarian diameter,and antral follicle count in the observation group were higher than those in the FMT group,whereas the RI in the observation group was lower than that in the FMT group(P<0.05).The PBAC scores in the observation and FMT groups increased after treatment,with that in the ob-servation group becoming significantly higher than that in the FMT group(P<0.05).After treatment,estradiol(E2)and anti-Mullerian hormone(AMH)levels increased,whereas follicle-stimulating hormone(FSH)levels decreased in the observation group and FMT group;E2 and AMH levels became significantly higher and FSH levels became significantly lower in the observation group than in the FMT group(P<0.05).CONCLUSION Compared with FMT,Kuntai capsules promoted uterine artery blood circulation,improved menstruation,relieved symptoms,regulated endocrine function,and improved curative effects.
文摘Background: The ovarian tumors with functioning stroma are defined by the morphological presence of endocrine active cells in stroma, and the clinical, biochemical or pathological evidence of endocrine function. Case Report: The ovarian endometrioid adenocarcinoma with functioning stroma accompanied with endometrial endometrioid adenocarcinoma was found in 64-year-old post-menopausal woman complaining abnormal genital bleeding and mammary distention. Her preoperative serum 17?-estradiol level was high (53.2 pg/ml) while human chorionic gonadotropin (hCG) level was within normal limit. Her right ovary with 8.8 × 5.3 cm in size and tan-yellow in color mostly consisted of solid tumor. Histologically, tumor was composed of estrogen receptor (ER)- and progesterone receptor (PgR)-positive, and androgen receptor (AR)-negative cancerous endometrial cells with aggregates of vacuolated foamy stromal cells resembling luteinized cells. These stromal cells contained lipid droplets, and was immunopositive for α-inhibin and 17?-estradiol. After surgery, serum 17?-estradiol level decreased and became normal (14.2 pg/ml). These findings indicate the production of steroid hormone (17?-estradiol) from the foamy stromal cells and may be correlated with the clinical symptoms. Furthermore, ER- and PgR-positive endometrial endometrioid adenocarcinoma developed synchronously. However, ovary and uterus were totally immunonegative for human chorionic gonadotropin (hCG). Four other cases from the literature including ours are reviewed. Conclusion: Cancer cells were positive for ER and PgR in both ovary and uterus responded to steroid hormone produced by foamy stromal cells, which played a role in proliferation and progression of ovarian and endometrial endometrioid adenocarcinoma, respectively.
文摘目的探究卵巢储备功能低下(decline in ovarian reserbe,DOR)患者的中医体质、中医证型分布特点及吴克明教授临床治疗的用药规律。方法遵循流行病学调查方法,采用《中医体质分类与判定表》对DOR患者进行打分和体质分类,参考《中医妇科常见病诊疗指南》及《中医妇科学》中“不孕症”“月经病”等证候分类,进行辨证分型,并收集吴克明教授门诊治疗DOR的中药处方信息。采用中医传承辅助平台(V2.5)进行挖掘分析相关用药规律。结果在所收集124例DOR患者的体质信息中,阳虚质36例,占29.03%;血瘀质19例,占15.32%;平和质16例,占12.9%;而气郁质、阴虚质、气虚质等占较少比例。中医证型分类中肾虚血瘀证共48例、脾肾阳虚证27例、肝郁肾虚证22例、气血两虚证14例、肝肾阴虚证13例。使用中医传承辅助平台对124例门诊处方进行数据挖掘,得出核心组方为:肉苁蓉、菟丝子、淫羊藿、枸杞子、覆盆子、黄精、当归、山萸肉、熟地黄、牡丹皮、香附。结论通过中医辅助平台对临床收集124例DOR患者的体质类型及其中药处方进行分析,阳虚质、血瘀质和肾虚血瘀证、脾肾阳虚证患者占比最多,而核心组方药物主要为肉苁蓉、菟丝子、淫羊藿、当归等,其中肉苁蓉、菟丝子、淫羊藿补肾精温肾阳,当归养血活血调经,初步揭示了吴克明教授在补肾养血活血法指导下临床治疗DOR的用药规律,并为不同体质类型、中医证型分类下DOR的临床治疗提供一定参考依据。
