“What's in a name?That which we call a rose by any other name would smell as sweet”-William Shakespeare Polycystic ovary syndrome(PCOS)is one of the commonest endocrinopathy in the reproductive age group,as depi...“What's in a name?That which we call a rose by any other name would smell as sweet”-William Shakespeare Polycystic ovary syndrome(PCOS)is one of the commonest endocrinopathy in the reproductive age group,as depicted in a study among the North Indian population[1].The nomenclatures,the diagnostic criteria,the pathophysiology,and the modalities of treatment are full of controversies.Other names for this syndrome include Stein-Leventhal syndrome,polycystic ovary disease(PCOD),polycystic ovarian disease,functional ovarian hyperandrogenism,ovarian hyperthecosis and sclerocystic ovary syndrome,etc.展开更多
Objective:Polycystic ovary syndrome(PCOS)is a common endocrine disorder that affects women’s health.This study aims to investigate gene and transcription factor(TF)expression differences between PCOS patients and hea...Objective:Polycystic ovary syndrome(PCOS)is a common endocrine disorder that affects women’s health.This study aims to investigate gene and transcription factor(TF)expression differences between PCOS patients and healthy individuals using bioinformatics approaches,and to verify the function of key transcription factors,with the goal of providing new insights into the pathogenesis of PCOS.Methods:Differentially expressed genes(DEGs)and differentially expressed transcription factors(DETFs)between PCOS patients and controls were identified from the RNA sequencing dataset GSE168404 using bioinformatics methods.Functional enrichment analysis was performed using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)databases.The expression and function of core transcription factors were further validated in ovarian tissues of PCOS model mice and control mice using Western blotting and reverse transcription quantitative polymerase chain reaction(RTqPCR).Results:A total of 332 DEGs were identified between PCOS patients and controls,including 259 upregulated and 73 downregulated genes in the PCOS group.19 DETFs were further screened,of which 16 were upregulated and 3 were downregulated in PCOS.The upregulated DETFs(including TFCP2L1,DACH1,ESR2,AFF3,SMAD9,ZNF331,HOPX,ATOH8,HIF3α,DPF3,HOXC4,HES1,ID1,JDP2,SOX4,and ID3)were primarily associated with lipid metabolism,development,and cell adhesion.Protein and mRNA expression analysis in PCOS model mice revealed significantly decreased levels of hypoxia-inducible factor(HIF)1αand HIF2α,and significantly increased expression of HIF3αcompared to control mice(all P<0.001).Conclusion:Significant differences in gene and TF expression exist between PCOS patients and healthy individuals.HIF-3αmay play a crucial role in PCOS and could serve as a novel biomarker for diagnosis and a potential therapeutic target.展开更多
Recent studies have potentiated the essential role of androgens in normal follicu-logenesis and,therefore,female fertility.Contrastingly,excess androgen levels,i.e.,hyperandrogenism(HA),a hallmark characteristic of po...Recent studies have potentiated the essential role of androgens in normal follicu-logenesis and,therefore,female fertility.Contrastingly,excess androgen levels,i.e.,hyperandrogenism(HA),a hallmark characteristic of polycystic ovary syndrome,overrides the delicate balance of folliculogenesis,leading to follicular arrest and ovulatory issues.Insulin resistance(IR)has a profound effect on elevating androgen secretion and is considered one of the primary factors driving both ovarian androgen production and metabolic dysfunction in polycystic ovary syndrome.Together with IR,disruptions in key intraovarian and systemic factors,including activin,inhibin,follistatin,anti-Mullerian hormone,bone morpho-genetic proteins,growth differentiation factor-9 and Kit ligand,as well as dysreg-ulation in both the insulin and the transforming growth factor-βsuperfamily signaling pathway,contribute to follicular arrest,elevated androgen levels and metabolic dysfunction,exacerbating HA.Additionally,suppression of sex hormone-binding globulin,disrupted adipose-neuroendocrine signaling and altered microRNA expression heighten HA,with IR serving as the fundamental contributor.Emerging evidence implicates impaired atresia together with non-apoptotic cell death,such as ferroptosis and pyroptosis,which have also been associated with ovarian dysfunction.A comprehensive understanding of the most significant factors,particularly IR,which amplifies androgen production through hyperinsulinemia-mediated stimulation of theca cells,is essential for identifying targeted therapeutic strategies.展开更多
Polycystic kidney disease (PKD) is an autosomal dominant genetic disorder that causes the formation of multiple cysts in the kidneys, leading to kidney failure. PKD is a common condition affecting approximately 1 in 5...Polycystic kidney disease (PKD) is an autosomal dominant genetic disorder that causes the formation of multiple cysts in the kidneys, leading to kidney failure. PKD is a common condition affecting approximately 1 in 500 individuals worldwide. The most prevalent type of PKD is autosomal dominant PKD (ADPKD). ADPKD is caused by mutations in either the PKD1 or PKD2 genes, which encode for proteins involved in cell growth and differentiation. These mutations lead to the formation of fluid-filled cysts in the kidneys, which can eventually lead to kidney failure. In addition to affecting the kidneys, PKD can also cause cysts in other organs, such as the liver, pancreas, and spleen. PKD can also lead to various complications, including high blood pressure, heart valve abnormalities, and brain aneurysms. This review focuses on the inheritance, pathophysiology, and treatment of PKD, with a specific emphasis on its effects on the cardiovascular system. Currently, there is no cure for PKD. However, several treatments are available to manage the symptoms and complications of the disease. These treatments include medications to control blood pressure, pain relievers, antibiotics for infections, and dialysis or kidney transplantation for kidney failure. Tolvaptan is the only FDA-approved drug specifically for ADPKD and has been shown to slow disease progression. In addition to summarizing current treatment options, this review will discuss promising future treatments, such as gene therapy and stem cell therapy.展开更多
Polycystic ovary syndrome(PCOS)is the most common endocrine disease afflicting women of childbearing age.It is characterized by irregular menstruation,clinical or biochemical hyperandrogenemia,and polycystic ovary mor...Polycystic ovary syndrome(PCOS)is the most common endocrine disease afflicting women of childbearing age.It is characterized by irregular menstruation,clinical or biochemical hyperandrogenemia,and polycystic ovary morphology.As a complex endocrine-metabolic syndrome(MS),PCOS shares several endocrine-metabolic features with the MS,with insulin resistance at the core of their pathogenic mechanisms.PCOS and MS are interrelated and thus have similarities in treatment.Currently,the common treatment modalities for both are lifestyle intervention,medication,and surgery.More studies have shown that lifestyle intervention and regulation of intestinal flora are more effective and sustainable.However,progress towards treatment and cure is hampered by unclear etiology and mechanisms.This review aimed to summarize the relationship between PCOS and MS,the pathogenesis of metabolic disorders,and the current nutritional therapeutic strategies,especially lifestyle modifications and modulation of intestinal flora.Lifestyle interventions combined with the regulation of gut flora can be a new perspective for treatment.This perspective has a positive significance in the early diagnosis,adoption of personalized treatment plans,and prevention of complications in PCOS and MS.The need to prevent the occurrence of MS in patients with PCOS should be emphasized.展开更多
Background:Bonducellin is one of the bioactive compounds present in Caesalpinia bonduc Roxb(L).It is a homoisoflavonoid recognized for its anti-cancer,anti-androgenic,and anti-estrogenic properties and could potential...Background:Bonducellin is one of the bioactive compounds present in Caesalpinia bonduc Roxb(L).It is a homoisoflavonoid recognized for its anti-cancer,anti-androgenic,and anti-estrogenic properties and could potentially treat polycystic ovary syndrome(PCOS).However,the underlying molecular mechanism remains unexplored.This study aims to elucidate the potential molecular mechanisms of bonducellin in treating PCOS and its associated symptoms through an integrated approach combining network pharmacology,molecular docking,molecular dynamics simulation,and in vivo validation.Methods:Bonducellin-associated and PCOS-related genes were intersected using VENN analysis to determine common gene targets.KEGG pathway analysis was conducted to investigate the biological pathways involving the co-targeted genes.The protein-protein interactions of the target genes were performed to identify the key proteins interacting with bonducellin.Molecular docking and 100 ns molecular simulations were carried out to evaluate the binding affinity and conformational stability of bonducellin with the target proteins.Additionally,the acute toxicity of bonducellin was assessed on zebrafish embryos and in vivo gene expression studies were performed to examine its regulatory effect on the top co-targeted gene.Results:The intersection of bonducellin-associated and PCOS-related genes identified 76 co-targeted genes.KEGG pathway analysis revealed their involvement in 15 critical pathways,including steroid hormone biosynthesis.Protein-protein interaction and pathway enrichment analysis highlighted key targets,including MMP9,AR,KDR,PRKACA,KIT,CYP19A1,HSD11B1,ESR1,STAT3,ESR2,PRKCA,ROCK1,BRAF,HSD17B2,PIK3R1,and RAF1,all of which exhibited strong binding to bonducellin.Molecular simulations confirmed the stability of bonducellin to the top proteins,MMP9 and AR,with high binding scores.Acute toxicity studies in zebrafish embryos determined the LC50 value of bonducellin as 0.8μg/mL at 48 hpf.Gene expression analysis revealed that bonducellin differentially regulates the MMP9 gene that is involved in modulating PCOS-related pathways.Conclusion:This study suggests potential gene pathways and protein interactions through which bonducellin could exert therapeutic effects on PCOS and its associated disorders.This provides valuable insights for future research into understanding and developing bonducellin-based treatments for PCOS.展开更多
Polycystic ovarian syndrome(PCOS)is the most principal reason for infertility in reproductive women,but no versatile treatment is feasible.Although trans-10-hydroxy-2-decenoic acid(10H2DA)exhibits the anti-inflammator...Polycystic ovarian syndrome(PCOS)is the most principal reason for infertility in reproductive women,but no versatile treatment is feasible.Although trans-10-hydroxy-2-decenoic acid(10H2DA)exhibits the anti-inflammatory,anti-cancerous and immunomodulatory properties,its role in improving PCOS remains elusive.This present study examined the effects of 10H2DA on the estrous cycle,ovarian morphology,reproductive hormone,glucose and insulin tolerances of PCOS mice,analyzed the binding between 10H2DA and free fatty acid receptor 4(FFAR4),and explored the regulation of 10H2DA on the c-Jun N-terminal kinase(JNK)/JUN(Jun proto-oncogene)signaling,cytosolic calcium ion(Ca2),endoplasmic reticulum(ER)Ca2release,mitochondrial Ca2+,mitochondrial function,autophagy,lysosomal acidification,mitochondrial fission,secretion function and apoptosis of ovarian granulosa cells(GCs)using enzyme-linked immunosorbent assay,flow cytometry,Western blotting,molecular docking,various fluorescent probes or plasmid,etc.The results showed that 10H2DA alleviated the symptom of PCOS mice through improving the secretion dysfunction of GCs and protecting GCs against apoptosis.After binding to FFAR4 and inactivation of JNK/JUN signaling,10H2DA restricted the release of ER Ca2through targeting ryanodine receptors(RYRs)which had been identified as the downstream targets of JUN,diminished cytosolic Ca^(²+) accumulation and prevented Ca^(²+) influx into mitochondria via adjusting the mitochondrial calcium uptake 1 and mitochondrial calcium uniporter.Concurrently,10H2DA kept the integrity of mitochondrial function through maintaining mitochondrial Ca2 homeostasis and suppressed the discharge of mitochondrial reactive oxygen species into the cytosol through blocking the mitochondrial permeability transition pore opening to avoid the lipid peroxidation and ameliorate the secretory function and apoptosis of GCs.Furthermore,1OH2DA rescued the defective autophagic flux along with the decline of autophagosomes and sequestosome 1 aggregation,restored the mitophagy flux with the abatement of mitophagosomes and Parkin recruitment to mitochondria,and accelerated the lysosomal degradation for depolarized mitochondria with the recovery of lysosomal acidification,whereas activation of JNK antagonized the amelioration of 10H2DA on above effectiveness,but this antagonism was counteracted by the attenuation of intracellular Ca2+.After application of 10H2DA,dynamin-related protein 1 phosphorylation was diminished and its recruitment to mitochondrial surface was impeded concomitant with the improvement of mitochondrial fragmentation,whereas inhibition of late-stage autophagy caused the failure of 10H2DA in improving mitochondrial fission.Collectively,10H2DA might ameliorate PCOS mice through modulating autophagy-mediated mitochondrial fission dependent on the maintenance of Ca^(2+) homeostasis between ER and mitochondria.展开更多
Background Polycystic ovarian syndrome(PCOS),a common endocrine disorder in reproductive-aged women,has substantial physical and psychological impacts.While the physical manifestations of PCOS are well established,the...Background Polycystic ovarian syndrome(PCOS),a common endocrine disorder in reproductive-aged women,has substantial physical and psychological impacts.While the physical manifestations of PCOS are well established,the psychological burden,especially anxiety,is understudied in Saudi Arabia.This study aimed to assess the prevalence of generalized anxiety disorder among females with PCOS compared to those without PCOS,and to identify the clinical and sociodemographic factors associated with anxiety in the Jazan region of Saudi Arabia.Methods A cross-sectional study was conducted between January and March 2023 using an Arabic self-administered online questionnaire distributed via social media platforms.The study recruited 410 reproductive-age females(≥18 years)from the Jazan region using convenience sampling.The questionnaire encompassed socio-demographic characteristics,economic indicators,medical history,PCOS symptoms,and the validated Generalized Anxiety Disorder-7(GAD-7)assessment tool.Results The prevalence of PCOS in the study population was 22.44%.Women with PCOS showed significantly higher anxiety levels compared to controls without PCOS(32.61%vs.22.33%).Biochemical hyperandrogenism was the strongest predictor of anxiety(OR=4.179).Menstrual irregularities demonstrated a dose-dependent relationship with anxiety risk,wherein participants with 2–3 months and≥3 months of amenorrhea had 2.5-and 3.3-times higher odds of anxiety compared to those with regular cycles(OR=2.451 and 3.314).Other PCOS-related dermatological manifestations were also associated with increased anxiety,including hirsutism(OR=1.745),alopecia(OR=2.285)and acne(OR=1.723).Marital status was a significant factor,with divorced/widowed females having 4.4-fold higher anxiety odds compared to single females(OR=4.371).Conclusion PCOS presents a significant psychological burden in Saudi women,with anxiety prevalence higher than the general population.The robust associations between PCOS manifestations and anxiety emphasize the need for integrated healthcare approaches that address both endocrine and mental health aspects.Routine psychological screening and support services should be incorporated into PCOS management protocols.展开更多
Polycystic ovary syndrome(PCOS)is a prevalent endocrine disorder that poses a significant threat to women’s health.As a classical traditional Chinese medicine(TCM)formulation,Guizhi-Fuling Wan(GFW)has a good applicat...Polycystic ovary syndrome(PCOS)is a prevalent endocrine disorder that poses a significant threat to women’s health.As a classical traditional Chinese medicine(TCM)formulation,Guizhi-Fuling Wan(GFW)has a good application prospect in the complementary treatment of PCOS.This study aimed to systematically summarize the traditional efficacy and pharmacological composition of the Chinese medicines contained in GFW and evaluate the clinical efficacy and safety of their active ingredients in the complementary treatment of PCOS.A growing number of studies have demonstrated that GFW is effective at complementally treating PCOS through various mechanisms,including inhibiting inflammatory responses,modulating the intraovarian extracellular matrix,regulating apoptosis and autophagy in granulosa cells,and correcting oxidative stress imbalances.In addition,the GFW has been shown to be effective in treating the complications of PCOS.However,there are several problems,and future work should focus on elucidating the efficacy,safe dosage,and safety of different dosage forms of GFW,increasing the toxicological value of traditional Chinese medicine,and confirming the safety of the combination of GFW with Western medicine for the treatment of PCOS.展开更多
OBJECTIVE:To evaluate the effectiveness and safety of the sequential therapy in treating infertility with polycystic ovary syndrome(PCOS)and luteal phase defects(LPD)by Yangxin Dianji decoction(养心奠基方,YXDJ-D)and N...OBJECTIVE:To evaluate the effectiveness and safety of the sequential therapy in treating infertility with polycystic ovary syndrome(PCOS)and luteal phase defects(LPD)by Yangxin Dianji decoction(养心奠基方,YXDJ-D)and Nuangong Tiaojing decoction(暖宫调经方,NGTJ-D).METHODS:This study was undertaken in the Jiangsu Province Hospital of Chinese Medicine.Altogether 90 eligible patients with PCOS and LPD were assigned to exposed group A(Chinese Medicine therapy,YXDJ-D and NGTJ-D),exposed group B(Chinese Medicine plus Western Medicine therapy),control group(Western Medicine therapy).The exposed group A adopted the sequential therapy that YXDJ-D is taken in the postmenstrual period(follicular phase)and NGTJ-D is taken in premenstrual period(luteal phase).Control group took letrozole,dydrogesterone and was given intramuscular injection of human menopausal gonadotropin,human chorionic gonadotropin.The exposed group B was treated with the above-mentioned therapy project of integrated Chinese Medicine and Western Medicine.This study lasted for 2 courses for 6 months.The primary outcomes were pregnancy rate and early abortion rate.The secondary outcomes were the Traditional Chinese Medicine(TCM)syndrome scores,estrogen(E2)and progesterone(P),endometrial volume(EV),vascularity index(VI),flow index(FI)and vascularization flow index(VFI).These outcomes will be assessed at baseline and post-intervention.RESULTS:The pregnancy rates of the exposed group A and B were higher than the control group(60.00%vs 60.00%vs 53.33%),while early abortion rates of exposed groups A and B were lower than the control group(33.33%vs 16.67%vs 43.75%,P>0.05).Total efficacy rates in exposed group A and B were better than the control group(93.30%vs 93.30%vs 53.30%,P<0.01).TCM symptom scores and endometrial receptivity indexes(EV,FI,VFI)were significantly lower in exposed groups compared to the control group(P<0.05).P increase in exposed group B was superior to the other two groups(P<0.01).No noticeable abnormalities in safety indicators in the three groups.CONCLUSION:The sequential therapy of YXDJ-D and NGTJ-D can effectively increase pregnancy rate,reduce the early abortion rate and alleviate the clinical symptoms of infertility in patients with PCOS and LPD by improving luteal function and promoting the endometrial receptivity.展开更多
BACKGROUND Equations for estimation glomerular filtration rate(eGFR)have been associated with poor clinical performance and their clinical accuracy and reliability have been called into question.AIM To assess the long...BACKGROUND Equations for estimation glomerular filtration rate(eGFR)have been associated with poor clinical performance and their clinical accuracy and reliability have been called into question.AIM To assess the longitudinal changes in measured glomerular filtration rate(mGFR)in patients with autosomal dominant polycystic kidney disease(ADPKD).METHODS Analysis of an ambispective data base conducted on consecutive patients diagnosed with ADPKD.The mGFR was assessed by iohexol clearance;while eGFR was calculated by three different formulas:(1)The chronic kidney disease epidemiology collaboration(CKD-EPI);(2)Modification of diet in renal disease(MDRD);and(3)The 24-hour urine creatinine clearance(CrCl).The primary end-points were the mean change in mGFR between the baseline and final visit,as well as the comparison of the mean change in mGFR with the change estimated by the different formulas.RESULTS Thirty-seven patients were included in the study.As compared to baseline,month-6 mGFR was significantly decrease by-4.4 mL/minute±10.3 mL/minute(P=0.0132).However,the CKD-EPI,MDRD,and CrCl formulas underestimated this change by 48.3%,89.0%,and 45.8%respectively,though none of these differences reached statistical significance(P=0.3647;P=0.0505;and P=0.736,respectively).The discrepancies between measured and estimated glomerular filtration rate values,as evaluated by CKD-EPI(r=0.29,P=0.086);MDRD(r=0.19,P=0.272);and CrCl(r=0.09,P=0.683),were not correlated with baseline mGFR values.CONCLUSION This study indicated that eGFR inaccurately reflects the decline in mGFR and cannot reliably track changes over time.This poses significant challenges for clinical decision-making,particularly in treatment strategies.展开更多
Polycystic ovary syndrome(PCOS)is a lifelong disorder affecting reproductive,metabolic,and psychological health.A healthy lifestyle and effective weight management strategies should underpin the treatment of PCOS.This...Polycystic ovary syndrome(PCOS)is a lifelong disorder affecting reproductive,metabolic,and psychological health.A healthy lifestyle and effective weight management strategies should underpin the treatment of PCOS.This case report documents the successful management of a Chinese patient with PCOS who was overweight and presented with oligomenorrhea and persistent adiposity.The patient was diagnosed using the Rotterdam criteria.The intervention was a 2-month program involving caloric restriction(1,350 kcal/day whole-food diet),progressive exercise titration(150–180 min/week of aerobic and resistance training),mindfulness practice,and metformin initiation after confirmed insulin resistance(HOMA-IR 3.67)resulted in clinically significant body composition improvements:fat mass was reduced by 5.0 kg,visceral adipose area was reduced by 44.7 cm^(2),skeletal muscle was increased by 1.4 kg,and regular menstrual cycles(32 day interval)were restored following 5% weight loss-consistent with evidence linking this threshold to improved ovarian function.The combination of a structured lifestyle modification program with targeted pharmacotherapy offers a viable clinical approach for metabolic PCOS phenotypes,although further validation is required to ascertain long-term efficacy.展开更多
As an important branch of traditional medicine,Zhuang Medicine is renowned for its unique prescriptions and techniques in clinical treatment,with significant therapeutic effects and widespread popularity.This article ...As an important branch of traditional medicine,Zhuang Medicine is renowned for its unique prescriptions and techniques in clinical treatment,with significant therapeutic effects and widespread popularity.This article introduces Professor Fang Gang’s experience in treating obesity-type polycystic ovary syndrome(PCOS)with modified Zhuang Medicine Mao Xia Yin.Professor Fang Gang proposes that the etiology and pathogenesis of obesity-type polycystic ovary syndrome(PCOS)primarily stem from spleen deficiency,which impairs the transport of water and dampness.This dysfunction leads to the accumulation of dampness that transforms into phlegm.Over time,the stagnation of phlegm and dampness generates internal heat,resulting in the formation of“dampness toxin,”“phlegm toxin,”and“heat toxin.”These pathological toxins obstruct the circulation of Qi and blood,causing stasis and the emergence of“stasis toxin.”The buildup of these toxins ultimately blocks the three channels and two pathways,disrupting the harmony among the three Qi of heaven,earth,and man.This disharmony culminates in impaired uterine gland function.Therefore,the treatment mainly focuses on tonifying deficiency,detoxifying,and regulating Qi.展开更多
Objective To observe the effect of electroacupuncture （EA） on egg quality of polycystic ovarian syndrome （PCOS） patients, and to explore its mechanism. Methods Two hundred patients who received in vitro fertilizat...Objective To observe the effect of electroacupuncture （EA） on egg quality of polycystic ovarian syndrome （PCOS） patients, and to explore its mechanism. Methods Two hundred patients who received in vitro fertilization-embryo transfer （IVF-ET） were divided into an EA group （102 cases） and a control group （98 cases） according to random number table. All the patients in the two groups were given Diane-35 and gonadotropin-releasing hormone agonist （GnRH-α） for ovarian hyperstimulation. Besides, EA intervention was applied to Shenshu （肾俞 BL 23）, Qihai （气海 GV 6）, Zusanli （足三里ST 36）, Sanyinjiao （三阴交 SP 6）, Neiguan （内关 PC 6） and Zigong （子宫 EX-CA1）, etc. in the EA group. Then egg quality, final outcome of pregnancy and levels of tumor necrosis factor-α （TNF-α） were compared between the two groups. Results （1） EA intervention significantly improved high quality embryo rate of PCOS patients （P〈0.05）, and clinical pregnancy rate was increased by 8.36%; （2） EA intervention significantly reduced the TNF-α levels of follicular fluid （13.61±15.46 vs 34.09±93.53, P〈0.05）; （3） TNF-α levels of serum and follicular fluid in the pregnancy group were lower than those of non-pregnancy group [pregnancy group： （53.91±63.32） pg/mL, （14.93±25.37） pg/mL, nonpregnancy group： （76.82 ± 82.96） pg/mL, （25.04 ± 35.79） pg/mL], and the differences were significant （both P〈0.05）. Conclusion EA improves egg quality of PCOS patients and increases the clinical pregnancy rate of IVF-ET, the mechanism may be related to TNF-α levels.展开更多
Objective To evaluate the differences of the clinical manifestation and endocrine situation in patients with different ovarian morphology of polycystic ovary syndrome （PCOS）. Methods A total of 234 PCOS patients wer...Objective To evaluate the differences of the clinical manifestation and endocrine situation in patients with different ovarian morphology of polycystic ovary syndrome （PCOS）. Methods A total of 234 PCOS patients were enrolled according to the ovary morphology and divided into three groups： 112 patients with B-polycystic ovary mor- phology （both two ovaries were PCOM, B-PCOM）, 50 with U-PCOM （only one ovary was PCOM） and 72 with N-PCOM （none was PCOM）. There were 39 infertile women without PCOS as control group. Data were analyzed by using SPSS 15.0 software. ResuIts There was no statistical difference in body mass index （BM1） among the three groups of PCOS. The endometrial thickness increased in patients with B-PCOM and decreased with N-PCOM. The levels of testosterone, androstenedione and luteinizing hormone increased in PCOS groups, especially in N-PCOM patients. HOMA-IR increased, HOMA-fl, disposition index （DI） and △160/AG60 decreased in patients with N- PCOM compared with in B-PCOM and U-PCOM groups. Higher level of total choles- terol （TC） and lower level of high-density lipoprotein （HDL）-C existed in PCOS patients, especially in N-PCOM. There were positive correlations between oligo-anovulation, endometrial thickness, LH/FSH ratio, fasting insulin （FINS）, the area under curve of glucose（A UCcLu） and PCOM, while there was a negative correlation between HOMA- IR and PCOM. Conclusion There are relationships among hyperandrogenism, hyperinsulinemia, insulin resistance （IR） and ovary morphology in PCOS patients. PCOS patients with- out PCOM have more serious IR and hyperandrogenism.展开更多
Objective This review aimed to systematically evaluate the evidence on the effects of acupoint catgut embedding （ACE） therapy for patients with polycystic ovary syndrome （PCOS）. Methods Five databases （CBM, CNKI,...Objective This review aimed to systematically evaluate the evidence on the effects of acupoint catgut embedding （ACE） therapy for patients with polycystic ovary syndrome （PCOS）. Methods Five databases （CBM, CNKI, Wanfang Database, VlP Database, and PubMed） were searched to identify relevant studies published before June 2027. The outcomes were resumption of menstruation and serum levels of testosterone （T）. The methodological quality of the included studies was judged using the Cochrane risk of bias tool. The overall level of evidence was judged by the Grading of Recommendations Assessment, Development, and Evaluation （GRADE） criteria. Results Twenty- five randomized controlled trials were included. ACE therapy significantly lowered serum T levels, and patients receiving ACE treatment reported resumption of menstruation. However, these results should be interpreted with caution due to a high risk of randomization and blinding bias, and likely publication bias. The level of evidence for resumption of menstruation and serum T levels was assessed as ＂low＂ and ＂low＂, respectively, using GRADE. Conclusion The current evidence on ACE therapy for PCOS is insufficient to draw firm conclusions due to the poor methodological quality. Future well- designed trials are needed to validate the therapeutic efficacy, safety, and mechanisms of ACE in patients with PCOS.展开更多
Objective To excavate and analyze the acupoint selection rules of acupuncture for PCOS. Methods A literature search was conducted in databases of Chinese Biomedicine Database（CBM）, Chinese National Knowledge Infrast...Objective To excavate and analyze the acupoint selection rules of acupuncture for PCOS. Methods A literature search was conducted in databases of Chinese Biomedicine Database（CBM）, Chinese National Knowledge Infrastructure Database（CNKI）, Wanfang Database, Chongqing VIP Chinese Science and Technology Periodical Database（VIP） and Pub Med. All clinical trials evaluating the effects of acupuncture in the treatment of polycystic ovary syndrome（PCOS） were included with or without methods of randomization and/or control. Four authors extracted information and two reviewers recorded information on titles, journals, interventions, main acupoints in selfestablished Excel sheet. Results The top ten acupoints of acupuncture therapy used most frequently were, by turns, Sānyīnjiāo（三阴交 SP 6）, Guānyuán（关元 CV 4）, Zhōngjí（中极 CV 3）, Zǐgōng（子宫 EX-CA 1）, Qìhǎi（气海 CV 6）, Zúsānlǐ（足三里 ST 36）, Shènshù（肾俞 BL 23）, Tiānshū（天枢 ST 25）, Guīlaí（归来 ST 29）, Zhōngwǎn（中脘 CV 12）. Conclusion Our study indicates that modern acupuncture treatment for PCOS is based on selection of specific acupoints according to traditional Chinese acupuncture theory. Points of spleen meridian, stomach meridian and conception vessel are chosen frequently which are most located on the abdomen and the lower limbs. Specific points used most are the front-mu points, the he-sea points, matching points and the back-shu points.展开更多
Objective To observe the effects of acupuncture on menstruation and endocrine in patients of normal body weight with polycystic ovary syndrome. Methods Twenty-seven patients were treated with acupuncture and moxibusti...Objective To observe the effects of acupuncture on menstruation and endocrine in patients of normal body weight with polycystic ovary syndrome. Methods Twenty-seven patients were treated with acupuncture and moxibustion for six months. Guanyuan （关元 4）, Zhongji （中极 CV 3）, and Zigong （子宫 EX-CA 1） on the abdomen and Sanyinjiao （三阴交SP 6）, Zusanli （足三里 ST 36）, Yinlingquan（阴陵泉 sP 9）, Fenglong （丰隆 ST 40）, xiaxi （侠溪GB 43）, Taichong （太冲 LR 3） were punctured. CV 3 on the abdomen and EX-CA 1 on both sides were manipulated by moxisbustion. The menstrual frequency, B ultrasound examination of uterus and adnexa uteri, luteinizing hormone （LH）, follicle stimulating hormone （FSH）, testosterone （T）, prolactin （PRL）, progesterone （PROG） and estradiol （E2） were recorded. Results Menstrual cycles were restored in twenty-six patients after six- month treatment. The total frequencies of menstruation were 105, of which 79 with normal ovulation accounting for 75.23%. The testosterone level of （109.65 ± 43.38） ng/dL before treatment were reduced to （53.7 ± 19.24） ng/dL after treatment, LH/FSH ratio of 4.15 ± 1.38 before treatment were reduced to 1.75 ± 1.09 after treatment. The differences were statistically significant （both P〈O.O5）. Conclusion Acupuncture can promote normal ovulation and menstrual cycles in patients with PCOS by regulating endocrine level.展开更多
OBJECTIVE： To explore the effect of electroacu- puncture and Chinese kidney-nourishing medicine on insulin （INS）, adiponectin （APN）, leptin （LEP）, and glucolipid metabolism of obese patients with polycystic ova...OBJECTIVE： To explore the effect of electroacu- puncture and Chinese kidney-nourishing medicine on insulin （INS）, adiponectin （APN）, leptin （LEP）, and glucolipid metabolism of obese patients with polycystic ovary syndrome （PCOS）. METHODS： Sixty-seven obese PCOS patients were randomly divided into two groups. Thirty-three pa- tients in the acupuncture-medicine group were treated three times a week with electroacupunc- ture at the Tianshu （ST 25）, Zhongwan （CV ] 2）, Qi- hai （CV 6）, Sanyinjiao （SP 6）, Geshu （BL 17）, and Cil-iao （BL 32） acupoints. They drug, Tiankui capsule, for 3 treatment. Point-taking and also took the Chinese months as a course of treatment in the elec- troacupuncture group of 34 patients was the same as those in the acupuncture-medicine group. We observed and compared the changes in the obesi- ty-related indexes of body weight （BW）, body mass index （BMI）, and waist-hip ratio （WHR）, as well as fasting plasma glucose （FPG）, fasting insulin （FINS）, APN, and LER RESULTS： BW, BMI, WHR, and FINS decreased and insulin sensitivity index （ISI） and APN were higher in the acupuncture-medicine group than in the electroacupuncture group （P〈0.01）. There was no obvious difference in LEP between the two groups （P〉0.05）. CONCLUSION： Acupuncture combined with medi- cine is better than just electroacupuncture for obese PCOS patients by improving obesity-related indexes, insulin sensitivity, and APN level. This indi- cates that acupuncture-medicine therapy is worth clinical popularization.展开更多
Adult polycystic liver disease (PCLD) is an autosomal dominant condition commonly associated with autosomal dominant polycystic kidney disease (ADPKD). However in the last decade, it has been recognized that there is ...Adult polycystic liver disease (PCLD) is an autosomal dominant condition commonly associated with autosomal dominant polycystic kidney disease (ADPKD). However in the last decade, it has been recognized that there is a distinct form of autosomal dominant PCLD that arises without concomitant ADPKD. Early knowledge of the pathogenesis was gained from the study of hepatic cysts in patients with ADPKD. Bile duct overgrowth after embryogenesis results in cystic hepatic dilatations that are known as biliary microhamartomas or von Meyenburg complexes. Further dilatation arises from cellular proliferation and fluid secretion into these cysts. There is a variable, broad spectrum of manifestations of PCLD. Although PCLD is most often asymptomatic, massive hepatomegaly can lead to disabling symptoms of abdominal pain, early satiety, persistent nausea, dyspnea, ascites, biliary obstruction, and lower body edema. Complications of PCLD include cyst rupture and cyst infection. Also, there are associated medical problems, especially intracranial aneurysms and valvular heart disease, which clinicians need to be aware of and evaluate in patients with PCLD. In asymptomatic patients, no treatment is indicated for PCLD. In the symptomatic patient, surgical therapy is the mainstay of treatment tailored to the extent of disease for each patient. Management options include cyst aspiration and sclerosis, open or laparoscopic fenestration, liver resection with fenestration, and liver transplantation. The surgical literature discussing treatment of PCLD, including techniques, outcomes, and complication rates, are summarized in this review.展开更多
文摘“What's in a name?That which we call a rose by any other name would smell as sweet”-William Shakespeare Polycystic ovary syndrome(PCOS)is one of the commonest endocrinopathy in the reproductive age group,as depicted in a study among the North Indian population[1].The nomenclatures,the diagnostic criteria,the pathophysiology,and the modalities of treatment are full of controversies.Other names for this syndrome include Stein-Leventhal syndrome,polycystic ovary disease(PCOD),polycystic ovarian disease,functional ovarian hyperandrogenism,ovarian hyperthecosis and sclerocystic ovary syndrome,etc.
基金supported by the Natural Science Foundation of Hunan Province,China(2022JJ30886).
文摘Objective:Polycystic ovary syndrome(PCOS)is a common endocrine disorder that affects women’s health.This study aims to investigate gene and transcription factor(TF)expression differences between PCOS patients and healthy individuals using bioinformatics approaches,and to verify the function of key transcription factors,with the goal of providing new insights into the pathogenesis of PCOS.Methods:Differentially expressed genes(DEGs)and differentially expressed transcription factors(DETFs)between PCOS patients and controls were identified from the RNA sequencing dataset GSE168404 using bioinformatics methods.Functional enrichment analysis was performed using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)databases.The expression and function of core transcription factors were further validated in ovarian tissues of PCOS model mice and control mice using Western blotting and reverse transcription quantitative polymerase chain reaction(RTqPCR).Results:A total of 332 DEGs were identified between PCOS patients and controls,including 259 upregulated and 73 downregulated genes in the PCOS group.19 DETFs were further screened,of which 16 were upregulated and 3 were downregulated in PCOS.The upregulated DETFs(including TFCP2L1,DACH1,ESR2,AFF3,SMAD9,ZNF331,HOPX,ATOH8,HIF3α,DPF3,HOXC4,HES1,ID1,JDP2,SOX4,and ID3)were primarily associated with lipid metabolism,development,and cell adhesion.Protein and mRNA expression analysis in PCOS model mice revealed significantly decreased levels of hypoxia-inducible factor(HIF)1αand HIF2α,and significantly increased expression of HIF3αcompared to control mice(all P<0.001).Conclusion:Significant differences in gene and TF expression exist between PCOS patients and healthy individuals.HIF-3αmay play a crucial role in PCOS and could serve as a novel biomarker for diagnosis and a potential therapeutic target.
基金Supported by Incentive Funding for Rated Researchers from the National Research Foundation,Pretoria,No.145943Research Reward from the Research Office of the University of KwaZulu-Natal,Durban,South Africa.
文摘Recent studies have potentiated the essential role of androgens in normal follicu-logenesis and,therefore,female fertility.Contrastingly,excess androgen levels,i.e.,hyperandrogenism(HA),a hallmark characteristic of polycystic ovary syndrome,overrides the delicate balance of folliculogenesis,leading to follicular arrest and ovulatory issues.Insulin resistance(IR)has a profound effect on elevating androgen secretion and is considered one of the primary factors driving both ovarian androgen production and metabolic dysfunction in polycystic ovary syndrome.Together with IR,disruptions in key intraovarian and systemic factors,including activin,inhibin,follistatin,anti-Mullerian hormone,bone morpho-genetic proteins,growth differentiation factor-9 and Kit ligand,as well as dysreg-ulation in both the insulin and the transforming growth factor-βsuperfamily signaling pathway,contribute to follicular arrest,elevated androgen levels and metabolic dysfunction,exacerbating HA.Additionally,suppression of sex hormone-binding globulin,disrupted adipose-neuroendocrine signaling and altered microRNA expression heighten HA,with IR serving as the fundamental contributor.Emerging evidence implicates impaired atresia together with non-apoptotic cell death,such as ferroptosis and pyroptosis,which have also been associated with ovarian dysfunction.A comprehensive understanding of the most significant factors,particularly IR,which amplifies androgen production through hyperinsulinemia-mediated stimulation of theca cells,is essential for identifying targeted therapeutic strategies.
文摘Polycystic kidney disease (PKD) is an autosomal dominant genetic disorder that causes the formation of multiple cysts in the kidneys, leading to kidney failure. PKD is a common condition affecting approximately 1 in 500 individuals worldwide. The most prevalent type of PKD is autosomal dominant PKD (ADPKD). ADPKD is caused by mutations in either the PKD1 or PKD2 genes, which encode for proteins involved in cell growth and differentiation. These mutations lead to the formation of fluid-filled cysts in the kidneys, which can eventually lead to kidney failure. In addition to affecting the kidneys, PKD can also cause cysts in other organs, such as the liver, pancreas, and spleen. PKD can also lead to various complications, including high blood pressure, heart valve abnormalities, and brain aneurysms. This review focuses on the inheritance, pathophysiology, and treatment of PKD, with a specific emphasis on its effects on the cardiovascular system. Currently, there is no cure for PKD. However, several treatments are available to manage the symptoms and complications of the disease. These treatments include medications to control blood pressure, pain relievers, antibiotics for infections, and dialysis or kidney transplantation for kidney failure. Tolvaptan is the only FDA-approved drug specifically for ADPKD and has been shown to slow disease progression. In addition to summarizing current treatment options, this review will discuss promising future treatments, such as gene therapy and stem cell therapy.
基金Special Funds for Guiding Local Scientific and Technological Development by the Central Government(GuikeZY22096025)National Natural Science Foundation of China(32272316)Beijing Innovation Team of Livestock Industry Technology System(BAIC05-2022).
文摘Polycystic ovary syndrome(PCOS)is the most common endocrine disease afflicting women of childbearing age.It is characterized by irregular menstruation,clinical or biochemical hyperandrogenemia,and polycystic ovary morphology.As a complex endocrine-metabolic syndrome(MS),PCOS shares several endocrine-metabolic features with the MS,with insulin resistance at the core of their pathogenic mechanisms.PCOS and MS are interrelated and thus have similarities in treatment.Currently,the common treatment modalities for both are lifestyle intervention,medication,and surgery.More studies have shown that lifestyle intervention and regulation of intestinal flora are more effective and sustainable.However,progress towards treatment and cure is hampered by unclear etiology and mechanisms.This review aimed to summarize the relationship between PCOS and MS,the pathogenesis of metabolic disorders,and the current nutritional therapeutic strategies,especially lifestyle modifications and modulation of intestinal flora.Lifestyle interventions combined with the regulation of gut flora can be a new perspective for treatment.This perspective has a positive significance in the early diagnosis,adoption of personalized treatment plans,and prevention of complications in PCOS and MS.The need to prevent the occurrence of MS in patients with PCOS should be emphasized.
文摘Background:Bonducellin is one of the bioactive compounds present in Caesalpinia bonduc Roxb(L).It is a homoisoflavonoid recognized for its anti-cancer,anti-androgenic,and anti-estrogenic properties and could potentially treat polycystic ovary syndrome(PCOS).However,the underlying molecular mechanism remains unexplored.This study aims to elucidate the potential molecular mechanisms of bonducellin in treating PCOS and its associated symptoms through an integrated approach combining network pharmacology,molecular docking,molecular dynamics simulation,and in vivo validation.Methods:Bonducellin-associated and PCOS-related genes were intersected using VENN analysis to determine common gene targets.KEGG pathway analysis was conducted to investigate the biological pathways involving the co-targeted genes.The protein-protein interactions of the target genes were performed to identify the key proteins interacting with bonducellin.Molecular docking and 100 ns molecular simulations were carried out to evaluate the binding affinity and conformational stability of bonducellin with the target proteins.Additionally,the acute toxicity of bonducellin was assessed on zebrafish embryos and in vivo gene expression studies were performed to examine its regulatory effect on the top co-targeted gene.Results:The intersection of bonducellin-associated and PCOS-related genes identified 76 co-targeted genes.KEGG pathway analysis revealed their involvement in 15 critical pathways,including steroid hormone biosynthesis.Protein-protein interaction and pathway enrichment analysis highlighted key targets,including MMP9,AR,KDR,PRKACA,KIT,CYP19A1,HSD11B1,ESR1,STAT3,ESR2,PRKCA,ROCK1,BRAF,HSD17B2,PIK3R1,and RAF1,all of which exhibited strong binding to bonducellin.Molecular simulations confirmed the stability of bonducellin to the top proteins,MMP9 and AR,with high binding scores.Acute toxicity studies in zebrafish embryos determined the LC50 value of bonducellin as 0.8μg/mL at 48 hpf.Gene expression analysis revealed that bonducellin differentially regulates the MMP9 gene that is involved in modulating PCOS-related pathways.Conclusion:This study suggests potential gene pathways and protein interactions through which bonducellin could exert therapeutic effects on PCOS and its associated disorders.This provides valuable insights for future research into understanding and developing bonducellin-based treatments for PCOS.
基金supported by Natural Science Foundation of Jilin Province(20220101287JC)National Natural Science Foundation of China(31873003 and 31472158)Graduate Innovation Fund of Jilin University(2022140).
文摘Polycystic ovarian syndrome(PCOS)is the most principal reason for infertility in reproductive women,but no versatile treatment is feasible.Although trans-10-hydroxy-2-decenoic acid(10H2DA)exhibits the anti-inflammatory,anti-cancerous and immunomodulatory properties,its role in improving PCOS remains elusive.This present study examined the effects of 10H2DA on the estrous cycle,ovarian morphology,reproductive hormone,glucose and insulin tolerances of PCOS mice,analyzed the binding between 10H2DA and free fatty acid receptor 4(FFAR4),and explored the regulation of 10H2DA on the c-Jun N-terminal kinase(JNK)/JUN(Jun proto-oncogene)signaling,cytosolic calcium ion(Ca2),endoplasmic reticulum(ER)Ca2release,mitochondrial Ca2+,mitochondrial function,autophagy,lysosomal acidification,mitochondrial fission,secretion function and apoptosis of ovarian granulosa cells(GCs)using enzyme-linked immunosorbent assay,flow cytometry,Western blotting,molecular docking,various fluorescent probes or plasmid,etc.The results showed that 10H2DA alleviated the symptom of PCOS mice through improving the secretion dysfunction of GCs and protecting GCs against apoptosis.After binding to FFAR4 and inactivation of JNK/JUN signaling,10H2DA restricted the release of ER Ca2through targeting ryanodine receptors(RYRs)which had been identified as the downstream targets of JUN,diminished cytosolic Ca^(²+) accumulation and prevented Ca^(²+) influx into mitochondria via adjusting the mitochondrial calcium uptake 1 and mitochondrial calcium uniporter.Concurrently,10H2DA kept the integrity of mitochondrial function through maintaining mitochondrial Ca2 homeostasis and suppressed the discharge of mitochondrial reactive oxygen species into the cytosol through blocking the mitochondrial permeability transition pore opening to avoid the lipid peroxidation and ameliorate the secretory function and apoptosis of GCs.Furthermore,1OH2DA rescued the defective autophagic flux along with the decline of autophagosomes and sequestosome 1 aggregation,restored the mitophagy flux with the abatement of mitophagosomes and Parkin recruitment to mitochondria,and accelerated the lysosomal degradation for depolarized mitochondria with the recovery of lysosomal acidification,whereas activation of JNK antagonized the amelioration of 10H2DA on above effectiveness,but this antagonism was counteracted by the attenuation of intracellular Ca2+.After application of 10H2DA,dynamin-related protein 1 phosphorylation was diminished and its recruitment to mitochondrial surface was impeded concomitant with the improvement of mitochondrial fragmentation,whereas inhibition of late-stage autophagy caused the failure of 10H2DA in improving mitochondrial fission.Collectively,10H2DA might ameliorate PCOS mice through modulating autophagy-mediated mitochondrial fission dependent on the maintenance of Ca^(2+) homeostasis between ER and mitochondria.
文摘Background Polycystic ovarian syndrome(PCOS),a common endocrine disorder in reproductive-aged women,has substantial physical and psychological impacts.While the physical manifestations of PCOS are well established,the psychological burden,especially anxiety,is understudied in Saudi Arabia.This study aimed to assess the prevalence of generalized anxiety disorder among females with PCOS compared to those without PCOS,and to identify the clinical and sociodemographic factors associated with anxiety in the Jazan region of Saudi Arabia.Methods A cross-sectional study was conducted between January and March 2023 using an Arabic self-administered online questionnaire distributed via social media platforms.The study recruited 410 reproductive-age females(≥18 years)from the Jazan region using convenience sampling.The questionnaire encompassed socio-demographic characteristics,economic indicators,medical history,PCOS symptoms,and the validated Generalized Anxiety Disorder-7(GAD-7)assessment tool.Results The prevalence of PCOS in the study population was 22.44%.Women with PCOS showed significantly higher anxiety levels compared to controls without PCOS(32.61%vs.22.33%).Biochemical hyperandrogenism was the strongest predictor of anxiety(OR=4.179).Menstrual irregularities demonstrated a dose-dependent relationship with anxiety risk,wherein participants with 2–3 months and≥3 months of amenorrhea had 2.5-and 3.3-times higher odds of anxiety compared to those with regular cycles(OR=2.451 and 3.314).Other PCOS-related dermatological manifestations were also associated with increased anxiety,including hirsutism(OR=1.745),alopecia(OR=2.285)and acne(OR=1.723).Marital status was a significant factor,with divorced/widowed females having 4.4-fold higher anxiety odds compared to single females(OR=4.371).Conclusion PCOS presents a significant psychological burden in Saudi women,with anxiety prevalence higher than the general population.The robust associations between PCOS manifestations and anxiety emphasize the need for integrated healthcare approaches that address both endocrine and mental health aspects.Routine psychological screening and support services should be incorporated into PCOS management protocols.
基金supported by funds from the Natural Science Foundation of Shandong Province(No.ZR2020MH346No.ZR2021MH003)the National Natural Science Foundation of China(No.81273667).
文摘Polycystic ovary syndrome(PCOS)is a prevalent endocrine disorder that poses a significant threat to women’s health.As a classical traditional Chinese medicine(TCM)formulation,Guizhi-Fuling Wan(GFW)has a good application prospect in the complementary treatment of PCOS.This study aimed to systematically summarize the traditional efficacy and pharmacological composition of the Chinese medicines contained in GFW and evaluate the clinical efficacy and safety of their active ingredients in the complementary treatment of PCOS.A growing number of studies have demonstrated that GFW is effective at complementally treating PCOS through various mechanisms,including inhibiting inflammatory responses,modulating the intraovarian extracellular matrix,regulating apoptosis and autophagy in granulosa cells,and correcting oxidative stress imbalances.In addition,the GFW has been shown to be effective in treating the complications of PCOS.However,there are several problems,and future work should focus on elucidating the efficacy,safe dosage,and safety of different dosage forms of GFW,increasing the toxicological value of traditional Chinese medicine,and confirming the safety of the combination of GFW with Western medicine for the treatment of PCOS.
基金Supported by National Natural Science Foundation of China:Elucidation of a New Mechanism of the Prescription for Reinforcing Kidney and Promoting Pregnancy (Bushen Zhuyun Decoction) in Treating Luteal Phase Defects Infertility based on Coenzyme Q10/Ubiquinol Mediated New Ferroptosis Pathway in Endometrium During Implantation (No. 82474567)Jiangsu Province Key Research and Development Plan (Society Development) Project:a Multicenter Real-world Study of Sequential Treatment of Luteal Phase Defects Infertility with “Improving Endometrial Receptivity” as the Effect Point (No. BE2021726)Project of Clinical Innovation Center of Traditional Chinese Medicine in Jiangsu Province:Clinical And Basic Research on the Treatment of Luteal Phase Defects Infertility with “Improving Endometrial Receptivity” as the Effect Point (No. k2021j18-1)
文摘OBJECTIVE:To evaluate the effectiveness and safety of the sequential therapy in treating infertility with polycystic ovary syndrome(PCOS)and luteal phase defects(LPD)by Yangxin Dianji decoction(养心奠基方,YXDJ-D)and Nuangong Tiaojing decoction(暖宫调经方,NGTJ-D).METHODS:This study was undertaken in the Jiangsu Province Hospital of Chinese Medicine.Altogether 90 eligible patients with PCOS and LPD were assigned to exposed group A(Chinese Medicine therapy,YXDJ-D and NGTJ-D),exposed group B(Chinese Medicine plus Western Medicine therapy),control group(Western Medicine therapy).The exposed group A adopted the sequential therapy that YXDJ-D is taken in the postmenstrual period(follicular phase)and NGTJ-D is taken in premenstrual period(luteal phase).Control group took letrozole,dydrogesterone and was given intramuscular injection of human menopausal gonadotropin,human chorionic gonadotropin.The exposed group B was treated with the above-mentioned therapy project of integrated Chinese Medicine and Western Medicine.This study lasted for 2 courses for 6 months.The primary outcomes were pregnancy rate and early abortion rate.The secondary outcomes were the Traditional Chinese Medicine(TCM)syndrome scores,estrogen(E2)and progesterone(P),endometrial volume(EV),vascularity index(VI),flow index(FI)and vascularization flow index(VFI).These outcomes will be assessed at baseline and post-intervention.RESULTS:The pregnancy rates of the exposed group A and B were higher than the control group(60.00%vs 60.00%vs 53.33%),while early abortion rates of exposed groups A and B were lower than the control group(33.33%vs 16.67%vs 43.75%,P>0.05).Total efficacy rates in exposed group A and B were better than the control group(93.30%vs 93.30%vs 53.30%,P<0.01).TCM symptom scores and endometrial receptivity indexes(EV,FI,VFI)were significantly lower in exposed groups compared to the control group(P<0.05).P increase in exposed group B was superior to the other two groups(P<0.01).No noticeable abnormalities in safety indicators in the three groups.CONCLUSION:The sequential therapy of YXDJ-D and NGTJ-D can effectively increase pregnancy rate,reduce the early abortion rate and alleviate the clinical symptoms of infertility in patients with PCOS and LPD by improving luteal function and promoting the endometrial receptivity.
文摘BACKGROUND Equations for estimation glomerular filtration rate(eGFR)have been associated with poor clinical performance and their clinical accuracy and reliability have been called into question.AIM To assess the longitudinal changes in measured glomerular filtration rate(mGFR)in patients with autosomal dominant polycystic kidney disease(ADPKD).METHODS Analysis of an ambispective data base conducted on consecutive patients diagnosed with ADPKD.The mGFR was assessed by iohexol clearance;while eGFR was calculated by three different formulas:(1)The chronic kidney disease epidemiology collaboration(CKD-EPI);(2)Modification of diet in renal disease(MDRD);and(3)The 24-hour urine creatinine clearance(CrCl).The primary end-points were the mean change in mGFR between the baseline and final visit,as well as the comparison of the mean change in mGFR with the change estimated by the different formulas.RESULTS Thirty-seven patients were included in the study.As compared to baseline,month-6 mGFR was significantly decrease by-4.4 mL/minute±10.3 mL/minute(P=0.0132).However,the CKD-EPI,MDRD,and CrCl formulas underestimated this change by 48.3%,89.0%,and 45.8%respectively,though none of these differences reached statistical significance(P=0.3647;P=0.0505;and P=0.736,respectively).The discrepancies between measured and estimated glomerular filtration rate values,as evaluated by CKD-EPI(r=0.29,P=0.086);MDRD(r=0.19,P=0.272);and CrCl(r=0.09,P=0.683),were not correlated with baseline mGFR values.CONCLUSION This study indicated that eGFR inaccurately reflects the decline in mGFR and cannot reliably track changes over time.This poses significant challenges for clinical decision-making,particularly in treatment strategies.
文摘Polycystic ovary syndrome(PCOS)is a lifelong disorder affecting reproductive,metabolic,and psychological health.A healthy lifestyle and effective weight management strategies should underpin the treatment of PCOS.This case report documents the successful management of a Chinese patient with PCOS who was overweight and presented with oligomenorrhea and persistent adiposity.The patient was diagnosed using the Rotterdam criteria.The intervention was a 2-month program involving caloric restriction(1,350 kcal/day whole-food diet),progressive exercise titration(150–180 min/week of aerobic and resistance training),mindfulness practice,and metformin initiation after confirmed insulin resistance(HOMA-IR 3.67)resulted in clinically significant body composition improvements:fat mass was reduced by 5.0 kg,visceral adipose area was reduced by 44.7 cm^(2),skeletal muscle was increased by 1.4 kg,and regular menstrual cycles(32 day interval)were restored following 5% weight loss-consistent with evidence linking this threshold to improved ovarian function.The combination of a structured lifestyle modification program with targeted pharmacotherapy offers a viable clinical approach for metabolic PCOS phenotypes,although further validation is required to ascertain long-term efficacy.
基金National Administration of Traditional Chinese Medicine high-level key discipline construction project on Ethnic Minority Medicine(Zhuang Medicine)(Project No.:zyyzdxk-2023164)Guangxi Higher Education Key Laboratory for Research on Toxin-related Diseases in Zhuang Medicine(Guijiao Keyan[2022]No.10).
文摘As an important branch of traditional medicine,Zhuang Medicine is renowned for its unique prescriptions and techniques in clinical treatment,with significant therapeutic effects and widespread popularity.This article introduces Professor Fang Gang’s experience in treating obesity-type polycystic ovary syndrome(PCOS)with modified Zhuang Medicine Mao Xia Yin.Professor Fang Gang proposes that the etiology and pathogenesis of obesity-type polycystic ovary syndrome(PCOS)primarily stem from spleen deficiency,which impairs the transport of water and dampness.This dysfunction leads to the accumulation of dampness that transforms into phlegm.Over time,the stagnation of phlegm and dampness generates internal heat,resulting in the formation of“dampness toxin,”“phlegm toxin,”and“heat toxin.”These pathological toxins obstruct the circulation of Qi and blood,causing stasis and the emergence of“stasis toxin.”The buildup of these toxins ultimately blocks the three channels and two pathways,disrupting the harmony among the three Qi of heaven,earth,and man.This disharmony culminates in impaired uterine gland function.Therefore,the treatment mainly focuses on tonifying deficiency,detoxifying,and regulating Qi.
基金Supported by the National Natural Science Foundation of China:30973790
文摘Objective To observe the effect of electroacupuncture （EA） on egg quality of polycystic ovarian syndrome （PCOS） patients, and to explore its mechanism. Methods Two hundred patients who received in vitro fertilization-embryo transfer （IVF-ET） were divided into an EA group （102 cases） and a control group （98 cases） according to random number table. All the patients in the two groups were given Diane-35 and gonadotropin-releasing hormone agonist （GnRH-α） for ovarian hyperstimulation. Besides, EA intervention was applied to Shenshu （肾俞 BL 23）, Qihai （气海 GV 6）, Zusanli （足三里ST 36）, Sanyinjiao （三阴交 SP 6）, Neiguan （内关 PC 6） and Zigong （子宫 EX-CA1）, etc. in the EA group. Then egg quality, final outcome of pregnancy and levels of tumor necrosis factor-α （TNF-α） were compared between the two groups. Results （1） EA intervention significantly improved high quality embryo rate of PCOS patients （P〈0.05）, and clinical pregnancy rate was increased by 8.36%; （2） EA intervention significantly reduced the TNF-α levels of follicular fluid （13.61±15.46 vs 34.09±93.53, P〈0.05）; （3） TNF-α levels of serum and follicular fluid in the pregnancy group were lower than those of non-pregnancy group [pregnancy group： （53.91±63.32） pg/mL, （14.93±25.37） pg/mL, nonpregnancy group： （76.82 ± 82.96） pg/mL, （25.04 ± 35.79） pg/mL], and the differences were significant （both P〈0.05）. Conclusion EA improves egg quality of PCOS patients and increases the clinical pregnancy rate of IVF-ET, the mechanism may be related to TNF-α levels.
文摘Objective To evaluate the differences of the clinical manifestation and endocrine situation in patients with different ovarian morphology of polycystic ovary syndrome （PCOS）. Methods A total of 234 PCOS patients were enrolled according to the ovary morphology and divided into three groups： 112 patients with B-polycystic ovary mor- phology （both two ovaries were PCOM, B-PCOM）, 50 with U-PCOM （only one ovary was PCOM） and 72 with N-PCOM （none was PCOM）. There were 39 infertile women without PCOS as control group. Data were analyzed by using SPSS 15.0 software. ResuIts There was no statistical difference in body mass index （BM1） among the three groups of PCOS. The endometrial thickness increased in patients with B-PCOM and decreased with N-PCOM. The levels of testosterone, androstenedione and luteinizing hormone increased in PCOS groups, especially in N-PCOM patients. HOMA-IR increased, HOMA-fl, disposition index （DI） and △160/AG60 decreased in patients with N- PCOM compared with in B-PCOM and U-PCOM groups. Higher level of total choles- terol （TC） and lower level of high-density lipoprotein （HDL）-C existed in PCOS patients, especially in N-PCOM. There were positive correlations between oligo-anovulation, endometrial thickness, LH/FSH ratio, fasting insulin （FINS）, the area under curve of glucose（A UCcLu） and PCOM, while there was a negative correlation between HOMA- IR and PCOM. Conclusion There are relationships among hyperandrogenism, hyperinsulinemia, insulin resistance （IR） and ovary morphology in PCOS patients. PCOS patients with- out PCOM have more serious IR and hyperandrogenism.
文摘Objective This review aimed to systematically evaluate the evidence on the effects of acupoint catgut embedding （ACE） therapy for patients with polycystic ovary syndrome （PCOS）. Methods Five databases （CBM, CNKI, Wanfang Database, VlP Database, and PubMed） were searched to identify relevant studies published before June 2027. The outcomes were resumption of menstruation and serum levels of testosterone （T）. The methodological quality of the included studies was judged using the Cochrane risk of bias tool. The overall level of evidence was judged by the Grading of Recommendations Assessment, Development, and Evaluation （GRADE） criteria. Results Twenty- five randomized controlled trials were included. ACE therapy significantly lowered serum T levels, and patients receiving ACE treatment reported resumption of menstruation. However, these results should be interpreted with caution due to a high risk of randomization and blinding bias, and likely publication bias. The level of evidence for resumption of menstruation and serum T levels was assessed as ＂low＂ and ＂low＂, respectively, using GRADE. Conclusion The current evidence on ACE therapy for PCOS is insufficient to draw firm conclusions due to the poor methodological quality. Future well- designed trials are needed to validate the therapeutic efficacy, safety, and mechanisms of ACE in patients with PCOS.
文摘Objective To excavate and analyze the acupoint selection rules of acupuncture for PCOS. Methods A literature search was conducted in databases of Chinese Biomedicine Database（CBM）, Chinese National Knowledge Infrastructure Database（CNKI）, Wanfang Database, Chongqing VIP Chinese Science and Technology Periodical Database（VIP） and Pub Med. All clinical trials evaluating the effects of acupuncture in the treatment of polycystic ovary syndrome（PCOS） were included with or without methods of randomization and/or control. Four authors extracted information and two reviewers recorded information on titles, journals, interventions, main acupoints in selfestablished Excel sheet. Results The top ten acupoints of acupuncture therapy used most frequently were, by turns, Sānyīnjiāo（三阴交 SP 6）, Guānyuán（关元 CV 4）, Zhōngjí（中极 CV 3）, Zǐgōng（子宫 EX-CA 1）, Qìhǎi（气海 CV 6）, Zúsānlǐ（足三里 ST 36）, Shènshù（肾俞 BL 23）, Tiānshū（天枢 ST 25）, Guīlaí（归来 ST 29）, Zhōngwǎn（中脘 CV 12）. Conclusion Our study indicates that modern acupuncture treatment for PCOS is based on selection of specific acupoints according to traditional Chinese acupuncture theory. Points of spleen meridian, stomach meridian and conception vessel are chosen frequently which are most located on the abdomen and the lower limbs. Specific points used most are the front-mu points, the he-sea points, matching points and the back-shu points.
文摘Objective To observe the effects of acupuncture on menstruation and endocrine in patients of normal body weight with polycystic ovary syndrome. Methods Twenty-seven patients were treated with acupuncture and moxibustion for six months. Guanyuan （关元 4）, Zhongji （中极 CV 3）, and Zigong （子宫 EX-CA 1） on the abdomen and Sanyinjiao （三阴交SP 6）, Zusanli （足三里 ST 36）, Yinlingquan（阴陵泉 sP 9）, Fenglong （丰隆 ST 40）, xiaxi （侠溪GB 43）, Taichong （太冲 LR 3） were punctured. CV 3 on the abdomen and EX-CA 1 on both sides were manipulated by moxisbustion. The menstrual frequency, B ultrasound examination of uterus and adnexa uteri, luteinizing hormone （LH）, follicle stimulating hormone （FSH）, testosterone （T）, prolactin （PRL）, progesterone （PROG） and estradiol （E2） were recorded. Results Menstrual cycles were restored in twenty-six patients after six- month treatment. The total frequencies of menstruation were 105, of which 79 with normal ovulation accounting for 75.23%. The testosterone level of （109.65 ± 43.38） ng/dL before treatment were reduced to （53.7 ± 19.24） ng/dL after treatment, LH/FSH ratio of 4.15 ± 1.38 before treatment were reduced to 1.75 ± 1.09 after treatment. The differences were statistically significant （both P〈O.O5）. Conclusion Acupuncture can promote normal ovulation and menstrual cycles in patients with PCOS by regulating endocrine level.
基金Supported by the National Basic Research Program of China(973 program,No.2009CB522900)Open Research Fund of Zhejiang First-foremost Key Subject-Acupuncture and Moxibustion(No.ZTK2010B02)Shanghai Municipal Health Bureau(No.20124049)
文摘OBJECTIVE： To explore the effect of electroacu- puncture and Chinese kidney-nourishing medicine on insulin （INS）, adiponectin （APN）, leptin （LEP）, and glucolipid metabolism of obese patients with polycystic ovary syndrome （PCOS）. METHODS： Sixty-seven obese PCOS patients were randomly divided into two groups. Thirty-three pa- tients in the acupuncture-medicine group were treated three times a week with electroacupunc- ture at the Tianshu （ST 25）, Zhongwan （CV ] 2）, Qi- hai （CV 6）, Sanyinjiao （SP 6）, Geshu （BL 17）, and Cil-iao （BL 32） acupoints. They drug, Tiankui capsule, for 3 treatment. Point-taking and also took the Chinese months as a course of treatment in the elec- troacupuncture group of 34 patients was the same as those in the acupuncture-medicine group. We observed and compared the changes in the obesi- ty-related indexes of body weight （BW）, body mass index （BMI）, and waist-hip ratio （WHR）, as well as fasting plasma glucose （FPG）, fasting insulin （FINS）, APN, and LER RESULTS： BW, BMI, WHR, and FINS decreased and insulin sensitivity index （ISI） and APN were higher in the acupuncture-medicine group than in the electroacupuncture group （P〈0.01）. There was no obvious difference in LEP between the two groups （P〉0.05）. CONCLUSION： Acupuncture combined with medi- cine is better than just electroacupuncture for obese PCOS patients by improving obesity-related indexes, insulin sensitivity, and APN level. This indi- cates that acupuncture-medicine therapy is worth clinical popularization.
基金Supported by an educational grant from Novartis Pharma-ceuticals
文摘Adult polycystic liver disease (PCLD) is an autosomal dominant condition commonly associated with autosomal dominant polycystic kidney disease (ADPKD). However in the last decade, it has been recognized that there is a distinct form of autosomal dominant PCLD that arises without concomitant ADPKD. Early knowledge of the pathogenesis was gained from the study of hepatic cysts in patients with ADPKD. Bile duct overgrowth after embryogenesis results in cystic hepatic dilatations that are known as biliary microhamartomas or von Meyenburg complexes. Further dilatation arises from cellular proliferation and fluid secretion into these cysts. There is a variable, broad spectrum of manifestations of PCLD. Although PCLD is most often asymptomatic, massive hepatomegaly can lead to disabling symptoms of abdominal pain, early satiety, persistent nausea, dyspnea, ascites, biliary obstruction, and lower body edema. Complications of PCLD include cyst rupture and cyst infection. Also, there are associated medical problems, especially intracranial aneurysms and valvular heart disease, which clinicians need to be aware of and evaluate in patients with PCLD. In asymptomatic patients, no treatment is indicated for PCLD. In the symptomatic patient, surgical therapy is the mainstay of treatment tailored to the extent of disease for each patient. Management options include cyst aspiration and sclerosis, open or laparoscopic fenestration, liver resection with fenestration, and liver transplantation. The surgical literature discussing treatment of PCLD, including techniques, outcomes, and complication rates, are summarized in this review.
