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
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
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 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
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
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 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
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 highly familial and heritable endocrine disorder. Over half of the daughters born to women with PCOS may eventually develop their own PCOS-related symptoms. Progress in the treatm...Polycystic ovary syndrome (PCOS) is a highly familial and heritable endocrine disorder. Over half of the daughters born to women with PCOS may eventually develop their own PCOS-related symptoms. Progress in the treatment of PCOS is currently hindered by the complexity of its clinical manifestations and incomplete knowledge of its etiopathogenesis. Various animal models, including experimentally induced, naturally occurring, and spontaneously arising ones, have been established to emulate a wide range of phenotypical and pathological traits of human PCOS. These studies have led to a paradigm shift in understanding the genetic, developmental, and evolutionary origins of this disorder. Furthermore, emerging evidence suggests that animal models are useful in evaluating state-of-the-art drugs and treatments for PCOS. This review aims to provide a comprehensive summary of recent studies of PCOS in animal models, highlighting the power of these disease models in understanding the biology of PCOS and aiding high-throughput approaches.展开更多
BACKGROUND Renal cell carcinoma(RCC)is more common in patients with autosomal dominant polycystic kidney disease(ADPKD)than in the general population.Diagnosing RCC in ADPKD is challenging due to the presence of multi...BACKGROUND Renal cell carcinoma(RCC)is more common in patients with autosomal dominant polycystic kidney disease(ADPKD)than in the general population.Diagnosing RCC in ADPKD is challenging due to the presence of multiple renal cysts,often leading to delays and difficulties in distinguishing RCC from cyst infection or hemorrhage.A total of 38 kidneys were excised from 19 patients,with a mean age of 56.8 years and an average hemodialysis duration of 84.2 months.Eight patients underwent open nephrectomies,and 11 underwent hand-assisted laparoscopic nephrec-tomies.RCC was detected in 15.8%of kidneys,affecting 21.1%of patients.Two patients had multifocal RCC in both kidneys.All RCC cases were pT1 stage,with the largest lesion averaging 16.5 mm in diameter.The average operative duration was 120 minutes,with intraoperative blood loss averaging 184.2 mL.Five patients required blood transfusions.Postoperative complications occurred in five patients,with a mean hospital stay of 17.1 days.The mean follow-up period was 28.1 months.CONCLUSION The prevalence of RCC is higher in patients with ADPKD with ESRD than in those with ESRD alone.Thus,clinicians should be cautious and implement surveillance programs to monitor the development of RCC in patients with ADPKD,particularly those on dialysis.展开更多
Objective:To systematically evaluate the effectiveness of acupuncture and moxibustion as a complementary treatment for polycystic ovary syndrome(Pcos)and provide evidence for clinical treatment.Methods:The following s...Objective:To systematically evaluate the effectiveness of acupuncture and moxibustion as a complementary treatment for polycystic ovary syndrome(Pcos)and provide evidence for clinical treatment.Methods:The following seven databases were searched from the date of database creation to October 29,2023:PubMed,Embase,the Cochrane Library,China Biology Medicine(CBM),Chinese National Knowledge Infrastructure(CNKI),Wanfang,and VIP.The literature was screened according to the inclusion and exclusion criteria,data were extracted,quality was evaluated using the Cochrane Risk of Bias Assessment Tool,and a meta-analysis of the outcomes was performed using Review Manager 5.4 software.Results:A total of 20 researches were included and the test group was treated with modern medicine,acupuncture,electroacupuncture,warm needling,and thunder-fire moxibustion.The control group was treated with modern medicine,including clomiphene,Diane-35,letrozole,metformin,and progesterone.The meta-analysis showed that acupuncture and moxibustion as a complementary therapy for Pcos improved the ovulation and pregnancy rates and reduced the body mass index(BMI),luteinizing hormone(LH)levels,the LH/follicle-stimulating hormone(FSH)ratio,and ovarian volume;however,due to high heterogeneity,the differences regarding improvements in FSH,estradiol(E2),testosterone(T)and progesterone(P)levels could not draw a definite conclusion when compared with modern first-line drugs alone.Conclusion:Acupuncture and moxibustion as a complementary treatment for Pcos has good clinical efficacy;however,because of the relatively low quality of the included studies,the results may be biased.More high-quality clinical studies are needed to verify the results.The Prospero Registration number is CRD42022368304.展开更多
Objective To investigate the relationship and potential pathways between metal(loid)exposure and the risk of polycystic ovary syndrome(PCOS)in women of childbearing age.Methods This case-control study included 200 pat...Objective To investigate the relationship and potential pathways between metal(loid)exposure and the risk of polycystic ovary syndrome(PCOS)in women of childbearing age.Methods This case-control study included 200 patients with PCOS(cases)and 896 non-PCOS controls with the age of 25-37 years.The concentrations of 29 metal(loid)s in the follicular fluid(FF)and clinical indicators in the serum were measured in all participants.Logistic regression analysis and mediation analysis were conducted to evaluate the associations between metal(loid)exposure and PCOS risk and investigate the possible roles of clinical indicators,respectively.Results Logistic regression analysis revealed an association between high copper levels in FF and increased PCOS risk(highest vs.lowest quartile:adjusted odds ratio=2.94,95%confidence interval:1.83-4.72).A high luteinizing hormone/follicle-stimulating hormone ratio and elevated levels of testosterone and anti-Müllerian hormone(AMH)were strongly associated with increased PCOS risk induced by high copper exposure.The mediation analysis indicated a mediating effect of AMH in the association between copper exposure and PCOS risk.Conclusion Copper may affect PCOS risk through the hypothalamic-pituitary-ovarian axis,mediated by AMH.Copper exposure and internal AMH levels are important indicators for early warning of PCOS development.展开更多
Objective:To explore the potential therapeutic impact of an alcoholic extract derived from the sea cucumber(Holothuria parva)on letrozole-induced polycystic ovary syndrome(PCOS)in adult female Sprague-Dawley rats.Meth...Objective:To explore the potential therapeutic impact of an alcoholic extract derived from the sea cucumber(Holothuria parva)on letrozole-induced polycystic ovary syndrome(PCOS)in adult female Sprague-Dawley rats.Methods:Sixteen female rats,aged 8 to 10 weeks,with a mean weight of(200±20)g,were randomly assigned to four groups:the control,PCOS,and two treatment groups receiving sea cucumber extract and metformin,respectively.PCOS was induced by administering letrozole at a dose of 1 mg/kg to initiate the treatment period at 60 days of age.The study spanned four weeks,during which ovarian and uterine tissues were collected for histological examination,and blood samples were collected for hormonal levels.Results:Significant decreases in luteinizing hormone/follicle stimulating hormone(LH/FSH)and testosterone and increases progesterone levels among groups treated with sea cucumber extract were observed.While no significant differences were observed in follicle-stimulating hormone(FSH)and testosterone levels,the distinctive variations in key hormones suggested a potential role for sea cucumber alcoholic extract in ameliorating PCOS symptoms.Conclusions:This research highlights the moderate efficacy of sea cucumber extract as a therapeutic intervention for PCOS,providing a novel perspective in the search for effective remedies.The observed hormonal alterations,particularly in LH,estradiol,and progesterone,underscore the need for further exploration into the underlying mechanisms and for optimizing the application of sea cucumber extract in PCOS management.展开更多
BACKGROUND To retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating autosomal dominant polycystic kidney disease(ADPKD)patients with gross hematuria.CASE SUMMARY The ...BACKGROUND To retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating autosomal dominant polycystic kidney disease(ADPKD)patients with gross hematuria.CASE SUMMARY The purpose of this study is to retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating ADPKD patients with gross hematuria.Materials and methods:During the period from January 2018 to December 2019,renal transcatheter arterial embolization was carried out on 6 patients with polycystic kidneys and gross hematuria.Renal arteriography was performed first,and then we determined the location of the hemorrhage and performed embolization under digital subtraction angiography monitoring.Improvements in routine blood test results,routine urine test results,urine color and postoperative reactions were observed and analyzed.Results:Renal transcatheter arterial embolization was successfully conducted in 6 patients.The indices of 5 patients and the color of gross hematuria improved after surgery compared with before surgery.No severe complication reactions occurred.CONCLUSION For autosomal dominant polycystic kidney syndrome patients with gross hematuria,transcatheter arterial embolization was safe and effective.展开更多
BACKGROUND Polycystic kidney disease(PKD)is the most common genetic cause of kidney disease.It is a progressive and irreversible condition that can lead to end-stage renal disease and many other visceral complications...BACKGROUND Polycystic kidney disease(PKD)is the most common genetic cause of kidney disease.It is a progressive and irreversible condition that can lead to end-stage renal disease and many other visceral complications.Current comprehensive data on PKD patterns in Africa is lacking.AIM To describe the prevalence and outcomes of PKD in the African population.METHODS A literature search of PubMed,African journal online,and Google Scholar databases between 2000 and 2023 was performed.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed to design the study.Clinical presentations and outcomes of patients were extracted from the included studies.RESULTS Out of 106 articles,we included 13 studies from 7 African countries.Ten of them were retrospective descriptive studies concerning 943 PKD patients with a mean age of 47.9 years.The accurate prevalence and incidence of PKD were not known but it represented the third causal nephropathy among dialysis patients.In majority of patients,the diagnosis of the disease was often delayed.Kidney function impairment,abdominal mass,and hypertension were the leading symptoms at presentation with a pooled prevalence of 72.1%(69.1-75.1),65.8%(62.2-69.4),and 57.4%(54.2-60.6)respectively.Hematuria and infections were the most frequent complications.Genotyping was performed in few studies that revealed a high proportion of new mutations mainly in the PKD1 gene.CONCLUSION The prevalence of PKD in African populations is not clearly defined.Clinical symptoms were almost present with most patients who had kidney function impairment and abdominal mass at the diagnostic.Larger studies including genetic testing are needed to determine the burden of PKD in African populations.展开更多
Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from th...Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from the CDC Pregnancy Risk Assessment of Monitoring System, specifically Standard Core and Phase 8 responses, with 9549 respondents across the United States through SPSS 28 software in this cross-sectional study. Two variables assessed PCOS status in respondents: history of PCOS and PCOS during pregnancy. With a history of PCOS, there were significantly increased odds of diabetic (OR 1.665, p < 0.001), hypertensive disorders (OR 1.589, p < 0.001) during pregnancy, neonatal mortality (OR 1.550, p < 0.001), cesarean section (C/S) (OR 1.489, p < 0.001), and preterm prelabor rupture of membranes (PPROM) (OR 2.081, p < 0.001). With PCOS diagnosed during pregnancy, there were significantly greater odds of diabetes (OR 3.278, p < 0.001), hypertensive disorders (OR 2.935, p < 0.001) during pregnancy, and significantly decreased risk for small for gestational age (2 standard deviations) (OR 0.337, p = 0.024). PCOS is a significant risk factor that contributes to maternal morbidity. Our results support the hypothesis that PCOS’ impact extends well into a woman’s obstetrical journey, with varying degrees of associated adverse maternal and fetal risks. Preliminary pathophysiologic explanations associated with PCOS gestational diabetes include pre-existing insulin resistance. Meanwhile, altered placentation and endovascular changes associated with PCOS secondary to a baseline deranged metabolic environment predispose patients to developing hypertensive disorders, PPROM, and preterm delivery. Associations between neonatal mortality and C/S can be attributed to elevated maternal body mass index. The pathophysiologic link between PCOS and the above obstetrical outcomes still remains unknown, necessitating further investigation;however, this study identifies the outcomes that require the most attention at this time.展开更多
Background: In Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) represents the final step in the management of Polycystic Ovarian Syndrome (PCOS). Our objective was to study the association between PCOS...Background: In Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) represents the final step in the management of Polycystic Ovarian Syndrome (PCOS). Our objective was to study the association between PCOS phenotypes and IVF/ICSI results in women admitted to Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital (CHRACERH). Material and Method: We carried out a cohort study with historical-prospective data collection over a period of seven years (January 2016 to March 2023) at Chracerh. PCOS patients were subdivided into 4 subgroups A, B, C and D. Results: We recruited 128 patients including 64 PCOS patients divided into four phenotypes and 64 non-PCOS patients constituting the control group. Phenotype D without hyperandrogenism had used the lowest dose of gonadotropins, i.e. 1939.7 ± 454.3 IU, and had produced a greater quantity of estradiol on the day ovulation was triggered (6529.8 ± 4324.8 ng/ml). The average number of punctured follicles and mature oocytes were higher in the phenotype D group. Ovarian hyperstimulation syndrome (OHSS) occurred mainly in phenotype D (3/35), with an estimated prevalence of 2.3%. The fertilization rate seemed lower in the hyperandrogenic phenotypes A, B, C compared to the group without hyperandrogenism without significant difference (p = 0.461). The biological pregnancy rate and live birth rate were comparable between the different groups. Conclusion: Phenotype D used less dose of gonadotropins. Biological pregnancy and live birth rates were comparable between the different phenotypes.展开更多
Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions an...Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions and the provision of diagnostic treatment. This study reports a case of PCOS with an ovarian mass in which LOD was aggressively used and a granulosa cell tumor (GCT) was found. A 34-year-old woman with secondary amenorrhea and irregular menstrual cycles presented to the emergency department with abdominal pain of unknown etiology. Imaging studies revealed a 6-cm left ovarian mass with an internal appearance suggestive of a hemorrhage. The patient’s secondary amenorrhea was subsequently diagnosed as PCOS, and LOD was performed to preserve her fertility. Simultaneously, a cystectomy was performed to evaluate the tumor in the left ovary;the diagnosis was adult-type GCT. Although concomitant GCT and PCOS are extremely rare, the two conditions have similar clinical manifestations. In women of reproductive age, the impact of surgery on future fertility should be considered, and the initial surgical technique should be chosen carefully.展开更多
Objective: To observe the therapeutic effect of combined traditional Chinese medicine (TCM) therapy with acupoint injection and herbal patch application on patients with ovulatory dysfunction associated with polycysti...Objective: To observe the therapeutic effect of combined traditional Chinese medicine (TCM) therapy with acupoint injection and herbal patch application on patients with ovulatory dysfunction associated with polycystic ovary syndrome (PCOS). Methods: A total of 80 PCOS patients who received treatment at the First Affiliated Hospital of Guangxi University of Chinese Medicine between October 2022 and March 2024 were enrolled in this study. They were randomly divided into a control group (n = 40) and an observation group (n = 40). The control group received conventional Western medical treatments, while the observation group was administered TCM combined with acupoint injection and herbal patch application. Pre- and post-treatment conditions were compared between the two groups. Results: After treatment, the overall effective rate was significantly higher in the observation group compared to the control group (P 0.05). Following treatment, both ovulation and pregnancy rates increased in both groups, but the increase was more evident in the observation group, showing a statistically significant difference (P < 0.01). Conclusion: For patients with oligoovulation or anovulation due to PCOS, the combined use of TCM, acupoint injection, and herbal patch application appears to be effective in improving systemic symptoms and achieving notable clinical outcomes.展开更多
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.
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.
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.
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.
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.
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.
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.
基金supported in part by the National Key R&D Program of China(2021YFC2700403 and 2018YFA0800102)the National Natural Science Foundation of China(31871249 and 31871452).
文摘Polycystic ovary syndrome (PCOS) is a highly familial and heritable endocrine disorder. Over half of the daughters born to women with PCOS may eventually develop their own PCOS-related symptoms. Progress in the treatment of PCOS is currently hindered by the complexity of its clinical manifestations and incomplete knowledge of its etiopathogenesis. Various animal models, including experimentally induced, naturally occurring, and spontaneously arising ones, have been established to emulate a wide range of phenotypical and pathological traits of human PCOS. These studies have led to a paradigm shift in understanding the genetic, developmental, and evolutionary origins of this disorder. Furthermore, emerging evidence suggests that animal models are useful in evaluating state-of-the-art drugs and treatments for PCOS. This review aims to provide a comprehensive summary of recent studies of PCOS in animal models, highlighting the power of these disease models in understanding the biology of PCOS and aiding high-throughput approaches.
基金The Research fund from the Chosun University Hospital,No.2023-26.
文摘BACKGROUND Renal cell carcinoma(RCC)is more common in patients with autosomal dominant polycystic kidney disease(ADPKD)than in the general population.Diagnosing RCC in ADPKD is challenging due to the presence of multiple renal cysts,often leading to delays and difficulties in distinguishing RCC from cyst infection or hemorrhage.A total of 38 kidneys were excised from 19 patients,with a mean age of 56.8 years and an average hemodialysis duration of 84.2 months.Eight patients underwent open nephrectomies,and 11 underwent hand-assisted laparoscopic nephrec-tomies.RCC was detected in 15.8%of kidneys,affecting 21.1%of patients.Two patients had multifocal RCC in both kidneys.All RCC cases were pT1 stage,with the largest lesion averaging 16.5 mm in diameter.The average operative duration was 120 minutes,with intraoperative blood loss averaging 184.2 mL.Five patients required blood transfusions.Postoperative complications occurred in five patients,with a mean hospital stay of 17.1 days.The mean follow-up period was 28.1 months.CONCLUSION The prevalence of RCC is higher in patients with ADPKD with ESRD than in those with ESRD alone.Thus,clinicians should be cautious and implement surveillance programs to monitor the development of RCC in patients with ADPKD,particularly those on dialysis.
基金Supported by the Special Support Plan for the National 12th Five Year Plan Project:2012BAI25B05.
文摘Objective:To systematically evaluate the effectiveness of acupuncture and moxibustion as a complementary treatment for polycystic ovary syndrome(Pcos)and provide evidence for clinical treatment.Methods:The following seven databases were searched from the date of database creation to October 29,2023:PubMed,Embase,the Cochrane Library,China Biology Medicine(CBM),Chinese National Knowledge Infrastructure(CNKI),Wanfang,and VIP.The literature was screened according to the inclusion and exclusion criteria,data were extracted,quality was evaluated using the Cochrane Risk of Bias Assessment Tool,and a meta-analysis of the outcomes was performed using Review Manager 5.4 software.Results:A total of 20 researches were included and the test group was treated with modern medicine,acupuncture,electroacupuncture,warm needling,and thunder-fire moxibustion.The control group was treated with modern medicine,including clomiphene,Diane-35,letrozole,metformin,and progesterone.The meta-analysis showed that acupuncture and moxibustion as a complementary therapy for Pcos improved the ovulation and pregnancy rates and reduced the body mass index(BMI),luteinizing hormone(LH)levels,the LH/follicle-stimulating hormone(FSH)ratio,and ovarian volume;however,due to high heterogeneity,the differences regarding improvements in FSH,estradiol(E2),testosterone(T)and progesterone(P)levels could not draw a definite conclusion when compared with modern first-line drugs alone.Conclusion:Acupuncture and moxibustion as a complementary treatment for Pcos has good clinical efficacy;however,because of the relatively low quality of the included studies,the results may be biased.More high-quality clinical studies are needed to verify the results.The Prospero Registration number is CRD42022368304.
基金supported by the National Key Research&Development Program of the Ministry of Science and Technology of China[Grant No.2022YFE01349002023YFC3708305]+2 种基金the Strategy Priority Research Program(Category B)of Chinese Academy of Sciences[No.XDB0750300]the Yunnan Major Scientific and Technological Projects[Grant No.202202AG050019]the National Natural Science Foundation of China[Grant No.42077390].
文摘Objective To investigate the relationship and potential pathways between metal(loid)exposure and the risk of polycystic ovary syndrome(PCOS)in women of childbearing age.Methods This case-control study included 200 patients with PCOS(cases)and 896 non-PCOS controls with the age of 25-37 years.The concentrations of 29 metal(loid)s in the follicular fluid(FF)and clinical indicators in the serum were measured in all participants.Logistic regression analysis and mediation analysis were conducted to evaluate the associations between metal(loid)exposure and PCOS risk and investigate the possible roles of clinical indicators,respectively.Results Logistic regression analysis revealed an association between high copper levels in FF and increased PCOS risk(highest vs.lowest quartile:adjusted odds ratio=2.94,95%confidence interval:1.83-4.72).A high luteinizing hormone/follicle-stimulating hormone ratio and elevated levels of testosterone and anti-Müllerian hormone(AMH)were strongly associated with increased PCOS risk induced by high copper exposure.The mediation analysis indicated a mediating effect of AMH in the association between copper exposure and PCOS risk.Conclusion Copper may affect PCOS risk through the hypothalamic-pituitary-ovarian axis,mediated by AMH.Copper exposure and internal AMH levels are important indicators for early warning of PCOS development.
基金supported by Shiraz University,Vice-Chancellor of Research as a master thesis.
文摘Objective:To explore the potential therapeutic impact of an alcoholic extract derived from the sea cucumber(Holothuria parva)on letrozole-induced polycystic ovary syndrome(PCOS)in adult female Sprague-Dawley rats.Methods:Sixteen female rats,aged 8 to 10 weeks,with a mean weight of(200±20)g,were randomly assigned to four groups:the control,PCOS,and two treatment groups receiving sea cucumber extract and metformin,respectively.PCOS was induced by administering letrozole at a dose of 1 mg/kg to initiate the treatment period at 60 days of age.The study spanned four weeks,during which ovarian and uterine tissues were collected for histological examination,and blood samples were collected for hormonal levels.Results:Significant decreases in luteinizing hormone/follicle stimulating hormone(LH/FSH)and testosterone and increases progesterone levels among groups treated with sea cucumber extract were observed.While no significant differences were observed in follicle-stimulating hormone(FSH)and testosterone levels,the distinctive variations in key hormones suggested a potential role for sea cucumber alcoholic extract in ameliorating PCOS symptoms.Conclusions:This research highlights the moderate efficacy of sea cucumber extract as a therapeutic intervention for PCOS,providing a novel perspective in the search for effective remedies.The observed hormonal alterations,particularly in LH,estradiol,and progesterone,underscore the need for further exploration into the underlying mechanisms and for optimizing the application of sea cucumber extract in PCOS management.
文摘BACKGROUND To retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating autosomal dominant polycystic kidney disease(ADPKD)patients with gross hematuria.CASE SUMMARY The purpose of this study is to retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating ADPKD patients with gross hematuria.Materials and methods:During the period from January 2018 to December 2019,renal transcatheter arterial embolization was carried out on 6 patients with polycystic kidneys and gross hematuria.Renal arteriography was performed first,and then we determined the location of the hemorrhage and performed embolization under digital subtraction angiography monitoring.Improvements in routine blood test results,routine urine test results,urine color and postoperative reactions were observed and analyzed.Results:Renal transcatheter arterial embolization was successfully conducted in 6 patients.The indices of 5 patients and the color of gross hematuria improved after surgery compared with before surgery.No severe complication reactions occurred.CONCLUSION For autosomal dominant polycystic kidney syndrome patients with gross hematuria,transcatheter arterial embolization was safe and effective.
文摘BACKGROUND Polycystic kidney disease(PKD)is the most common genetic cause of kidney disease.It is a progressive and irreversible condition that can lead to end-stage renal disease and many other visceral complications.Current comprehensive data on PKD patterns in Africa is lacking.AIM To describe the prevalence and outcomes of PKD in the African population.METHODS A literature search of PubMed,African journal online,and Google Scholar databases between 2000 and 2023 was performed.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed to design the study.Clinical presentations and outcomes of patients were extracted from the included studies.RESULTS Out of 106 articles,we included 13 studies from 7 African countries.Ten of them were retrospective descriptive studies concerning 943 PKD patients with a mean age of 47.9 years.The accurate prevalence and incidence of PKD were not known but it represented the third causal nephropathy among dialysis patients.In majority of patients,the diagnosis of the disease was often delayed.Kidney function impairment,abdominal mass,and hypertension were the leading symptoms at presentation with a pooled prevalence of 72.1%(69.1-75.1),65.8%(62.2-69.4),and 57.4%(54.2-60.6)respectively.Hematuria and infections were the most frequent complications.Genotyping was performed in few studies that revealed a high proportion of new mutations mainly in the PKD1 gene.CONCLUSION The prevalence of PKD in African populations is not clearly defined.Clinical symptoms were almost present with most patients who had kidney function impairment and abdominal mass at the diagnostic.Larger studies including genetic testing are needed to determine the burden of PKD in African populations.
文摘Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from the CDC Pregnancy Risk Assessment of Monitoring System, specifically Standard Core and Phase 8 responses, with 9549 respondents across the United States through SPSS 28 software in this cross-sectional study. Two variables assessed PCOS status in respondents: history of PCOS and PCOS during pregnancy. With a history of PCOS, there were significantly increased odds of diabetic (OR 1.665, p < 0.001), hypertensive disorders (OR 1.589, p < 0.001) during pregnancy, neonatal mortality (OR 1.550, p < 0.001), cesarean section (C/S) (OR 1.489, p < 0.001), and preterm prelabor rupture of membranes (PPROM) (OR 2.081, p < 0.001). With PCOS diagnosed during pregnancy, there were significantly greater odds of diabetes (OR 3.278, p < 0.001), hypertensive disorders (OR 2.935, p < 0.001) during pregnancy, and significantly decreased risk for small for gestational age (2 standard deviations) (OR 0.337, p = 0.024). PCOS is a significant risk factor that contributes to maternal morbidity. Our results support the hypothesis that PCOS’ impact extends well into a woman’s obstetrical journey, with varying degrees of associated adverse maternal and fetal risks. Preliminary pathophysiologic explanations associated with PCOS gestational diabetes include pre-existing insulin resistance. Meanwhile, altered placentation and endovascular changes associated with PCOS secondary to a baseline deranged metabolic environment predispose patients to developing hypertensive disorders, PPROM, and preterm delivery. Associations between neonatal mortality and C/S can be attributed to elevated maternal body mass index. The pathophysiologic link between PCOS and the above obstetrical outcomes still remains unknown, necessitating further investigation;however, this study identifies the outcomes that require the most attention at this time.
文摘Background: In Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) represents the final step in the management of Polycystic Ovarian Syndrome (PCOS). Our objective was to study the association between PCOS phenotypes and IVF/ICSI results in women admitted to Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital (CHRACERH). Material and Method: We carried out a cohort study with historical-prospective data collection over a period of seven years (January 2016 to March 2023) at Chracerh. PCOS patients were subdivided into 4 subgroups A, B, C and D. Results: We recruited 128 patients including 64 PCOS patients divided into four phenotypes and 64 non-PCOS patients constituting the control group. Phenotype D without hyperandrogenism had used the lowest dose of gonadotropins, i.e. 1939.7 ± 454.3 IU, and had produced a greater quantity of estradiol on the day ovulation was triggered (6529.8 ± 4324.8 ng/ml). The average number of punctured follicles and mature oocytes were higher in the phenotype D group. Ovarian hyperstimulation syndrome (OHSS) occurred mainly in phenotype D (3/35), with an estimated prevalence of 2.3%. The fertilization rate seemed lower in the hyperandrogenic phenotypes A, B, C compared to the group without hyperandrogenism without significant difference (p = 0.461). The biological pregnancy rate and live birth rate were comparable between the different groups. Conclusion: Phenotype D used less dose of gonadotropins. Biological pregnancy and live birth rates were comparable between the different phenotypes.
文摘Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions and the provision of diagnostic treatment. This study reports a case of PCOS with an ovarian mass in which LOD was aggressively used and a granulosa cell tumor (GCT) was found. A 34-year-old woman with secondary amenorrhea and irregular menstrual cycles presented to the emergency department with abdominal pain of unknown etiology. Imaging studies revealed a 6-cm left ovarian mass with an internal appearance suggestive of a hemorrhage. The patient’s secondary amenorrhea was subsequently diagnosed as PCOS, and LOD was performed to preserve her fertility. Simultaneously, a cystectomy was performed to evaluate the tumor in the left ovary;the diagnosis was adult-type GCT. Although concomitant GCT and PCOS are extremely rare, the two conditions have similar clinical manifestations. In women of reproductive age, the impact of surgery on future fertility should be considered, and the initial surgical technique should be chosen carefully.
文摘Objective: To observe the therapeutic effect of combined traditional Chinese medicine (TCM) therapy with acupoint injection and herbal patch application on patients with ovulatory dysfunction associated with polycystic ovary syndrome (PCOS). Methods: A total of 80 PCOS patients who received treatment at the First Affiliated Hospital of Guangxi University of Chinese Medicine between October 2022 and March 2024 were enrolled in this study. They were randomly divided into a control group (n = 40) and an observation group (n = 40). The control group received conventional Western medical treatments, while the observation group was administered TCM combined with acupoint injection and herbal patch application. Pre- and post-treatment conditions were compared between the two groups. Results: After treatment, the overall effective rate was significantly higher in the observation group compared to the control group (P 0.05). Following treatment, both ovulation and pregnancy rates increased in both groups, but the increase was more evident in the observation group, showing a statistically significant difference (P < 0.01). Conclusion: For patients with oligoovulation or anovulation due to PCOS, the combined use of TCM, acupoint injection, and herbal patch application appears to be effective in improving systemic symptoms and achieving notable clinical outcomes.
