Androgen replacement therapy （ART） efficacy on late-onset hypogonadism （LOH） has been widely investigated in Western countries; however, it remains controversial whether ART can improve health and prolong active l...Androgen replacement therapy （ART） efficacy on late-onset hypogonadism （LOH） has been widely investigated in Western countries; however, it remains controversial whether ART can improve health and prolong active lifestyles. We prospectively assessed long-term ART effects on the physical and mental statuses of aging men with LOH in Japan. The primary endpoint was health-related quality of life assessed by questionnaires. Secondary endpoints included glycemic control, lipid parameters, blood pressure, waist circumference, body composition, muscular strength, International Prostate Symptom Scores （IPSS）, International Index of Erectile Function-5 （IIEF-5） scores, and serum prostate-specific antigen levels. Of the 1637 eligible volunteers, 334 patients 〉 40 years with LOH were randomly assigned to either the ART （n = 169） or control groups （n = 165）. Fifty-two weeks after the initial treatment, ART significantly affected the role physical subdomain of the short form-36 health survey （SF-36） scale （P= 0.0318）. ART was also associated with significant decreases in waist circumstance （P = 0.002） and serum triglyceride （TG） （P = 0.013） and with significant increases in whole-body and leg muscle mass volumes （P= 0.071 and 0.0108, respectively）, serum hemoglobin （P 〈 0.001）, IPSS voiding subscore （P = 0.0418）, and the second question on I IEF-5 （P = 0.0049）. There was no significant difference between the groups in terms of severe adverse events. In conclusion, in patients with LOH, long-term ART exerted beneficial effects on Role Physical subdomain of the SF-36 scale, serum TG, waist circumstance, muscle mass volume, voiding subscore of IPSS, and the second question of IIEF-5. We hope our study will contribute to the future development of this area.展开更多
Polychlorinated biphenyls （PCBs） are common environmental contaminants that represent a considerable risk to reproductive toxicity in exposed human populations. Although some experimental studies have suggested an a...Polychlorinated biphenyls （PCBs） are common environmental contaminants that represent a considerable risk to reproductive toxicity in exposed human populations. Although some experimental studies have suggested an association between the levels of PCBs and semen quality, the direct effects of PCBs on human sperm parameters remain largely unexplored. To this aim, a short-term in vitro incubation experiment that better imitated the putative exposure of sperm to Aroclor 1254 （a commercial PCB mixture） in male reproduction tissue was conducted. Human sperm were incubated with various concentrations （0, 1, 5, or 25 mg ｜^-1） of Aroclor 1254 for different amounts of time （3 and 6 h） in vitro. Sperm motility parameters were analyzed with computer-assisted sperm analysis （CASA）. The proportion of sperm with high mitochondrial membrane potential （ΔΨm） and the levels of intracellular reactive oxygen species （ROS） were detected to explore the probable cause of sperm impairment. Human sperm exposed to continuous Aroclor 1254 exhibited： （i） reduced sperm motility and kinematic parameters, （ii） a proportion of sperm with high ΔΨm that decreased in a dose-dependent manner （P 〈 0.05）, and （iii） increased levels of ROS compared with controls （P 〈 0.05）. In conclusion, Aroclor 1254 can decrease sperm motility, which may culminate in increased ROS and general mitochondrial dysfunction, thus affecting the fertilization potential of sperm. Our findings suggest a broader understanding of the effect of Aroclor 1254 on human soerm.展开更多
OBJECTIVE:To review beneficial effects of red clover(Trifolium pratense L.)on biological processes.METHODS:A systematic review was carried out according tothe PRISMA checklist.Using Me SH keywords,385 articles were ex...OBJECTIVE:To review beneficial effects of red clover(Trifolium pratense L.)on biological processes.METHODS:A systematic review was carried out according tothe PRISMA checklist.Using Me SH keywords,385 articles were extracted from national and international databases(Pub Med,Science Direct,SID,and Google Scholar search engine)without time limit.After removing duplicates,80 articles were reviewed.RESULTS:Our findings revealed that the compositions of red clover promote anti-oxidant and anti-cancer effects.Furthermore,they exude beneficial effects on cardiovascular functionand improvesymptoms of menopause.Also,these compounds can regulate blood glucose and lipid markers.The effects of the herb on have also been investigated on various tissues including endometrium,breast,skin and reproductive system.CONCLUSION:In recent studies,the anti-cancer effects of clover(Trifolium)extract co-administrated with standard drugs have been reportedin different cancers.展开更多
Introduction: Postcesarean infection can cause maternal mortality and morbidity. Use of prophylactic antibiotics could decrease surgical site infection. Despite using prophylactic antibiotics in obese women, compared ...Introduction: Postcesarean infection can cause maternal mortality and morbidity. Use of prophylactic antibiotics could decrease surgical site infection. Despite using prophylactic antibiotics in obese women, compared to normal weighted women the rate of wound infection is higher in this group. The aim of this study is to compare prophylactic effect of azithromycin and cephalexin on febrile morbidity and postcesarean infection in women with BMI > 30. Methods and Materials: This randomized controlled double blind clinical trial was done on 231 women with BMI > 30 who underwent elective cesarean section. Patients were randomly divided to intervention and control groups. Keflin 2 gr IV was administered 0.5 hr before surgery for both intervention and control groups. Cefalexin (placebo) every 6 hr and azythromycin (placebo) every 12 hr for control group and cephalexin 500 mg every 6 hr and azithromycin 250 mg every 12 hr for intervention group were administered for 48 hrs. Patients were under observation till 1 month after surgery. Fever, wound infection, endometritis and hospitalization were compared between two groups with SPSS v. 18. Results: A total of 231 patients 113 (48.9%) were enrolled in intervention group and 118 (51.1%) in control group with mean age of (28.53 ± 5.51) recruited. BMI distribution did not differ in the two groups. Hospitalization in control group was significantly higher than that in intervention group (2.58 ± 0.99) vs (2.11 ± 0.45) (P value < 0.001). BMI in intervention group with and without fever was (34.62 ± 2.64) and (30.89 ± 2.80), respectively (P value < 0.001). In control group, BMI in patients with and without fever was (38.60 ± 2.80) and (31.29 ± 1.28), respectively (P value = 0.001). Fever and endometritis simultaneously was seen in 3 (2.7%) of intervention group and 8 (6.8%) of control group. In interventions 3 (2.7%) had fever but no endometritis and 2 (1.8%) had endometritis but no fever (P < 0.001). In control group, 23 (19.5%) patients had fever but no endometritis and 4 (3.4%) patients had endometritis but no fever (P value < 0.001). Febrile patients in control group 31 (26.3%) were significantly more than those in intervention group 6 (5.3%) (P value < 0.001). Discussion: Administration of prophylactic azithromycin and cephalexin resulted in a decrease in febrile morbidity and length of hospital stay and is recommended. BMI of patients with fever was significantly higher in both intervention and control groups compared to those who didn’t experience fever. Postcesarean endometritis wasn’t significantly different in two groups. Postcesarean wound infection wasn’t seen in any group.展开更多
Objective:To evaluate the effect of Heracleum persicum L.against gentamicin-induced nephrotoxicity in rats.Methods:Thirty-six Wistar rats were divided into 6 groups including control(normal saline),gentamicin(80 mg/kg...Objective:To evaluate the effect of Heracleum persicum L.against gentamicin-induced nephrotoxicity in rats.Methods:Thirty-six Wistar rats were divided into 6 groups including control(normal saline),gentamicin(80 mg/kg/d for 10 d),Heracleum persicum(750 mg/kg/d),and gentamicin(10 d)+Heracleum persicum extract at three different doses(250,500,and 750 mg/kg/d for 40 d).Urine creatinine,urea,protein,and albumin levels were determined.In addition,serum urea,creatinine,sodium,potassium,cytokines(TNF-α,IL-1β,IL-6,and IL-10),glutathione peroxidase activity,total antioxidant capacity,kidney malondialdehyde,stereological parameters,and expressions of apoptosis-related genes(p53,Bax,Bcl-2,and caspase-3)were measured.The LD50 of Heracleum persicum extract was determined based on Lorke’s method.Histopathological evaluation was also performed.Results:In addition to decreased urine protein and albumin,and increased creatinine and urea,co-treatment with gentamicin and Heracleum persicum significantly reduced levels of creatinine and urea,and increased sodium and potassium in serum.Heracleum persicum treatment also improved stereological parameters and serum inflammatory cytokines.There was a significant increase in serum glutathione peroxidase activity and total antioxidant capacity as well as a reduction in malondialdehyde level.Furthermore,treatment with Heracleum persicum extracts downregulated p53,caspase-3,and Bax and upregulated Bcl-2 expressions.In histopathological evaluation,Heracleum persicum extracts showed protection against gentamicin-induced renal damages.Conclusions:Heracleum persicum exhibits protective effects against gentamicin-induced structural and functional renal impairments.展开更多
Monozygotic 24-year-old twins presented with discordant ovarian function. One had had premature ovarian failure at the age of 14 years, whereas her sister had normal ovaries and three naturally conceived children. Aft...Monozygotic 24-year-old twins presented with discordant ovarian function. One had had premature ovarian failure at the age of 14 years, whereas her sister had normal ovaries and three naturally conceived children. After unsuccessful egg-donation therapy, the sterile twin received a transplant of ovarian cortical tissue from her sister by means of a minilaparotomy. Within three months after transplantation, the recipient’ s cycles resumed and serum gonadotropin levels fell to the normal range. During the second cycle, she conceived, and her pregnancy progressed uneventfully. At 38 weeks’ gestation, she delivered a healthy-appearing female infant.展开更多
There continues to be an increase in utilization of assisted reproductive technology(ART), including the use of third party gametes. Specifically, the use of third party oocytes, most recently reported in 2010 by the ...There continues to be an increase in utilization of assisted reproductive technology(ART), including the use of third party gametes. Specifically, the use of third party oocytes, most recently reported in 2010 by the United States(US) Center for Disease Control and Society of Reproductive Medicine, accounted for 15 504 cycles and 7334 live births. This translates into approximately 11% of all the in vitro fertilization cases performed in the US. As utilization increases and the technological tools advance, they have created underappreciated and unforeseen ethical quandaries. As such, many practitioners think they "have heard it all". However, each ART scenario is novel with the potential to pose complex unforeseen issues, potentially creating global challenges that could impact broad social and legal questions and test the moral consciousness' of practitioners, policymakers and patients. While there are published US national guidelines to assist practitioners, we have identified new complex issues in assisted reproduction that present unique challenges, and we give a perspective from oureyes in the Western Hemisphere looking out to a global level. Specifically, this review focuses on some of the more recent and evolving issues that currently are and will be confronting us in the upcoming years. Particular attention focuses on discrepancies between third party legal contracts and ART consents regarding level of information sharing, and oocyte and embryo directives and management; dilemmas and obligations surrounding disclosure of medical outcomes especially in the context of growing access to Direct to Consumer genetic testing and Reproductive Tourism-Exile. Given the complexity of these and other ethical questions, finding answers may be achieved by ending the isolation of reproductive professionals and instead promoting increased and consistent communication among physicians, embryologists, therapists and reproductive attorneys to confront these evolving ethical quandaries.展开更多
This study aimed to ascertain the current status of Japanese sperm banking for young cancer patients. During 2015, we mailed the directors of 695 institutes where sperm cryopreservation might be performed with questio...This study aimed to ascertain the current status of Japanese sperm banking for young cancer patients. During 2015, we mailed the directors of 695 institutes where sperm cryopreservation might be performed with questionnaires requesting information on the number of patients, age, precryopreservation chemotherapy, semen analyses results and diagnoses, cryopreservation success rate, and causes of unsuccessful cryopreservation. Of these 695 institutes, 92 had cryopreserved sperm before chemotherapy within the study period. In all, 820 cancer patients （237 testicular, 383 hematological, 46 bone and soft tissue, 20 brain, and 134 other malignancy） consulted the responding institutes for sperm cryopreservation. Except for testicular tumor, the number of patients whose sperm was preserved before cancer treatment was low compared to that of young cancer patients. Approximately 20% of patients with malignancies other than testicular tumor underwent chemotherapy before cryopreservation. The success rate of cryopreservation in hematological malignancy was 82.5%, significantly lower than that of both the testicular cancer （93.6%） and other malignancy groups （95.6%） （P 〈 0.05）. The primary reasons for preservation failure were azoospermia and poor semen quality. Patients with hematological malignancies had a higher rate of unsuccessful cryopreservation compared to those in other groups, possibly due to the large number of patients requesting sperm cryopreservation after chemotherapy induction. In Japan, information regarding sperm banking prior to cancer treatment appears to be lacking. Information regarding sperm preservation before chemotherapy should be provided to all Japanese oncologists.展开更多
The success rate of in vitro fertilization and embryo transfer is only about 28.5%.The combination of traditional Chinese medicine and assisted reproduction technology can effectively improve the pregnancy rate,which ...The success rate of in vitro fertilization and embryo transfer is only about 28.5%.The combination of traditional Chinese medicine and assisted reproduction technology can effectively improve the pregnancy rate,which has good application prospect.However,there is no relevant record in traditional Chinese medicine.Unified diagnosis and treatment system has yet been established.According to many years of clinical experience,Professor Qi Cong summarized the treatment strategy of traditional Chinese medicine.Treatment of invigorating the spleen to nourish blood,reinforcing the spleen and kidney,tonifying the kidney and activating blood circulation,enriching the kidney to prevent miscarriage,cooling blood to stop bleeding are given based on the characteristics of each stage and patients'symptoms during the transplantation.Disease differentiation matters during intermittent stage.Besides,she advocated treating husband and wife together.All of the above are characterized by Chinese medicine concept of pre cultivating the loss,treating the same disease with different methods,and three categories of etiologic factors.展开更多
Purpose: Endometriosis can be managed effectively by medication, surgery, or a combination of both. Numerous studies have been conducted on surgical and medication treatment options, but their results are still under ...Purpose: Endometriosis can be managed effectively by medication, surgery, or a combination of both. Numerous studies have been conducted on surgical and medication treatment options, but their results are still under discussion. Therefore, we performed a study to develop a combinational treatment for various stages of endometriosis. Methods: Over a 3-year period, 218 documented endometriosis patients were classified in 4 stages. After first laparoscopy (with electrocoagulation and adhesion removal for stages I to III), the patients were treated with GnRH analogs (Gonadotropin Releasing Hormone Agonist-375 mg of Decapeptyl) for 3, 6 & 6 months, respectively. The second and third laparoscopy procedures were performed after 3 and 6 months, with add-back therapy. The treatment was evaluated by direct observation based on laparoscopic view and the pain relief was measured by the VAS (Visual Analogue Scale) after the first step of medication for patients of stages I-III. Results: After 3 months, 70/76 patients (91.9%) with stage-I endometriosis showed complete recovery (six cases after 6 months) while 65/72 and 32/43 cases with stage-II and -III (90.3 and 74.4%), respectively, showed complete recovery after 6 months of treatment. The remaining patients had GnRH treatment for another 3 months, and all showed a complete recovery after 9 months. Furthermore, 12 of the patients with stage-IV symptoms were candidates for laparoscopy or laparotomy, and their treatment response rate was 55.6%. The pain relief was significant after the combinational treatment in patients with stages I-III (P = 0.0001). Conclusion: Our study showed efficacy of the developed protocol for the endometriosis management.展开更多
Cystic fibrosis(CF)is one of the most common recessive genetic diseases,with a wide spectrum of phenotypes,ranging from infertility to severe pulmonary disease.Mutations in the cystic fibrosis transmembrane conductanc...Cystic fibrosis(CF)is one of the most common recessive genetic diseases,with a wide spectrum of phenotypes,ranging from infertility to severe pulmonary disease.Mutations in the cystic fibrosis transmembrane conductance regulator(CFTR)gene are considered the main genetic cause for CF.In this study,we recruited a consanguineous Iranian pedigree with four male patients diagnosed with congenital unilateral absence of the vas deferens(CUAVD),and one female patient diagnosed with congenital absence of the uterus(CAU).Testicular biopsy of one patient was performed,and hematoxylin and eosin(H and E)staining of testis sections displayed the presence of germ cell types ranging from spermatogonia to mature spermatids,indicating obstructive azoospermia.To explore the underlying genetic factor in this familial disorder,we therefore performed whole-exome sequencing(WES)on all available family members.WES data filtration and CFTR haplotype analysis identified compound heterozygous mutations in CFTR among four patients(two CUAVD patients carried p.H949Y and p.L997F,and one CUAVD and the female CAU patient carried p.H949Y and p.I148T).All these mutations were predicted to be deleterious by at least half of the prediction software programs and were confirmed by Sanger sequencing.Our study reported that CFTR compound heterozygous mutations in a consanguineous Iranian family cause infertility in both sexes.展开更多
Since December 2019,a novel coronavirus that represents a serious threat to human lives has emerged.There is still no definite treatment for severe cases of the disease caused by this virus,named coronavirus disease 2...Since December 2019,a novel coronavirus that represents a serious threat to human lives has emerged.There is still no definite treatment for severe cases of the disease caused by this virus,named coronavirus disease 2019(COVID-19).One of the most considered treatment strategies targets the exaggerated immune regulator,and interleukin(IL)-6 is a crucial pro-inflammatory mediator.Severe acute respiratory syndrome coronavirus 2(SARSCoV-2)cases show an elevated level of IL-6 related to disease severity.IL-6 activity can be inhibited by the following:IL-6 itself,IL-6 signaling pathways such as Janus kinase and signal transducer and activator of transcription(JAK-STAT),gp130,IL-6R,and downstream activated ILs,such as IL-17 and IL-6 cytokine.Currently,according to these studies and their results,IL-6 blockade with anti-IL-6 or its receptor antibodies such as tocilizumab in COVID-19 is beneficial in severe cases and may reduce the mortality rate.JAK-STAT inhibitors block the cytokine storm by inhibiting several crucial pro-inflammatory mediators such as TNF-αand IL-6 and have shown various results in clinical trials.IL-6 induces IL-17 secretion,and IL-17 is involved in the pathogenesis of inflammatory processes.Clinical trials of anti-IL-17 drugs are currently recruiting,and anti-gp130 antibody is preclinical.However,this agent has shown positive effects in inflammatory bowel disease clinical trials and could be tested for SARS-CoV-2.This study aimed to review the role of IL-6 in the cytokine storm and studies regarding IL-6 and blockade of its inflammatory pathways in COVID-19 to determine if any of these agents are beneficial for COVID-19 patients.展开更多
Background : Diabetes-induced oxidative stress can have adverse effects on sperm and its DNA integrity. The Ashrasi date palm(ADP) has potent antioxidant properties.The aim of this study was to evaluate the antioxidan...Background : Diabetes-induced oxidative stress can have adverse effects on sperm and its DNA integrity. The Ashrasi date palm(ADP) has potent antioxidant properties.The aim of this study was to evaluate the antioxidant effect of ADP hydroalcoholic extract on sperm parameters and sperm DNA fragmentation in diabetic rats.Methods : Forty male rats were randomly divided into five groups( n = 7): 1, control;2, diabetic;3– 5, diabetic + ADP(30, 90 and 270 mg/kg for groups 3, 4 and 5, respectively). After preparation of ADP extract and its phytochemical screening, it was administered orally to rats, once a day for 5 weeks. At the end of the study, sperm parameters and sperm DNA fragmentation in all groups were investigated.Results : At doses of 90 and 270 mg/kg, ADP extract significantly increased the sperm viability compared to diabetic group 2( p = 0.04 and p = 0.03, respectively)and resulted in a significant decrease in immotile sperm( p = 0.002 and p = 0.006,respectively). At a dose of 270 mg/kg, a considerable enhancement of forward sperm motility was observed( p = 0.04) and there was a significant decrease in sperm DNA fragmentation( p = 0.04).Conclusions : The findings of the present study show for the first time that the hydroalcoholic extract of ADP has protective and antioxidant effects against diabetesinduced oxidative stress and can improve sperm parameters and protect sperm DNA integrity.展开更多
Objective: The purpose of this study was to compare the effectiveness of a thorough sonographic oocyte retrieval to a routine in vitro fertilization retrieval to induce ovulation, pregnancy, and endocrine changes in p...Objective: The purpose of this study was to compare the effectiveness of a thorough sonographic oocyte retrieval to a routine in vitro fertilization retrieval to induce ovulation, pregnancy, and endocrine changes in patients with polycystic ovarian syndrome in their post-in vitro fertilization cycles. Study design: Sixty-four patients from a tertiary infertility clinic, with clomiphene citrate-resistant polycystic ovarian syndrome and who were undergoing in vitro fertilization, were assigned randomly into 2 groups. Group 1 (n = 34) had a thorough (every possible follicle punctured) sonographic oocyte retrieval, and group 2 (n = 30) had a routine (only follicles that were likely to contain oocytes) in vitro fertilization retrieval. These patients who did not conceive in their in vitro fertilization cycle were monitored with ultrasound scanning for evidence of ovulation, pregnancy, before and after day 3 gonadotropin,and steroid hormone levels. Analysis of variance and the Student t test were used for statistical significance. Results: Ovulation rates of 53% (18/34) and cumulative pregnancy rate of 44% (8/18) were observed in group 1, with no ovulations in group 2. Significant decreases in luteinizing hormone/FSH ratio (4.1 to 1.7) and testosterone (1.2 to 0.7 ng/mL) occurred after treatment in the thorough sonographic oocyte retrieval group, with no change after routine in vitro fertilization. Operating time was increased signifi cantly in the thorough sonographic oocyte retrieval group (45 vs 24 minutes) in group 2. Conclusion: Thorough sonographic oocyte retrieval during in vitro fertilization cycle can produce significant improvements in the endocrinologic abnormalities, ovulation, and pregnancies that are comparable with ovarian wedge resection in patients with clomiphene citrate-resistant polycystic ovarian syndrome.展开更多
Objective:Duphaston is used as an alternative to gonadotropin-releasing hormone(GnRH)antagonists for suppressing premature luteinizing hormone(LH)surges.This study aimed to compare the efficacy of Duphaston protocols ...Objective:Duphaston is used as an alternative to gonadotropin-releasing hormone(GnRH)antagonists for suppressing premature luteinizing hormone(LH)surges.This study aimed to compare the efficacy of Duphaston protocols with that of Cetrotide in suppressing the LH surge.Methods:In this retrospective cross-sectional study,669 infertile women(aged 25-40 years)were administered recombinant follicle-stimulating hormone(rFSH)from the third day of their menstrual cycle.After the follicular diameter reached 13 to 14 mm,Cetrotide was prescribed orally to the control subjects,also case subjects took Duphaston orally.The retrieved oocytes were fertilized by an intracytoplasmic sperm injection(ICSI).Results:The levels of FSH,LH,and estradiol did not differ significantly between the groups(P>0.05).However,the findings indicated that Duphaston led to greater oocyte retrieval than Cetrotide(P=0.006).However,the number of mature oocytes and viable embryos in the case subjects did not reach a significant difference compared to that in the control subjects(P>0.05).The number of good-quality embryos(stage 1)was significantly higher in the case subjects(P=0.04).In addition,there is no significant difference in the chemical,clinical pregnancy,implantation rate,and miscarriage rate between both groups(P>0.05).Conclusion:Duphaston could be utilized as a suitable medication rather than a GnRH antagonist in women subjected to controlled ovarian hyperstimulation.展开更多
Acupuncture has been used to treat infertility extensively, including ovulatory dysfunction, in vitro fertilization and embryo transfer （IVF-ET）, and male infertility. This review summarizes the recent studies which...Acupuncture has been used to treat infertility extensively, including ovulatory dysfunction, in vitro fertilization and embryo transfer （IVF-ET）, and male infertility. This review summarizes the recent studies which investigated the role of acupuncture in infertility. In conclusion, most of the existing studies suggest a positive effect of acupuncture in infertility treatment. Firstly, acupuncture may improve ovulation by modulating the central and peripheral nervous systems, the neuroendocrine and endocrine systems, the ovarian blood flow, and metabolism. Secondly, acupuncture can improve the outcome of IVF-ET, and the mechanisms may be related to the increased uterine blood flow, inhibited uterine motility, and the anesis of depression, anxiety and stress. Its effect on modulating immune function also suggests helpfulness in improving the outcome of IVF-ET. Finally, the studies suggest that acupuncture plays a positive role in male infertility, the mechanism of which is not yet clear. Even though a positive effect of acupuncture in infertility has been found, well-designed multi-center, prospective randomized controlled studies are still needed to provide more reliable and valid scientific evidence. Furthermore, it is urgent and necessary to clarify the mechanism of acupuncture for infertility.展开更多
Objective:Trifolium pratense has many healing properties,including fewer complications of menopause,cancer cell suppression,reducing blood glucose and lipids,as well as cardiovascular beneficial effects.The purpose of...Objective:Trifolium pratense has many healing properties,including fewer complications of menopause,cancer cell suppression,reducing blood glucose and lipids,as well as cardiovascular beneficial effects.The purpose of this study was to identify the phytochemical and mineral composition of T.pratense.Methods:Plant aerial parts were harvested and dried,and then hydroalcoholic and alcoholic extracts were prepared.Gas chromatography-mass spectrometry(GC-MS)analytical method was used to identify volatile compounds then liquid chromatography-electrospray ionization mass spectrometry(LC-ESI-MS)was used to identify polyphenols and the mineral elements were identify by inductively coupled plasma atomic emission spectrometer/ICP-AES and scanning electron microscope-energy-dispersive X-ray spectroscopy(SEM-EDS)methods.Total phenolic content(TPC)was determined based on colorimetric method,and total flavonoid content(TFC)was established based on the folin-chiocalteau reagent.Furthermore,two assays(DPPH and FRAP)were used to measure the antioxidant capacity of T.pratense ethanolic extract.Results:A total of 37 polyphenols and 107 peaks were identified by LC-ESI-MS analysis,and the GC/MS method also detected 21 volatile compounds,the most important of which were methylcyclopentane,dimethylpentanal and hexadecanol.A total of 18 mineral elements,including K,Mg,Al,Si,Zn,Ni,Cu,Se,Co,Fe,Mn,and Ca in the plant,were identified ICP-AES and SEM-EDS analysis.Conclusion:T.pratense has many therapeutic compounds such as polyphenol(isoflavone and flavonoids),volatile compounds,and essential mineral elements,which can be formulated purely and used in the pharmaceutical and traditional medicine industries.展开更多
Objective:To assess the impact of advanced maternal age on pregnancy and childbirth outcomes of singleton pregnancies.Study design:We retrospectively assessed singleton pregnant mothers who gave birth at Khaleej-e-Far...Objective:To assess the impact of advanced maternal age on pregnancy and childbirth outcomes of singleton pregnancies.Study design:We retrospectively assessed singleton pregnant mothers who gave birth at Khaleej-e-Fars Hospital in Bandar Abbas,Iran,from January 2020 to January 2022.Demographic and obstetrical factors include educational level,medical insurance,residency place,access to prenatal care facilities,number of prenatal care visits,smoking status,gestational age,parity,infertility,maternal comorbidities,preeclampsia,eclampsia,preterm birth,low birth weight(LBW),intrauterine growth restriction(IUGR),macrosomia,placenta abnormalities(previa/acreta),placenta abruption,chorioamnionitis,meconium fluid,fetal distress,methods of delivery,rate of cesarean section(CS),perineal lacerations,postpartum hemorrhage,childbirth injury,shoulder dystocia,congenital malformation,neonatal asphyxia,and unfavorable maternal and neonatal outcome were compared between two groups.The Chi-square test assessed the relationship between categorical factors and maternal age groups.The influence of advanced maternal age on the risk of unfavorable pregnancy outcomes was evaluated using bivariate and multivariate logistic regression.Results:Of 8354 singleton deliveries,22.2%belonged to advanced-age mothers.Advanced-age mothers had less education than those aged 20–34 years old.Chronic hypertension,cardiovascular disease,overt diabetes,and thyroid dysfunction were more prevalent among advanced-age mothers.Compared with mothers aged 20–34 years,mothers aged 35 years and higher had a significantly higher risk of gestational diabetes(aOR:3.18,95%CI:1.56–6.95),preeclampsia(aOR:2.91,95%CI:1.35–4.72),placenta abnormalities(aOR:1.09,95%CI:0.77–1.94),CS(aOR:3.16,95%CI:1.51–3.87),postpartum hemorrhage(aOR:1.94,95%CI:1.24–2.61),intensive care unit admission(aOR:1.36,95%CI:1.15–1.99),LBW(aOR:1.35,95%CI:0.97–2.96),preterm birth(aOR:2.36,95%CI:1.65–4.83),stillbirth(aOR:1.18,95%CI:1.01–3.16),and neonatal intensive care admission(aOR:2.09,95%CI:0.73–3.92).According to bivariate regression,the risk of meconium fluid was lower in advanced-age mothers;however,the result of multivariate logistic regression found no correlation between advanced age and the Incidence of meconium fluid.Conclusion:Advanced-age mothers are at increased risk of adverse pregnancy and childbirth outcomes,which persist even after adjusting for several potential confounders.展开更多
Objective:To assess the obstetric and neonatal outcomes associated with adolescent pregnancy in Iran.Methods:We retrospectively assessed women who gave birth between January 1st,2020,and January 1st,2022.These pregnan...Objective:To assess the obstetric and neonatal outcomes associated with adolescent pregnancy in Iran.Methods:We retrospectively assessed women who gave birth between January 1st,2020,and January 1st,2022.These pregnant women were separated into two groups:(1)women aged 19 and younger;(2)women aged 20-34 years.Main outcome measures include preterm birth,maternal comorbidities,preeclampsia,eclampsia,low birth weight(LBW),intrauterine growth restriction(IUGR),placenta abnormalities,placenta abruption,cho-rioamnionitis,meconium fluid,fetal distress,methods of delivery,rate of cesarean section(CS),perineal lacer-ations,postpartum hemorrhage,childbirth trauma,shoulder dystocia,congenital malformation,and unfavorable maternal and neonatal outcome.Logistic regression models were used to determine the influence of teenage pregnancy on adverse pregnancy and childbirth outcomes.Results:Of 7033 deliveries,92.4%of women were adults,and 7.6%were adolescents.Adolescents residing in rural districts were more common than adults(42.3%vs.33.7%).However,access to prenatal facility care was the same as the majority of women had 6-10 prenatal care visits during their pregnancy.There was no difference in the risk of preeclampsia,placenta abruption,placenta previa,fetal distress,preterm labor,shoulder dystocia,perineal lacerations,childbirth trauma,congenital malformation,postpartum hemorrhage,intensive care unit admission,maternal death,and unfavorable neonatal outcome including stillbirth,neonatal intensive care unit admission,neonatal death in adolescent pregnancies compared to adults.Adolescents had a significantly higher risk of LBW(OR:1.47,95%CI:1.01-2.73),IUGR(OR:1.96,95%CI:1.31-2.45),and meconium fluid(OR:1.74,95%CI:1.41-2.32),however,there was no statistically significant difference after adjusting the confounding factors.Compared with adults,adolescents had a significantly lower risk of CS(aRR:0.67,95%CI:0.51-0.77)and a lower risk of gestational diabetes(aRR:0.78,95%CI:0.51-0.95).Conclusions:Although we found no serious consequences of adolescent pregnancy,more research is needed to reach a more accurate conclusion about teenage pregnancy.展开更多
Background:Little is known about potential urban-rural differences in adverse pregnancy outcomes.The purpose of this study is to look into the urban-rural differences in the trend of adverse maternal and neonatal outc...Background:Little is known about potential urban-rural differences in adverse pregnancy outcomes.The purpose of this study is to look into the urban-rural differences in the trend of adverse maternal and neonatal outcomes.Methods:We retrospectively assessed the pregnancy outcome of singleton pregnant mothers who gave birth at a tertiary hospital in Bandar Abbas,Iran,between January 1st,2020,and January 1st,2022.Mothers were divided into two groups based on living residency:1)urban groupand 2)rural group.Demographic factors,obstetrical factors,maternal comorbidities,and adverse maternal and neonatal outcomeswere extracted from the electronic data of each mother.The Chi-square testwas used to compare differences between the groups for categorical variables.Logistic regression models were used to assess the association of adverse pregnancy,childbirth,and neonatal outcome with living residency.Results:Of 8888 mothers that gave birth during the study period,2989(33.6%)lived in rural areas.Adolescent pregnancy was more common in the rural area.Urban mothers had a higher education than rural mothers.Rural mothers were at higher risk for preterm birth aOR 1.81(CI:1.24-2.99),post-term pregnancy aOR 1.5(CI:1.07-2.78),anemia aOR 2.02(CI:1.07-2.34),low birth weight(LBW)aOR 1.89(CI:1.56-2.11),need for neonatal resuscitation aOR 2.66(CI:1.78-3.14),and neonatal intensive care unit(NICU)admission aOR 1.98(CI:1.34-2.79).On the other hand,the risk of cesarean section was significantly lower compared to urban mothers aOR 0.58(CI:0.34-0.99).Conclusions:Our study discovered that mothers living in rural areas had a higher risk of developing anemia,preterm birth,post-term pregnancies,LBW,need for neonatal resuscitation,and NICU admission,but a lower risk of cesarean section.展开更多
文摘Androgen replacement therapy （ART） efficacy on late-onset hypogonadism （LOH） has been widely investigated in Western countries; however, it remains controversial whether ART can improve health and prolong active lifestyles. We prospectively assessed long-term ART effects on the physical and mental statuses of aging men with LOH in Japan. The primary endpoint was health-related quality of life assessed by questionnaires. Secondary endpoints included glycemic control, lipid parameters, blood pressure, waist circumference, body composition, muscular strength, International Prostate Symptom Scores （IPSS）, International Index of Erectile Function-5 （IIEF-5） scores, and serum prostate-specific antigen levels. Of the 1637 eligible volunteers, 334 patients 〉 40 years with LOH were randomly assigned to either the ART （n = 169） or control groups （n = 165）. Fifty-two weeks after the initial treatment, ART significantly affected the role physical subdomain of the short form-36 health survey （SF-36） scale （P= 0.0318）. ART was also associated with significant decreases in waist circumstance （P = 0.002） and serum triglyceride （TG） （P = 0.013） and with significant increases in whole-body and leg muscle mass volumes （P= 0.071 and 0.0108, respectively）, serum hemoglobin （P 〈 0.001）, IPSS voiding subscore （P = 0.0418）, and the second question on I IEF-5 （P = 0.0049）. There was no significant difference between the groups in terms of severe adverse events. In conclusion, in patients with LOH, long-term ART exerted beneficial effects on Role Physical subdomain of the SF-36 scale, serum TG, waist circumstance, muscle mass volume, voiding subscore of IPSS, and the second question of IIEF-5. We hope our study will contribute to the future development of this area.
基金This work was supported by the National Natural Science Foundation of China （Grant Numbers 81571511, 81370711, and 30901603）, the Science and Technology Foundation of Shandong （Grant Number 2010GSF 10814）, the Shandong Provincial Natural Science Foundation （Grant Number ZR2013HM090）, and the Science Foundation of Qilu Hospital of Shandong University, Fundamental Research Funds of Shandong University （Grant Numbers 2015QLMS24, 2016QLQN24 and 2015QLQN50）.
文摘Polychlorinated biphenyls （PCBs） are common environmental contaminants that represent a considerable risk to reproductive toxicity in exposed human populations. Although some experimental studies have suggested an association between the levels of PCBs and semen quality, the direct effects of PCBs on human sperm parameters remain largely unexplored. To this aim, a short-term in vitro incubation experiment that better imitated the putative exposure of sperm to Aroclor 1254 （a commercial PCB mixture） in male reproduction tissue was conducted. Human sperm were incubated with various concentrations （0, 1, 5, or 25 mg ｜^-1） of Aroclor 1254 for different amounts of time （3 and 6 h） in vitro. Sperm motility parameters were analyzed with computer-assisted sperm analysis （CASA）. The proportion of sperm with high mitochondrial membrane potential （ΔΨm） and the levels of intracellular reactive oxygen species （ROS） were detected to explore the probable cause of sperm impairment. Human sperm exposed to continuous Aroclor 1254 exhibited： （i） reduced sperm motility and kinematic parameters, （ii） a proportion of sperm with high ΔΨm that decreased in a dose-dependent manner （P 〈 0.05）, and （iii） increased levels of ROS compared with controls （P 〈 0.05）. In conclusion, Aroclor 1254 can decrease sperm motility, which may culminate in increased ROS and general mitochondrial dysfunction, thus affecting the fertilization potential of sperm. Our findings suggest a broader understanding of the effect of Aroclor 1254 on human soerm.
基金Supported by the Kermanshah University of Medical Science(KUMS)(No.980292)。
文摘OBJECTIVE:To review beneficial effects of red clover(Trifolium pratense L.)on biological processes.METHODS:A systematic review was carried out according tothe PRISMA checklist.Using Me SH keywords,385 articles were extracted from national and international databases(Pub Med,Science Direct,SID,and Google Scholar search engine)without time limit.After removing duplicates,80 articles were reviewed.RESULTS:Our findings revealed that the compositions of red clover promote anti-oxidant and anti-cancer effects.Furthermore,they exude beneficial effects on cardiovascular functionand improvesymptoms of menopause.Also,these compounds can regulate blood glucose and lipid markers.The effects of the herb on have also been investigated on various tissues including endometrium,breast,skin and reproductive system.CONCLUSION:In recent studies,the anti-cancer effects of clover(Trifolium)extract co-administrated with standard drugs have been reportedin different cancers.
文摘Introduction: Postcesarean infection can cause maternal mortality and morbidity. Use of prophylactic antibiotics could decrease surgical site infection. Despite using prophylactic antibiotics in obese women, compared to normal weighted women the rate of wound infection is higher in this group. The aim of this study is to compare prophylactic effect of azithromycin and cephalexin on febrile morbidity and postcesarean infection in women with BMI > 30. Methods and Materials: This randomized controlled double blind clinical trial was done on 231 women with BMI > 30 who underwent elective cesarean section. Patients were randomly divided to intervention and control groups. Keflin 2 gr IV was administered 0.5 hr before surgery for both intervention and control groups. Cefalexin (placebo) every 6 hr and azythromycin (placebo) every 12 hr for control group and cephalexin 500 mg every 6 hr and azithromycin 250 mg every 12 hr for intervention group were administered for 48 hrs. Patients were under observation till 1 month after surgery. Fever, wound infection, endometritis and hospitalization were compared between two groups with SPSS v. 18. Results: A total of 231 patients 113 (48.9%) were enrolled in intervention group and 118 (51.1%) in control group with mean age of (28.53 ± 5.51) recruited. BMI distribution did not differ in the two groups. Hospitalization in control group was significantly higher than that in intervention group (2.58 ± 0.99) vs (2.11 ± 0.45) (P value < 0.001). BMI in intervention group with and without fever was (34.62 ± 2.64) and (30.89 ± 2.80), respectively (P value < 0.001). In control group, BMI in patients with and without fever was (38.60 ± 2.80) and (31.29 ± 1.28), respectively (P value = 0.001). Fever and endometritis simultaneously was seen in 3 (2.7%) of intervention group and 8 (6.8%) of control group. In interventions 3 (2.7%) had fever but no endometritis and 2 (1.8%) had endometritis but no fever (P < 0.001). In control group, 23 (19.5%) patients had fever but no endometritis and 4 (3.4%) patients had endometritis but no fever (P value < 0.001). Febrile patients in control group 31 (26.3%) were significantly more than those in intervention group 6 (5.3%) (P value < 0.001). Discussion: Administration of prophylactic azithromycin and cephalexin resulted in a decrease in febrile morbidity and length of hospital stay and is recommended. BMI of patients with fever was significantly higher in both intervention and control groups compared to those who didn’t experience fever. Postcesarean endometritis wasn’t significantly different in two groups. Postcesarean wound infection wasn’t seen in any group.
基金financially supported by Kermanshah University of Medical Science(grant number 981004)
文摘Objective:To evaluate the effect of Heracleum persicum L.against gentamicin-induced nephrotoxicity in rats.Methods:Thirty-six Wistar rats were divided into 6 groups including control(normal saline),gentamicin(80 mg/kg/d for 10 d),Heracleum persicum(750 mg/kg/d),and gentamicin(10 d)+Heracleum persicum extract at three different doses(250,500,and 750 mg/kg/d for 40 d).Urine creatinine,urea,protein,and albumin levels were determined.In addition,serum urea,creatinine,sodium,potassium,cytokines(TNF-α,IL-1β,IL-6,and IL-10),glutathione peroxidase activity,total antioxidant capacity,kidney malondialdehyde,stereological parameters,and expressions of apoptosis-related genes(p53,Bax,Bcl-2,and caspase-3)were measured.The LD50 of Heracleum persicum extract was determined based on Lorke’s method.Histopathological evaluation was also performed.Results:In addition to decreased urine protein and albumin,and increased creatinine and urea,co-treatment with gentamicin and Heracleum persicum significantly reduced levels of creatinine and urea,and increased sodium and potassium in serum.Heracleum persicum treatment also improved stereological parameters and serum inflammatory cytokines.There was a significant increase in serum glutathione peroxidase activity and total antioxidant capacity as well as a reduction in malondialdehyde level.Furthermore,treatment with Heracleum persicum extracts downregulated p53,caspase-3,and Bax and upregulated Bcl-2 expressions.In histopathological evaluation,Heracleum persicum extracts showed protection against gentamicin-induced renal damages.Conclusions:Heracleum persicum exhibits protective effects against gentamicin-induced structural and functional renal impairments.
文摘Monozygotic 24-year-old twins presented with discordant ovarian function. One had had premature ovarian failure at the age of 14 years, whereas her sister had normal ovaries and three naturally conceived children. After unsuccessful egg-donation therapy, the sterile twin received a transplant of ovarian cortical tissue from her sister by means of a minilaparotomy. Within three months after transplantation, the recipient’ s cycles resumed and serum gonadotropin levels fell to the normal range. During the second cycle, she conceived, and her pregnancy progressed uneventfully. At 38 weeks’ gestation, she delivered a healthy-appearing female infant.
文摘There continues to be an increase in utilization of assisted reproductive technology(ART), including the use of third party gametes. Specifically, the use of third party oocytes, most recently reported in 2010 by the United States(US) Center for Disease Control and Society of Reproductive Medicine, accounted for 15 504 cycles and 7334 live births. This translates into approximately 11% of all the in vitro fertilization cases performed in the US. As utilization increases and the technological tools advance, they have created underappreciated and unforeseen ethical quandaries. As such, many practitioners think they "have heard it all". However, each ART scenario is novel with the potential to pose complex unforeseen issues, potentially creating global challenges that could impact broad social and legal questions and test the moral consciousness' of practitioners, policymakers and patients. While there are published US national guidelines to assist practitioners, we have identified new complex issues in assisted reproduction that present unique challenges, and we give a perspective from oureyes in the Western Hemisphere looking out to a global level. Specifically, this review focuses on some of the more recent and evolving issues that currently are and will be confronting us in the upcoming years. Particular attention focuses on discrepancies between third party legal contracts and ART consents regarding level of information sharing, and oocyte and embryo directives and management; dilemmas and obligations surrounding disclosure of medical outcomes especially in the context of growing access to Direct to Consumer genetic testing and Reproductive Tourism-Exile. Given the complexity of these and other ethical questions, finding answers may be achieved by ending the isolation of reproductive professionals and instead promoting increased and consistent communication among physicians, embryologists, therapists and reproductive attorneys to confront these evolving ethical quandaries.
文摘This study aimed to ascertain the current status of Japanese sperm banking for young cancer patients. During 2015, we mailed the directors of 695 institutes where sperm cryopreservation might be performed with questionnaires requesting information on the number of patients, age, precryopreservation chemotherapy, semen analyses results and diagnoses, cryopreservation success rate, and causes of unsuccessful cryopreservation. Of these 695 institutes, 92 had cryopreserved sperm before chemotherapy within the study period. In all, 820 cancer patients （237 testicular, 383 hematological, 46 bone and soft tissue, 20 brain, and 134 other malignancy） consulted the responding institutes for sperm cryopreservation. Except for testicular tumor, the number of patients whose sperm was preserved before cancer treatment was low compared to that of young cancer patients. Approximately 20% of patients with malignancies other than testicular tumor underwent chemotherapy before cryopreservation. The success rate of cryopreservation in hematological malignancy was 82.5%, significantly lower than that of both the testicular cancer （93.6%） and other malignancy groups （95.6%） （P 〈 0.05）. The primary reasons for preservation failure were azoospermia and poor semen quality. Patients with hematological malignancies had a higher rate of unsuccessful cryopreservation compared to those in other groups, possibly due to the large number of patients requesting sperm cryopreservation after chemotherapy induction. In Japan, information regarding sperm banking prior to cancer treatment appears to be lacking. Information regarding sperm preservation before chemotherapy should be provided to all Japanese oncologists.
基金Experts Qi cong's Academic Experience Laboratory of Shanghai University of Traditional Chinese Medicine(No.SZYMZYGZS4014)Shanghai Xinglin New Star project(No.2018-2020-RCPY-3012)。
文摘The success rate of in vitro fertilization and embryo transfer is only about 28.5%.The combination of traditional Chinese medicine and assisted reproduction technology can effectively improve the pregnancy rate,which has good application prospect.However,there is no relevant record in traditional Chinese medicine.Unified diagnosis and treatment system has yet been established.According to many years of clinical experience,Professor Qi Cong summarized the treatment strategy of traditional Chinese medicine.Treatment of invigorating the spleen to nourish blood,reinforcing the spleen and kidney,tonifying the kidney and activating blood circulation,enriching the kidney to prevent miscarriage,cooling blood to stop bleeding are given based on the characteristics of each stage and patients'symptoms during the transplantation.Disease differentiation matters during intermittent stage.Besides,she advocated treating husband and wife together.All of the above are characterized by Chinese medicine concept of pre cultivating the loss,treating the same disease with different methods,and three categories of etiologic factors.
文摘Purpose: Endometriosis can be managed effectively by medication, surgery, or a combination of both. Numerous studies have been conducted on surgical and medication treatment options, but their results are still under discussion. Therefore, we performed a study to develop a combinational treatment for various stages of endometriosis. Methods: Over a 3-year period, 218 documented endometriosis patients were classified in 4 stages. After first laparoscopy (with electrocoagulation and adhesion removal for stages I to III), the patients were treated with GnRH analogs (Gonadotropin Releasing Hormone Agonist-375 mg of Decapeptyl) for 3, 6 & 6 months, respectively. The second and third laparoscopy procedures were performed after 3 and 6 months, with add-back therapy. The treatment was evaluated by direct observation based on laparoscopic view and the pain relief was measured by the VAS (Visual Analogue Scale) after the first step of medication for patients of stages I-III. Results: After 3 months, 70/76 patients (91.9%) with stage-I endometriosis showed complete recovery (six cases after 6 months) while 65/72 and 32/43 cases with stage-II and -III (90.3 and 74.4%), respectively, showed complete recovery after 6 months of treatment. The remaining patients had GnRH treatment for another 3 months, and all showed a complete recovery after 9 months. Furthermore, 12 of the patients with stage-IV symptoms were candidates for laparoscopy or laparotomy, and their treatment response rate was 55.6%. The pain relief was significant after the combinational treatment in patients with stages I-III (P = 0.0001). Conclusion: Our study showed efficacy of the developed protocol for the endometriosis management.
基金supported by the National Key Research and Developmental Program of China(No.2018YFC1003403 and No.2018YFC1004700)the National Natural Science Foundation of China(No.32070850 and No.31771668).
文摘Cystic fibrosis(CF)is one of the most common recessive genetic diseases,with a wide spectrum of phenotypes,ranging from infertility to severe pulmonary disease.Mutations in the cystic fibrosis transmembrane conductance regulator(CFTR)gene are considered the main genetic cause for CF.In this study,we recruited a consanguineous Iranian pedigree with four male patients diagnosed with congenital unilateral absence of the vas deferens(CUAVD),and one female patient diagnosed with congenital absence of the uterus(CAU).Testicular biopsy of one patient was performed,and hematoxylin and eosin(H and E)staining of testis sections displayed the presence of germ cell types ranging from spermatogonia to mature spermatids,indicating obstructive azoospermia.To explore the underlying genetic factor in this familial disorder,we therefore performed whole-exome sequencing(WES)on all available family members.WES data filtration and CFTR haplotype analysis identified compound heterozygous mutations in CFTR among four patients(two CUAVD patients carried p.H949Y and p.L997F,and one CUAVD and the female CAU patient carried p.H949Y and p.I148T).All these mutations were predicted to be deleterious by at least half of the prediction software programs and were confirmed by Sanger sequencing.Our study reported that CFTR compound heterozygous mutations in a consanguineous Iranian family cause infertility in both sexes.
文摘Since December 2019,a novel coronavirus that represents a serious threat to human lives has emerged.There is still no definite treatment for severe cases of the disease caused by this virus,named coronavirus disease 2019(COVID-19).One of the most considered treatment strategies targets the exaggerated immune regulator,and interleukin(IL)-6 is a crucial pro-inflammatory mediator.Severe acute respiratory syndrome coronavirus 2(SARSCoV-2)cases show an elevated level of IL-6 related to disease severity.IL-6 activity can be inhibited by the following:IL-6 itself,IL-6 signaling pathways such as Janus kinase and signal transducer and activator of transcription(JAK-STAT),gp130,IL-6R,and downstream activated ILs,such as IL-17 and IL-6 cytokine.Currently,according to these studies and their results,IL-6 blockade with anti-IL-6 or its receptor antibodies such as tocilizumab in COVID-19 is beneficial in severe cases and may reduce the mortality rate.JAK-STAT inhibitors block the cytokine storm by inhibiting several crucial pro-inflammatory mediators such as TNF-αand IL-6 and have shown various results in clinical trials.IL-6 induces IL-17 secretion,and IL-17 is involved in the pathogenesis of inflammatory processes.Clinical trials of anti-IL-17 drugs are currently recruiting,and anti-gp130 antibody is preclinical.However,this agent has shown positive effects in inflammatory bowel disease clinical trials and could be tested for SARS-CoV-2.This study aimed to review the role of IL-6 in the cytokine storm and studies regarding IL-6 and blockade of its inflammatory pathways in COVID-19 to determine if any of these agents are beneficial for COVID-19 patients.
基金The financial support for this study was provided by Kermanshah University of Medical Sciences,Kermanshah,Iran (grant number:4000504)。
文摘Background : Diabetes-induced oxidative stress can have adverse effects on sperm and its DNA integrity. The Ashrasi date palm(ADP) has potent antioxidant properties.The aim of this study was to evaluate the antioxidant effect of ADP hydroalcoholic extract on sperm parameters and sperm DNA fragmentation in diabetic rats.Methods : Forty male rats were randomly divided into five groups( n = 7): 1, control;2, diabetic;3– 5, diabetic + ADP(30, 90 and 270 mg/kg for groups 3, 4 and 5, respectively). After preparation of ADP extract and its phytochemical screening, it was administered orally to rats, once a day for 5 weeks. At the end of the study, sperm parameters and sperm DNA fragmentation in all groups were investigated.Results : At doses of 90 and 270 mg/kg, ADP extract significantly increased the sperm viability compared to diabetic group 2( p = 0.04 and p = 0.03, respectively)and resulted in a significant decrease in immotile sperm( p = 0.002 and p = 0.006,respectively). At a dose of 270 mg/kg, a considerable enhancement of forward sperm motility was observed( p = 0.04) and there was a significant decrease in sperm DNA fragmentation( p = 0.04).Conclusions : The findings of the present study show for the first time that the hydroalcoholic extract of ADP has protective and antioxidant effects against diabetesinduced oxidative stress and can improve sperm parameters and protect sperm DNA integrity.
文摘Objective: The purpose of this study was to compare the effectiveness of a thorough sonographic oocyte retrieval to a routine in vitro fertilization retrieval to induce ovulation, pregnancy, and endocrine changes in patients with polycystic ovarian syndrome in their post-in vitro fertilization cycles. Study design: Sixty-four patients from a tertiary infertility clinic, with clomiphene citrate-resistant polycystic ovarian syndrome and who were undergoing in vitro fertilization, were assigned randomly into 2 groups. Group 1 (n = 34) had a thorough (every possible follicle punctured) sonographic oocyte retrieval, and group 2 (n = 30) had a routine (only follicles that were likely to contain oocytes) in vitro fertilization retrieval. These patients who did not conceive in their in vitro fertilization cycle were monitored with ultrasound scanning for evidence of ovulation, pregnancy, before and after day 3 gonadotropin,and steroid hormone levels. Analysis of variance and the Student t test were used for statistical significance. Results: Ovulation rates of 53% (18/34) and cumulative pregnancy rate of 44% (8/18) were observed in group 1, with no ovulations in group 2. Significant decreases in luteinizing hormone/FSH ratio (4.1 to 1.7) and testosterone (1.2 to 0.7 ng/mL) occurred after treatment in the thorough sonographic oocyte retrieval group, with no change after routine in vitro fertilization. Operating time was increased signifi cantly in the thorough sonographic oocyte retrieval group (45 vs 24 minutes) in group 2. Conclusion: Thorough sonographic oocyte retrieval during in vitro fertilization cycle can produce significant improvements in the endocrinologic abnormalities, ovulation, and pregnancies that are comparable with ovarian wedge resection in patients with clomiphene citrate-resistant polycystic ovarian syndrome.
文摘Objective:Duphaston is used as an alternative to gonadotropin-releasing hormone(GnRH)antagonists for suppressing premature luteinizing hormone(LH)surges.This study aimed to compare the efficacy of Duphaston protocols with that of Cetrotide in suppressing the LH surge.Methods:In this retrospective cross-sectional study,669 infertile women(aged 25-40 years)were administered recombinant follicle-stimulating hormone(rFSH)from the third day of their menstrual cycle.After the follicular diameter reached 13 to 14 mm,Cetrotide was prescribed orally to the control subjects,also case subjects took Duphaston orally.The retrieved oocytes were fertilized by an intracytoplasmic sperm injection(ICSI).Results:The levels of FSH,LH,and estradiol did not differ significantly between the groups(P>0.05).However,the findings indicated that Duphaston led to greater oocyte retrieval than Cetrotide(P=0.006).However,the number of mature oocytes and viable embryos in the case subjects did not reach a significant difference compared to that in the control subjects(P>0.05).The number of good-quality embryos(stage 1)was significantly higher in the case subjects(P=0.04).In addition,there is no significant difference in the chemical,clinical pregnancy,implantation rate,and miscarriage rate between both groups(P>0.05).Conclusion:Duphaston could be utilized as a suitable medication rather than a GnRH antagonist in women subjected to controlled ovarian hyperstimulation.
基金Supported by the National Nature Science Foundation of China (No.30600838)
文摘Acupuncture has been used to treat infertility extensively, including ovulatory dysfunction, in vitro fertilization and embryo transfer （IVF-ET）, and male infertility. This review summarizes the recent studies which investigated the role of acupuncture in infertility. In conclusion, most of the existing studies suggest a positive effect of acupuncture in infertility treatment. Firstly, acupuncture may improve ovulation by modulating the central and peripheral nervous systems, the neuroendocrine and endocrine systems, the ovarian blood flow, and metabolism. Secondly, acupuncture can improve the outcome of IVF-ET, and the mechanisms may be related to the increased uterine blood flow, inhibited uterine motility, and the anesis of depression, anxiety and stress. Its effect on modulating immune function also suggests helpfulness in improving the outcome of IVF-ET. Finally, the studies suggest that acupuncture plays a positive role in male infertility, the mechanism of which is not yet clear. Even though a positive effect of acupuncture in infertility has been found, well-designed multi-center, prospective randomized controlled studies are still needed to provide more reliable and valid scientific evidence. Furthermore, it is urgent and necessary to clarify the mechanism of acupuncture for infertility.
基金This work was supported by the Kermanshah University of Medical Science(grant number:980292)for Ph.D.thesis.
文摘Objective:Trifolium pratense has many healing properties,including fewer complications of menopause,cancer cell suppression,reducing blood glucose and lipids,as well as cardiovascular beneficial effects.The purpose of this study was to identify the phytochemical and mineral composition of T.pratense.Methods:Plant aerial parts were harvested and dried,and then hydroalcoholic and alcoholic extracts were prepared.Gas chromatography-mass spectrometry(GC-MS)analytical method was used to identify volatile compounds then liquid chromatography-electrospray ionization mass spectrometry(LC-ESI-MS)was used to identify polyphenols and the mineral elements were identify by inductively coupled plasma atomic emission spectrometer/ICP-AES and scanning electron microscope-energy-dispersive X-ray spectroscopy(SEM-EDS)methods.Total phenolic content(TPC)was determined based on colorimetric method,and total flavonoid content(TFC)was established based on the folin-chiocalteau reagent.Furthermore,two assays(DPPH and FRAP)were used to measure the antioxidant capacity of T.pratense ethanolic extract.Results:A total of 37 polyphenols and 107 peaks were identified by LC-ESI-MS analysis,and the GC/MS method also detected 21 volatile compounds,the most important of which were methylcyclopentane,dimethylpentanal and hexadecanol.A total of 18 mineral elements,including K,Mg,Al,Si,Zn,Ni,Cu,Se,Co,Fe,Mn,and Ca in the plant,were identified ICP-AES and SEM-EDS analysis.Conclusion:T.pratense has many therapeutic compounds such as polyphenol(isoflavone and flavonoids),volatile compounds,and essential mineral elements,which can be formulated purely and used in the pharmaceutical and traditional medicine industries.
基金This study complies with the Declaration of Helsinki and was performed according to ethics committee approval.The Ethics and Research Committee of the Hormozgan University of Medical Sciences approved the study(number:HUMS.REC.1401.115).
文摘Objective:To assess the impact of advanced maternal age on pregnancy and childbirth outcomes of singleton pregnancies.Study design:We retrospectively assessed singleton pregnant mothers who gave birth at Khaleej-e-Fars Hospital in Bandar Abbas,Iran,from January 2020 to January 2022.Demographic and obstetrical factors include educational level,medical insurance,residency place,access to prenatal care facilities,number of prenatal care visits,smoking status,gestational age,parity,infertility,maternal comorbidities,preeclampsia,eclampsia,preterm birth,low birth weight(LBW),intrauterine growth restriction(IUGR),macrosomia,placenta abnormalities(previa/acreta),placenta abruption,chorioamnionitis,meconium fluid,fetal distress,methods of delivery,rate of cesarean section(CS),perineal lacerations,postpartum hemorrhage,childbirth injury,shoulder dystocia,congenital malformation,neonatal asphyxia,and unfavorable maternal and neonatal outcome were compared between two groups.The Chi-square test assessed the relationship between categorical factors and maternal age groups.The influence of advanced maternal age on the risk of unfavorable pregnancy outcomes was evaluated using bivariate and multivariate logistic regression.Results:Of 8354 singleton deliveries,22.2%belonged to advanced-age mothers.Advanced-age mothers had less education than those aged 20–34 years old.Chronic hypertension,cardiovascular disease,overt diabetes,and thyroid dysfunction were more prevalent among advanced-age mothers.Compared with mothers aged 20–34 years,mothers aged 35 years and higher had a significantly higher risk of gestational diabetes(aOR:3.18,95%CI:1.56–6.95),preeclampsia(aOR:2.91,95%CI:1.35–4.72),placenta abnormalities(aOR:1.09,95%CI:0.77–1.94),CS(aOR:3.16,95%CI:1.51–3.87),postpartum hemorrhage(aOR:1.94,95%CI:1.24–2.61),intensive care unit admission(aOR:1.36,95%CI:1.15–1.99),LBW(aOR:1.35,95%CI:0.97–2.96),preterm birth(aOR:2.36,95%CI:1.65–4.83),stillbirth(aOR:1.18,95%CI:1.01–3.16),and neonatal intensive care admission(aOR:2.09,95%CI:0.73–3.92).According to bivariate regression,the risk of meconium fluid was lower in advanced-age mothers;however,the result of multivariate logistic regression found no correlation between advanced age and the Incidence of meconium fluid.Conclusion:Advanced-age mothers are at increased risk of adverse pregnancy and childbirth outcomes,which persist even after adjusting for several potential confounders.
文摘Objective:To assess the obstetric and neonatal outcomes associated with adolescent pregnancy in Iran.Methods:We retrospectively assessed women who gave birth between January 1st,2020,and January 1st,2022.These pregnant women were separated into two groups:(1)women aged 19 and younger;(2)women aged 20-34 years.Main outcome measures include preterm birth,maternal comorbidities,preeclampsia,eclampsia,low birth weight(LBW),intrauterine growth restriction(IUGR),placenta abnormalities,placenta abruption,cho-rioamnionitis,meconium fluid,fetal distress,methods of delivery,rate of cesarean section(CS),perineal lacer-ations,postpartum hemorrhage,childbirth trauma,shoulder dystocia,congenital malformation,and unfavorable maternal and neonatal outcome.Logistic regression models were used to determine the influence of teenage pregnancy on adverse pregnancy and childbirth outcomes.Results:Of 7033 deliveries,92.4%of women were adults,and 7.6%were adolescents.Adolescents residing in rural districts were more common than adults(42.3%vs.33.7%).However,access to prenatal facility care was the same as the majority of women had 6-10 prenatal care visits during their pregnancy.There was no difference in the risk of preeclampsia,placenta abruption,placenta previa,fetal distress,preterm labor,shoulder dystocia,perineal lacerations,childbirth trauma,congenital malformation,postpartum hemorrhage,intensive care unit admission,maternal death,and unfavorable neonatal outcome including stillbirth,neonatal intensive care unit admission,neonatal death in adolescent pregnancies compared to adults.Adolescents had a significantly higher risk of LBW(OR:1.47,95%CI:1.01-2.73),IUGR(OR:1.96,95%CI:1.31-2.45),and meconium fluid(OR:1.74,95%CI:1.41-2.32),however,there was no statistically significant difference after adjusting the confounding factors.Compared with adults,adolescents had a significantly lower risk of CS(aRR:0.67,95%CI:0.51-0.77)and a lower risk of gestational diabetes(aRR:0.78,95%CI:0.51-0.95).Conclusions:Although we found no serious consequences of adolescent pregnancy,more research is needed to reach a more accurate conclusion about teenage pregnancy.
基金The Ethics and Research Committee of the Hormozgan University of Medical Sciences approved the study(number:HUMS.REC.1401.115).
文摘Background:Little is known about potential urban-rural differences in adverse pregnancy outcomes.The purpose of this study is to look into the urban-rural differences in the trend of adverse maternal and neonatal outcomes.Methods:We retrospectively assessed the pregnancy outcome of singleton pregnant mothers who gave birth at a tertiary hospital in Bandar Abbas,Iran,between January 1st,2020,and January 1st,2022.Mothers were divided into two groups based on living residency:1)urban groupand 2)rural group.Demographic factors,obstetrical factors,maternal comorbidities,and adverse maternal and neonatal outcomeswere extracted from the electronic data of each mother.The Chi-square testwas used to compare differences between the groups for categorical variables.Logistic regression models were used to assess the association of adverse pregnancy,childbirth,and neonatal outcome with living residency.Results:Of 8888 mothers that gave birth during the study period,2989(33.6%)lived in rural areas.Adolescent pregnancy was more common in the rural area.Urban mothers had a higher education than rural mothers.Rural mothers were at higher risk for preterm birth aOR 1.81(CI:1.24-2.99),post-term pregnancy aOR 1.5(CI:1.07-2.78),anemia aOR 2.02(CI:1.07-2.34),low birth weight(LBW)aOR 1.89(CI:1.56-2.11),need for neonatal resuscitation aOR 2.66(CI:1.78-3.14),and neonatal intensive care unit(NICU)admission aOR 1.98(CI:1.34-2.79).On the other hand,the risk of cesarean section was significantly lower compared to urban mothers aOR 0.58(CI:0.34-0.99).Conclusions:Our study discovered that mothers living in rural areas had a higher risk of developing anemia,preterm birth,post-term pregnancies,LBW,need for neonatal resuscitation,and NICU admission,but a lower risk of cesarean section.
