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At present, the etiology and pathogenesis of Premature ovarian insufficiency have not been fully elucidated, and no effective medical treatment options are found.This article reviews the research progress of the etiology of POI, in order to provide theoretical basis for clinical identification of high-risk groups and early prevention and treatment.
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Objective To investigate the expression changes of p53 and p21 in premature ovarian failure in female rats exposed to coal burning fluorosis.Methods Ablactation 24 SD female rats were chosen to establish animal model (the model group),in fluorine 90 days were put to death.Observed the changes of the teeth of the female rats during fluorine exposure and ovarian granulosa cell premature aging change,detected fluorine contents of urine and bone,and expression of the ovarian granular cell gene p53 and p21.Results In the model group,fluorine spot tooth,the fluorine contents of urine and bone increased significantly.In the model group,there was no premature aging of ovarian granulosa cells in the low fluorine group,but with the increase of dye fluorine metering,ovarian granulosa cells became mild,moderate to severe progressive edema trends,cells morphological damaged fuzzy,and atresia follicles increased significantly,corpus luteum degraded,mature follicle significantly reduced,and the ovarian function gradually signs of premature aging presented.With the increase of dye fluoride measurement,the expression of aging gene p53 and p21 in each group gradually increased,compared with the control group,there was statistically significant difference (P＜0.05).Conclusion Premature ovarian failure caused by coal-burning fluorosis was significantly related to the expression of genes p53 and p21.
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Objective To observe the therapeutic effect and security of Thermal Moxibustion combined with Yougui Pills in the treatment of premature ovary failure(POF) of spleen and kidney Yang-deficiency.Methods One hundred and forty-two patients with POF of spleen and kidney Yang-deficiency were randomly divided into the treatment group and control group,71 cases in each group.The observation group were treated with Thermal Moxibustion combined with Yougui Pills,while the control group took oral Yougui Pills,12 weeks as a course of treatment.After treatment,the clinical therapeutic effects,K upperman score,related hormones levels(E2,FSH,LH) and occurrence rate of adverse reactions were compared between the two groups.Results The total efficacy rate of the observation group was 95.77％,which of the control group was 77.46％,and the observation group was significantly better than the control group(P＜0.05);there were significant improvement in the Kupperman score and levels of related hormones after treatment in the two groups(P＜0.05),but the improvement degree of the observation group was superior to the control group(P＜0.05).Conclusion Thermal Moxibustion combined with Yougui Pills can alleviate the clinical symptoms with high safety and higher clinical application value
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Objective To explore the Chinese medicine treatment of QUNTAI capsule in different stages of premature ovarian failure effect.Methods Sixty SD female rats were divided into 6 groups:normal group,model group,prevention group,intervention group,the treatment group,and Western medicine group.To observe the changes of behavior in rats,enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of follicle stimulating hormone FSH,LH,serum estradiol E2,and anti Mueller hormone AMH.RT-PCR was used to detect ovarian tissue vascular endothelial growth factor (VEGF) and basic effect of fibroblast growth factor (bFGF) mRNA expression.Results The levels of FSH and LH in the normal group and the administration group were significantly lower compare to model group (P＜0.05),and the contents of AMH and E2 were significantly higher compare to model group (P＜0.05).The FSH and LH content in the model group was significantly higher than that of the normal group and each treatment group,E2,AMH content was significantly lower than that of the normal group and each treatment group (P＜0.05);the expression of VEGF andbFGF mRNA in each treatment group and nornial group was significantly higher than that of model group (P＜0.05),Prevention group was higher than intervention group and treat ment group (P＜0.05),there was no Gignificont difference between prevention group and Western medicine group(P＞0.05).Conclusion QUNTAI capsule can increase serum E2 and AMH levels,lower serum FSH,LH levels,improve ovarian sensitivity to sex hormone levels,repair damaged ovarian tissue,promote follicular growth and development,Thereby inhibiting premature follicle depletion.
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Objective To observe the repairing effect of human umbilical cord mesenchymal stem cells (hUC-MSCs) and goserelin on chemotherapy-induced ovarian injury, and the distribution and growth of hUC-MSCs transplanted in rat chemotherapy-induced ovarian injury. Methods A total of 120 SD rats were randomized into group A-E:A normal group, B NS control group, C goserelin group, D hUC-MSCs group and E hUC-MSCs+goserelin group. The rat premature ovarian failure (POF) model was established by given a loading dose of cyclophosphamide (CTX, 50 mg/kg) followed by daily intraperitoneal injection of CTX (8 mg/kg) for consecutive 14-day. The hUC-MSCs were injected through caudal vein, and goserelin was given by subcutaneous injection 4 days before POF model established. The serum level of estrogen was detected and numbers of follicles were counted. After GFP was transfected by lentivirus, the distribution and growth of stem cells transplanted in rats were observed by animal in vivo imaging system. Results At day 46, the serum level of estrogen showed no significant difference between group A and group E (P > 0.05). There were no significant differences in the counted follicles between group A and group E (P>0.05). After tail vein injection of the transfected cells, GFP positive cells were found in injury ovarian. Conclusion There is a repairing effect of hUC-MSCs and goserelin on ovarian injury.
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Objective To study risk factors of cardiovascular disease (CVD) and status of bone mineral density (BMD) in women with hypoestrogenism.Methods From Jul 2011 to April 2013,a total of 256 women with hypoestrogenism in the First Affiliated Hospital of Shanxi Medical University were enrolled in this retrospective study,which were divided into four groups:133 women in ppausal group,25 women in premature ovarian failure (POF) group,67 women in menopausal transition group and 31 women in premature ovarian failure transition group.General statue,CVD risk factors and BMD were compared among four groups.General statue include menopausal period,menopausal symptoms (Kupperman Index),CVD risk factors include body mass index,blood pressure,waist circumference,waist-hip ratio,blood lipids and glucose,BMD include left hip,lumbar spine bone mineral density and T or Z value.Results (1) The median menopausal period were 3.4 years in postmenopausal group and 3.6 years in premature ovarian failure group,which did not show no statistical difference (P ＞ 0.05).Kupperman Index in four groups were 12 in postmenopausal group,9 in POF group,9 in menopausal transition group and 8 in premature ovarian failure transition group,which reached statistical difference (P ＜ 0.05).(2) The difference of body mass index (BMI),waist circumference,waist-hip ratio,diastolic blood pressure were no statistically significant among four groups(P ＞ 0.05) ; the systolic blood pressure in four groups were 120,110,110,110 mm Hg (1 mm Hg =0.133 kPa),their differences were statistically significance (P ＜ 0.05); the high-density lipoprotein (HDL-C) was 1.6 mmol/L in postmenopausal group,and 1.3 mmol/L in premature ovarian failure transition group,their differences were all statistically significance (P ＜ 0.05) ; the difference of the fasting plasma glucose (FPG) was not statistically different in 4 groups (P ＞0.05).(3) The abnormal rate of lower bone mass in lumbar spine were 57％ (46/81) postmenopausal group,8/15 in POF group,32％ (9/28) in menopausal transition group,12/19 in premature ovarian failure transition group,and osteoporosis was 9％ (7/81),3/15,1％ (3/28)and 0 respectively,their differences were statistically different (P ＜ 0.05) ; the abnormal rate of BMD of left hip and lumbar spine of 11/15 and 12/16 in POF group was higher than 65％ (53/81) in postmenopausal group.In the mean time,the abnormal rate of BMD of left hip and lumbar spine were,12/19 and 10/20 in premature ovarian failure transition group,which were significantly higher than 43％ (12/28) and 39％ (12/31) in the menopausal transition group.Conclusions The menopausal symptoms resulting from hypoestrogenism in natural postmenopausal women are mostly remarkable.The decrease of BMD in lumbar spine is more significant than that of left hip among postmenopausal women.Women with earlier menopause was prone to cause the changes of blood fat and abnormal of BMD,especially HDL-C decreased significantly compared with those natural postmenopause,it is more likely to cause CVD and osteoporosis.
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Objective To evaluate clinical value of denaturing high performance liquid chromatography (DHPLC) used in detecting transforming growth factor beta receptor 3 (TGFBR-3) exons 11 and 12 polymorphism in women with idiopathic premature ovarian failure (POF).Methods From Feb.2009 to Dec.2011,110 patients with idiopathic POF undergoing treatment at Shenzhen Maternal & Child Health Institute affiliated to Southern Medical University were enrolled as POF group in this study.In the mean time,110 women under 40 years old with normal hormonal level and menstrual cycles as control group.The exons 11 and 12 of TGFBR-3 gene polymorphism were screened by using DHPLC,and results of DNA sequencing was as golden standard.Some related indexes were calculated,such as sensitivity,specificity,false negative value,false positive value,Youden index,positive predictive value,and negative predictive value.At the same time,20％ of the tested specimens were chosen randomly and detected by DHPLC again.The value of Kappa index were calculated by comparing the results between the first and second DHPLC analysis.Results The exon 11 of TGFBR-3 were not identified gene polymorphism and two nucleotide polymorphisms were identified in exon 12.For 2022 T/C polymorphism,the frequencies of CC with 0.9％ (1/110),TC with 22.7％ (25/110),TT with 76.4％ (84/110),Cwith12.3％ (27/220) and T with 87.7％ (193/220) in POF group were significantly different from CC with 0,TC with 9.1％ (10/110)and TT with 90.9％ (100/110),C with 4.5％ (10/220) and T with 95.5％ (210/220) in control group (all P ＜ 0.05).Allelic and genotypic frequencies of 2161-75 C/T were not differed significantly between the two groups (all P ＞ 0.05).As DNA sequencing as golden standard,DHPLC showed that the sensitivity was 100％,specificity was 97.9％,Youden index was 97.9％,positive predictive value was 96.3％,negative predictive value was 100％,and Kappa index was 0.888 (P ＜ 0.05).Conclusion DHPLC analysis is higher validity,reliability and practicability method in detecting TGFBR-3 polymorphism in idiopathic premature ovarian failure.
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Objective To observe the clinical effects of ximingting plan in treatment of osteoporesis result in hypofunction of ovary.Methods Sixty women with osteoporesis result in hypofunefion of ovary were divided into two groups by random digits table with 30 cases each.The investigated group received ximingting pian,the controlled group received hormone replacement therapy(HRT).The changes of bone density,bone gla protein(BGP),estradiol,follicle-stimulating hormone(FSH),the thickness of endometrium,blood routine,urine routine,liver function and kidney function before and after 6 months treatment were measured.Results Bone density and BGP after treatment wag higher than that before treatment in two (6.78±3.97)g/L;in controlled group:(0.617±0.065)g/cm2 vs.(0.552±0.073)g/cm2 and(8.92 4±4.43)g/L vs.(6.83±4.29)g/L](P0.05);but not this in controlled group(P0.05).There was no significant difference in blood routine,urine routine,liver function and kidney function before and after treatment in two groups(P>0.05).Conclusion Ximingting pian is efficacious and safe in the treatment of osteoporosis result in hypofunction of ovary.
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A falência ovariana prematura exige, para avaliação conveniente dos diversos fenômenos etiológicos envolvidos, adequada análise de seus fatores causais. Entre as possíveis causas genéticas, encontram-se anomalias gênicas ou cromossômicas, seja nos cromossomos X ou nos autossomos. O presente estudo apresenta, de modo sucinto, revisão dos fatores genéticos que são responsáveis por tais fenômenos etiológicos.
Premature ovarian failure demands a proper analysis of countless factors for an accurate assessment of the several etiological phenomena processes involved. Among the possible genetic causes, it has been detected genic of chromossomal anomalies, ocurring either on the sex chromosomes or on the autosomes. This study presents a review of the genetic and chromosomal factors which account for etiological phenomena.
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Humans , Female , Congenital Abnormalities/genetics , Chromosome Aberrations , X Chromosome/genetics , Genetic Diseases, X-Linked/genetics , Genetic Predisposition to Disease , Primary Ovarian Insufficiency/etiology , Primary Ovarian Insufficiency/genetics , Chromosome Disorders/geneticsABSTRACT
Objective To observe the changes of serum anti-mttllerian hormone (AMH) level in women with premature ovarian fail-ure (POF) and its clinical significance. Methods Fasting serum levels of AMH in 25 POF patients were measured with enzyme-linked im-mtmosorbent assay (ELISA). Twenty healthy women matched for age and body mass index (BMI) were chosen as controls. Results The serum AMH level in POF group was (1.1±0.1) pmol/L, which was significantly lower than that of control group(P < 0.01). The serum AMH levels in 20 patients of POF group were undetectable. The other 5 patients were treated with artificial cycle at first, and then ovulated with hMG/HCG.2 patients had ovulation and 1 patient was pregnant. Conclusion The serum AMH level in POF patients was significantly decreased, and the measure for serum AMH had some significance for POF diagnosis and treatment.
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Objective To investigate whether low level 45, X/46, XX mosaicism presents in women with premature ovarian failure (POF) and the sensitivity and specificity of fluorescent in situ hybridization (FISH) for detecting X chromosome mosaicism. Methods Karyotypes of peripheral lymphocyte in 18 patients with POF and 9 normal controls were analyzed and the orange signals during FISH using X chromosome enumeration probes (CEPX) were counted. Results Single signals of X chromosome (45, X) were found in 7.6% of the total counted cells, which was significantly greater than that in the controls, in spite of the normal 46, XX karyotypes by routine analyses in all POF patients. Conclusions This study indicated that some POF patients may attribute to low level 45, X/46, XX mosaicism. FISH is more sensitive than the routine chromosome analyses in detecting low level X chromosome monosomy.