Role of TLR4/ERK1/2 signaling pathway in decidual tissue of unexplained spontaneous abortion / 中国免疫学杂志

Objective:To investigate the expression of Toll-like receptor 4(TLR4)and extracellular signal-regulated protein kinase 1/2(ERK1/2)in decidua tissue of patients with unexplained spontaneous abortion and their correlation.Methods:The expres-sions of TLR4,ERK1/2 and p-ERK1/2 in decidua tissues of 32 patients with unexplained spontaneous abortion(abortion group)and 32 normal pregnancy(control group)were detected by immunohistochemistry and Western blot,respectively.The correlation between TLR4 and p-ERK1/2 in abortion group were analyzed by Pearson hierarchical correlation analysis.Results:In immunohistochemical experiments,the cytoplasm of decidua cells in the two groups is the expression locus of TLR4,ERK1/2 and p-ERK1/2,the expression of the three proteins were different,and the expressions of TLR4 and p-ERK1/2 in abortion group were significantly higher than that in control group(P<0.01).There was no significant difference in ERK1/2 expression between abortion group and control group(P>0.05);In decidua tissue samples of abortion group,the protein level of TLR4 was higher than that of control group(P<0.05);the pro-tein level of p-ERK1/2 was significantly higher than that of control group(P<0.01),and the protein level of ERK1/2 in decidua tissue of abortion group was not statistically different from that of control group(P>0.05).TLR4 was positively correlated with p-ERK1/2 expression in abortion group(r=0.890,P<0.01).Conclusion:Abnormal activation of TLR4/ERK1/2 signaling pathway may be one of the mechanisms of unexplained spontaneous abortion.

Effects of Shoutai Pills in Regulating Histone Modification on Endometrial Decidualization of Mice with Recurrent Spontaneous Abortion / 中国中医药信息杂志

Objective To observe the effect of Shoutai Pills on endometrial decidualization of mice with recurrent spontaneous abortion(RSA);To explore its possible mechanism in the treatment of RSA based on histone modification.Methods Totally 40 female CBA/J mice were divided into normal group,model group,Shoutai Pills low-dosage group(7.5 g/kg),Shoutai Pills high-dosage group(15 g/kg)and dydrogesterone group(3 mg/kg).The normal group were co housed with BALB/C male mice,while the other groups were co housed with DBA/2 male mice to establish an RSA mouse model.After modeling,the administration groups were given corresponding medication solution by gavage,while the normal group and model group were given equal volume of pure water by gavage for 10 consecutive days.The embryo condition was observed and the embryo loss rate was calculated,ELISA was used to detect serum prolactin(PRL)content,HE staining was used to observe the morphological changes of decidual tissue,RT-PCR was used to detect PRL mRNA expression in decidual tissue,Western blot was used to detect the protein expressions of H4ac,H3K27ac,H3K27me3.Results Compared with the normal group,the model group mice showed a significant increase in embryo loss rate,a significant decrease in serum PRL content,disordered arrangement of decidual cells,and extensive bleeding and necrosis;the expression of PRL mRNA and protein in decidual tissue significantly decreased,the protein expressions of H4ac and H3K27ac significantly decreased,while the expression of H3K27me3 protein significantly increased,with statistical significance(P<0.05).Compared with the model group,the embryo loss rate of Shoutai Pills low-and high-dosage groups and the dexamethasone group significantly decreased,the serum PRL content significantly increased,tightly arranged decidual cells,reduced necrosis,and intact glands;the expression of PRL mRNA and protein in decidual tissue of mice in Shoutai Pills high-dosage group and the dexamethasone group significantly increased,the protein expressions of H4ac and H3K27ac significantly increased,the expression of H3K27me3 protein significantly decreased,with statistical significance(P<0.05).Conclusion Shoutai Pills can promote endometrial decidualization in RSA mice,which is related to the changes of histone modification in endometrial stromal cells.

Discussion on Etiology and Pathogenesis of Recurrent Spontaneous Abortion Caused by Immune Factors Based on"Latent Toxic Hiding in Membrane" / 中国中医药信息杂志

Immune factors play an important role in recurrent spontaneous abortion(RSA),and immune imbalance affects embryo implantation,growth,and development.There is currently no consensus on the etiology and pathogenesis of RSA caused by immune factors.Based on the theory of latent toxic in TCM and combined with the pathological mechanism of the dynamic changes of immune abnormal substances in the body,this article proposed that latent toxic is the key cause of RSA caused by immune factors.Furthermore,it expounded the pathogenic characteristics of latent toxic:combination of heat and blood stasis hidden in the womb,and latent toxic plays a role in embryo formation under qi deficiency conditions.It is established that latent toxin stagnation in the membrane is the pathogenic mechanism.Moreover,this article revealed the variable pathological changes such as the blockage of the inner membrane system and the outer membrane system.Treatment should be based on the basic methods of tonifying qi and nourishing blood,tonifying kidney to secure the Thoroughfare Vessel,clearing heat and cooling blood,promoting blood circulation and removing blood stasis.This article could provide a theoretical basis for TCM syndrome differentiation and treatment of RSA caused by immune factors.

Correlation between gene polymorphisms of coagulation factor Ⅻ rs1801020 and resistin rs1862513 and unexplained recurrent spontaneous abortion / 国际检验医学杂志

Objective To investigate the correlation between gene polymorphisms of coagulation factor Ⅻ(FⅫ)rs1801020 and resistin rs1862513 and unexplained recurrent spontaneous abortion(URSA).Methods A total of 189 patients diagnosed with URSA and 191 healthy postpartum women during the same period were selected from the obstetric clinic of Changning Maternity and Infant Health Hospital from January 2020 to December 2022.The probe PCR was used to detect gene polymorphisms of rs1801020 and rs1862513 in peripheral blood,and the differences in genotype distribution between the groups were observed.Results The frequencies of geno-types and alleles for F Ⅻ rs1801020 in the URSA-A group were 4.9％(CC),35.7％(CT),59.5％(TT),22.7％(C),and 77.3％(T),respectively.In the control A group,the frequencies were 8.0％(CC),47.1％(CT),44.9％(TT),31.5％(C)and 68.5％(T).The frequencies of genotypes and alleles for resistin rs1862513 in the URSA-B group were 11.3％(CC),47.3％(CG),41.4％(GG),34.9％(C)and 65.1％(G).In the control B group,the frequencies were 10.2％(CC),34.1％(CG),55.7％(GG),27.3％(C)and 72.7％(G).There was no significant difference in genotype frequency of the two loci(P＞0.05),but there was a sig-nificant difference in allele frequency(P＜0.05).The distribution frequency of F Ⅻ rs1801020 T allele in the URSA group was higher than that in the control group(X2=6.32,OR=1.567,95％CI:1.100-2.238,P=0.012).The distribution frequency of resistin rs1862513 G allele in URSA group was lower than that in con-trol group(X2=4.96,OR=1.433,95％CI:1.050-1.969,P=0.026).The mutation of F Ⅻ rs1801020 C to T was a risk factor for the occurrence of URSA,while the mutation of rs1862513 C to G was a protective factor for the occurrence of URSA(P＜0.05).The combined genotype analysis showed that compared to the popu-lation carrying the rs1801020 CC+rs1862513 CC genotype combination,the population carrying the rs1801020 TT+rs1862513 CG genotype had a significantly higher risk of URSA(OR=5.684,95％CI:1.210-30.920,P=0.035).Conclusion FⅫ rs1801020 T allele may increase the risk of URSA and resistin rs1862513 G al-lele may the risk of URSA.People with rs1801020 TT+rs1862513 CG genotype combination is more likely to develop URSA than those with rs1801020 CC+rs1862513 CC genotype combination.

Expression and clinical significance of hsa_circ_0005075 in serum extracellular vesicles of patients with recurrent spontaneous abortion / 临床检验杂志

Objective To investigate the expression level and clinical significance of hsa_circ_0005075 in serum extracellular vesicles(EVs)of patients with recurrent spontaneous abortion(RSA).Methods Fourteen RSA patients and 14 normal pregnant women from the Department of Obstetrics and Gynecology,Qilu Hospital of Shandong University were enrolled in a training set,and 64 RSA pa-tients and 48 normal pregnant women were enrolled in a validation set.The expression levels of hsa_circ_0005075 in serum EVs were detected by the quantitative real-time PCR(qRT-PCR),and their correlation with clinical pathological parameters of RSA patients were analyzed.Serum anti-thyroid globulin antibody(A-TG)and anti-thyroid peroxidase antibody(A-TPO)were detected by the elec-trochemiluminescence assay.Serum anticardiolipin(ACA)IgA,IgG,and IgM antibodies and anti-β2 glycoprotein 1(β2GP1)IgA,IgG,and IgM antibodies were determined by the chemiluminescence immunoassay.The correlation of these autoantibodies with the lev-els of hsa_circ_0005075 in serum EVs was analyzed by the Pearson correlation.The clinical application value of hsa_circ_0005075 in the diagnosis of RSA was evaluated by the receiver operating characteristic(ROC)curve.Results The detection results of the training set showed that the expression levels of hsa_circ_0005075 in serum EVs of RSA patients(7.69[4.74,42.15])were significantly high-er than that in normal pregnant women(1.02[0.51,4.23],U=28,P＜0.01].Similarly,in the validation set,the expression levels of hsa_circ_0005075 in RSA patients(4.96[1.73,8.89])were also significantly higher than that in normal pregnant women(1.00[0.24,2.96],U=693,P＜0.01).The ROC curve showed that hsa_circ_0005075 in serum EVs had good diagnostic value for RSA(AUCROC=0.774),with 70.3%of sensitivity and75.0%of specificity.In addition,the expression level of hsa_circ_0005075 in serum EVs was significantly correlated with A-TPO(r=0.298,P＜0.05).Conclusion The hsa_circ_0005075 in serum EVs is highly ex-pressed in RSA patients,which may have a potential differential diagnostic value for the diagnosis of RSA.

Relationship between endometrial lactobacillus-dominated microbiota and reproduction / 实用医学杂志

An increasing number of studies in recent years have focused on the association between female endometrial microbiota and fertility.Once the endometrial microflora microecology is unbalanced,it will cause a series of endometrial lesions,thereby destroying endometrial receptivity,affecting embryo implantation,resulting in embryo implantation or implantation failure.Among them,the most concerned is the positive significance of lactobacillus-led microbiota on reproductive outcome.Although the relationship between endometrial microbiota and reproductive outcome has not reached a consensus,most studies recognize the positive impact of lactobacillus-led microbiota on reproductive outcome.In this review,the relationship between lactobacillus-dominated microbiota and reproductive outcome is reviewed.

Analysis of risk factors for recurrent spontaneous abortion and construction of prediction model / 新乡医学院学报

Objective To analyze the risk factors of recurrent spontaneous abortion(RSA),construct a prediction model based on the risk factors,and evaluate its efficacy in predicting the occurrence of RSA.Methods A total of 324 pregnant women who were registered in the Department of Reproductive Medicine of the Third Affiliated Hospital of Xinxiang Medical University from January 2019 to October 2022 were selected as the research subjects,and they were divided into normal group(n=234)and abortion group(n=90)according to the presence or absence of RSA.Univariate and multivariate logistic regression were used to analyze the risk factors of RSA,a prediction model was constructed based on the selected risk factors,and predictive efficiency of the model was evaluated by drawing the receiver operating characteristic(ROC)curve.Results Univariate analysis showed that there were significant differences in 25-hydroxyvitamin D[25-(OH)D],progesterone(P),homocysteine(Hey),fibrinogen(FIB),D-dimer(D-D),thyroid-stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),pulse index(PI),resistance index(RI)and ratio of peak systolic velocity to lowest diastolic velocity(S/D)between the two groups(P＜0.05);there were no significant differences in age,pre-pregnancy body mass index,pre-pregnancy menstrual cycle,gestational sac size,free triiodothyronine(FT3)and free thyroxine(F4)between the two groups(P＞0.05).Multivariate logistic regression analysis showed that low 25-(OH)D and P,as well as high Hey,TPOAb,PI,RI and S/D,were risk factors for RSA in pregnant women(P＜0.05).The ROC curve analysis results showed that the sensitivity,accuracy,positive predictive value and area under the curve of the constructed model in predicting the occurrence of RSA were 92.60％,90.25％,89.26％and 0.914,respectively.Conclusion Decreased 25-(OH)D and P as well as increased Hcy,TPOAb,PI,RI and S/D are risk factors for RSA,and the constructed model based on these risk factors has high efficiency in predicting the occurrence of RSA.

Expression and clinical significance of miR-141-5p as a biomarker in the serum of patients with early spontaneous abortion

Abstract Aim miR-141-5p expression in patients with Early Spontaneous Abortion (ESA) and its correlation with hormone levels during pregnancy were investigated. Methods A total of 70 pregnant women with ESA were selected as the research group, and 70 normal pregnant women who chose abortion for non-medical reasons were selected as the Con group. Serum β-HCG, Progesterone (P), and Estrogen (E2) were detected by enzyme-linked immunosorbent assay. Differentially expressed miRNAs were screened by miRNA microarray analysis. miR-141-5p expression was detected by RT-qPCR, and its correlation with serum β-HCG, P, and E2 levels was analyzed. The diagnostic value of miR-141-5p for ESA was evaluated by the ROC curve. Results Serum β-HCG, P, and E2 were decreased and serum miR-141-5p was increased in patients with ESA. Pearson correlation analysis showed that serum β-HCG, P, and E2 levels were negatively correlated with miR-141-5p expression levels. ROC curve showed that miR-141-5p had a diagnostic value for ESA. Conclusions miR-141-5p is related to hormone levels during pregnancy and is expected to become a new candidate diagnostic marker for ESA.

Prognostic model on pregnancy outcomes for women with recurrent spontaneous abortions treated with cyclosporin A: A single-institution experience

Abstract Background: This study aimed to identify prognostic factors for pregnancy outcomes and construct a prognostic model for pregnancy outcomes in women with Recurrent Spontaneous Abortions (RSA) treated with cyclosporin A. Methods: A total of 154 RSA patients treated with cyclosporin A between October 2016 and October 2018 were retrospectively recruited. Multivariate logistic regression was applied to identify the prognostic factors for pregnancy success in RSA women treated with cyclosporin A. The Receiver Operating Characteristic (ROC) curve was applied to construct prognostic value, and the prognostic performance was assessed using area under the ROC. Results: After adjusting potential confounding factors, the authors noted increased age (OR = 0.771; 95 % CI 0.693‒0.858; p < 0.001) and positive antinuclear antibodies (OR = 0.204; 95 % CI 0.079‒0.526; p = 0.001) were associated with a reduced incidence of pregnancy success, while positive anti-β2 glycoprotein-I-antibody (OR = 21.941; 95 % CI 1.176‒409.281; p = 0.039) was associated with an increased incidence of pregnancy success after treated with cyclosporin A. The AUC of combining these variables for predicting pregnancy failure was 0.809 (95 % CI 0.735‒0.880). Conclusion: This study systematically identified the prognostic factors for pregnancy success in women treated with cyclosporin A, and the constructed prognostic model based on these factors with relatively higher prognostic value. Further large-scale prospective studies should be performed to validate the prognostic value of the constructed model.

Development and internal validation of a clinical prediction model for spontaneous abortion risk in early pregnancy

Abstract Objective: This study aimed to develop and internally validate a prediction model for estimating the risk of spontaneous abortion in early pregnancy. Methods: This prospective cohort study included 9,895 pregnant women who received prenatal care at a maternal health facility in China from January 2021 to December 2022. Data on demographics, medical history, lifestyle factors, and mental health were collected. A multivariable logistic regression analysis was performed to develop the prediction model with spontaneous abortion as the outcome. The model was internally validated using bootstrapping techniques, and its discrimination and calibration were assessed. Results: The spontaneous abortion rate was 5.95% (589/9,895) 1. The final prediction model included nine variables: maternal age, history of embryonic arrest, thyroid dysfunction, polycystic ovary syndrome, assisted reproduction, exposure to pollution, recent home renovation, depression score, and stress score 1. The model showed good discrimination with a C-statistic of 0.88 (95% CI 0.87‒0.90) 1, and its calibration was adequate based on the Hosmer-Lemeshow test (p = 0.27). Conclusions: The prediction model demonstrated good performance in estimating spontaneous abortion risk in early pregnancy based on demographic, clinical, and psychosocial factors. Further external validation is recommended before clinical application.

As trombofilias na perda gestacional de repetição: uma revisão de prevalência e condutas / Thrombophilias in recurrent pregnancy loss: a review of prevalence and conduct

Objetivo: Discutir o papel das trombofilias na perda gestacional de repetição, com foco em prevalência/associação dessas patologias com perdas de repetição e seu tratamento, por meio de resultados de ensaios clínicos, revisões sistemáticas e metanálises. Métodos: Trata-se de uma revisão não sistemática de artigos publi- cados nas bases eletrônicas PubMed, Cochrane e SciELO nos últimos cinco anos, utilizando os seguintes descritores: "recurrent pregnancy loss", "recurrent abortion", "habitual abortion", "thrombophilia", "antiphospholipid syndrome" e "treatment". Resultados: A maioria dos estudos relatou forte associação entre os anticorpos antifosfolípides específicos e a síndrome do anticorpo antifosfolípide com perda gestacional de repetição. Mulheres portadoras da mutação do fator V de Leiden, mutação do gene da protrombina e deficiência de proteína S apresentaram alto risco de perda gestacional de repetição em uma grande revisão sistemática. Estudos recentes demonstraram taxas de prevalência das trombofilias hereditárias e da síndrome do anticorpo antifosfolípide, em mulheres com perda gestacional de repetição, semelhantes às da população em geral. Os estudos atuais endossam o uso da heparina associada à aspirina em mulheres com síndrome do anticorpo antifosfolípide, com aumento da taxa de nascidos vivos, mas sem diferença em re- lação às complicações obstétricas. Conclusão: Apesar de novos estudos demons- trarem que a prevalência das trombofilias hereditárias e adquiridas em mulheres com perda gestacional de repetição é semelhante à da população em geral, reco- menda-se a pesquisa rotineira de síndrome do anticorpo antifosfolípide nessas pacientes. O uso de aspirina em baixas doses associada à heparina é a intervenção farmacológica de primeira linha para a prevenção de perda gestacional de repeti- ção em pacientes com síndrome do anticorpo antifosfolípide.

Objective: To discuss the role of thrombophilias in recurrent pregnancy loss, focu- sing on the prevalence/association of these pathologies with recurrent abortion and treatment, through results of clinical trials, systematic reviews and meta-analyses. Methods: This is a non-systematic review of articles published in electronic databa- ses PubMed, Cochrane, SciELO in the last five years, using the following descriptors: "recurrent pregnancy loss", "recurrent abortion", "habitual abortion", "thrombophilia", "antiphospholipid syndrome", and "treatment". Results: Most studies have reported a strong association between specific antiphospholipid antibodies and antiphospho- lipid antibody syndrome with recurrent pregnancy loss. Women carrying the factor V Leiden mutation, prothrombin gene mutation, and protein S deficiency were shown to be at high risk of recurrent pregnancy loss in a large systematic review. Recent studies have shown prevalence rates of hereditary thrombophilias and antiphospholipid antibody syndrome, in women with re- current pregnancy loss, similar to those of the general po- pulation. Current studies endorse the use of heparin plus aspirin in women with antiphospholipid antibody syndrome, with an increase in live birth rate, but with no difference in obstetric complications. Conclusion: Although new studies demonstrate that the prevalence of hereditary and acquired thrombophilias in women with recurrent pregnancy loss is si- milar to that of the general population, routine investigation of antiphospholipid antibody syndrome in these patients is recommended. The use of low-dose aspirin plus heparin is the first-line pharmacological intervention for the prevention of recurrent pregnancy loss in patients with antiphospholipid antibody syndrome.

RISK FACTORS FOR SPONTANEOUS ABORTIONS IN TWO YAOUNDÉ DISTRICT HOSPITALS

Background. Abortion is the termination of a pregnancy before the age of fetal viability which, according to the WHO, is 22 weeks of pregnancy and/or with the fetus weigh less than 500 g. Spontaneous abortion is a public health problem. It's one of the most common complications of pregnancy. In order to contribute to the decrease of the morbidity and mortality linked to spontaneous abortions, we conducted this study, which the general objective was to study risk factors of spontaneous abortion. We carried out a cross-sectional case-control study in the District Hospitals of Biyem Methods. - Assi and Efoulan in Yaoundé. During six months, we collected 3774 records of pregnant women from January 1, 2020 to December 31.,2020. For each case (record of woman who had a spontaneous abortion), two controls (records of those who gave birth spontaneously at term) of the same age, were immediately recruited. Data were analyzed using IBM SPSS Version.23.0 software. Tools used to assess our results were: Fischer's exact test, frequency, odds ratio (OR) and P, with P signicant for any value less than 5%. We recruited 104 cases and 208 controls. Being unmarried, being from the littoral region, having a Results. history of stress, smoking, having started antenatal care and having had prenuptial check-up, independently increased the risk of spontaneous abortion with respectively aOR = 2.8 IC=1.24-6.31 aP= 0.013, aOR=4.31 IC= 1.09-17.02 aP= 0.037, aOR=11.86; CI=3.88-36.19; aP=<0.001, aOR=8.57; CI=3.41-21.54; aP=<0.001, aOR=10.4; CI=1.12-96.82; aP=0.04) and aOR=3.37; CI=1.67-6.79; aP<0.001). These risk factors being mostly modiable, should be sought and prevented Conclusion. in order to improve the prognosis of pregnancies in our context

Bushen Huoxue Fang improves recurrent miscarriage in mice by down-regulating the JAK2/STAT3 pathway / 南方医科大学学报

OBJECTIVE@#To investigate the efficacy of Bushen Huoxue Fang (BSHXF, a traditional Chinese medicine formula) for improving recurrent spontaneous abortion (RSA) in mice and the role of tyrosine kinase (JAK2) and transcriptional activator (STAT3) signaling pathway in its therapeutic mechanism.@*METHODS@#Female CBA/J mice were caged with male DBA/2 mice to establish RSA mouse models, which were randomly divided into model group, dydrogesterone group and BSHXF group, with the female mice caged with male BALB/c mice as the control group (n=6). From the first day of pregnancy, the mice were subjected to daily intragastric administration of BSHXF, dydrogesterone, or distilled water (in control and model groups) for 12 days. After the treatments, serum levels of antithrombin III (AT-III), activated protein C (APC), tissue plasminogen activator (t-PA), progesterone, human chorionic gonadotropin (HCG), and estradiol (E2) were detected in each group using ELISA. HE staining was used to observe the morphological changes of the endometrium of the mice. Western blotting was performed to determine the expressions of p-JAK2, p-Stat3 and Bcl-2 in the placenta of the mice.@*RESULTS@#Compared with the control mice, the mouse models of RSA showed a significantly increased embryo loss rate with decreased serum levels of AT-III, T-PA, progesterone, APC and HCG, increased placental expressions of p-JAK2, p-STAT3 and Bax, and decreased expression of Bcl-2 (P < 0.05). Treatments with BSHXF and dydrogesterone both increased serum levels of AT-III, t-PA and HCG in the mouse models; Serum APC level was significantly reduced in BSHXF group and serum progesterone level was significantly increased in dydrogesterone group (P < 0.05).@*CONCLUSION@#BSHXF can improve the prethrombotic state and inhibit cell apoptosis by downregulating the JAK2/STAT3 pathway to increase the pregnancy rate in mouse models of RSA.

Effectiveness of Scutellaria baicalensis Georgi root in pregnancy-related diseases: A review / 中西医结合学报

The root of Scutellaria baicalensis Georgi, also called Huangqin, is frequently used in traditional Chinese medicine. In ancient China, S. baicalensis root was used to clear heat, protect the fetus, and avoid a miscarriage for thousands of years. In modern times, pregnancy-related diseases can seriously affect maternal and fetal health, but few systematic studies have explored the mechanisms and potential targets of S. baicalensis root in the treatment of pregnancy-related diseases. Flavonoids (baicalein, wogonin and oroxylin A) and flavonoid glycosides (baicalin and wogonoside) are the main chemical components in the root of S. baicalensis. This study presents the current understanding of the major chemical components in the root of S. baicalensis, focusing on their traditional uses, potential therapeutic effects and ethnopharmacological relevance to pregnancy-related disorders. The mechanisms, potential targets and experimental models of S. baicalensis root for ameliorating pregnancy-related diseases, such as recurrent spontaneous abortion, preeclampsia, preterm birth, fetal growth restriction and gestational diabetes mellitus, are highlighted.

"Disease-syndrome-therapy" Spontaneous Abortion Models and Application Trends of Single-cell Multimodal Omics： A Review / 中国实验方剂学杂志

The incidence of spontaneous abortion （SAB） has been increasing year by year， and its etiology is complex， with limited treatment options， which poses a serious threat to social stability. The "disease-syndrome-therapy" research model can significantly improve the clinical efficacy of traditional Chinese medicine （TCM） for preventing miscarriage， but there has always been a lack of key and recognized diagnostic and treatment evaluation markers， which need to be further explored to establish a scientific and unified evaluation standard system. It is proposed to collect existing "disease-syndrome-therapy" SAB animal models， transplant and improve the model evaluation indicators， evaluate the degree of match between SAB animal models and the clinical characteristics of TCM and Western medicine diseases and syndromes， and compare the advantages and disadvantages of different SAB animal models in terms of construction methods， target selection， and evaluation indicators. In addition， the frontiers of TCM experimental research will be explored. In view of the current status and related bottlenecks of molecular biomarkers research on SAB TCM animal models， a single-cell multimodal omics research strategy will be proposed to break through the related evaluation defects of the "disease-syndrome-therapy" SAB and analyze the differences in various cell types， cell subpopulations， spatiotemporal trajectories， and gene expression in the mother-fetal interface tissue at the single-cell level. This will provide accurate guidance and model animal platform support for the in-depth study of disease-syndrome models， Zang-fu biology， and novel targeted drugs. It will also provide a basis for establishing a stable and repeatable "disease-syndrome-therapy" SAB animal model and evaluation indicator system， which is beneficial for the long-term development of TCM reproductive animal model research.

Values of sperm nucleoprotein transformation in predicting recurrent abortion / 临床检验杂志

Objective To investigate the values of nucleoprotein transformation in sperm for predicting recurrent abortion.Methods A total of 521 infertile couples with complete test indicators on fertility were selected from the reproductive medical clinic of our hospital from 2019 to 2022,among which the ages of the male were from 23 to 56 years old.The following factors causing recurrent abortion were excluded,including the age of woman,body mass index,metabolic disease,antiphospholipid syndrome,uterine and accessory abnormalities,history of caesarean section and intrauterine myoma/cervical conectomy,peripheral blood chromosome abnormalities of both the couple,and adverse life history,such as smoking/alcohol abuse.According to the abortion situation,they were divided into the recurrent abortion group(≥two spontaneous abortions),one spontaneous abortion group and no abortion group.Tukey's multiple comparison was performed to compare the differences of nucleoprotein transformation of sperm in each group by using GraphPad6.0 sta-tistical software.The Pearson method was used to analyze the correlation between nucleoprotein transformation and recurrent abortion.The predictive values of nucleoprotein transformation in recurrent abortion were analyzed by the parameters of sensitivity,specificity,positive predictive value,negative predictive value,Youden index and odd ratio.Results The percentages of abnormal nucleoprotein transformation in recurrent abortion group[(33.31±13.83)％]were significantly higher than those in non-abortion group[(26.85± 15.38)％]and the one abortion group[(28.20±12.50)％,P＜0.05].Pearson correlation analysis showed that there was a significant positive correlation between abnormal nucleoprotein transformation and recurrent abortion.The sensitivity and specificity of nucleoprote-in transformation for predicting recurrent abortion were 45.24％and 73.64％,respectively.All of the data of positive predictive value(15.70％),negative predictive value(92.53％),Youden index(18.88％)and odd ratio(2.31)of nucleoprotein transformation in predicting recurrent abortion were higher than those of high DNA stainability(10.64％,90.31％,1.05％and 1.11).Conclusion In the spouses of patients with recurrent abortion,the immaturity of sperm nuclear protein is significantly increased and significantly posi-tively correlated with recurrent abortion.The abnormal nucleoprotein transformation of sperm may be the important factor of recurrent a-bortion in males,and it has high predictive value for recurrent spontaneous abortion in clinical practice.

Correlation between Clinical Manifestations and Gut Microbiota of URSA Patients with the Syndrome of Liver Depression and Kidney Deficiency / 世界科学技术-中医药现代化

Objective Comparing the differences of gut microbiota between healthy women and URSA patients with the syndrome of liver depression and kidney deficiency,and the relationship between gut microbiota and age,abortion times,TCM syndrome score,and DASS-42 in URSA patients.Exploring the relationship between gut microbiota and clinical symptoms.Methods The observation group was 28 unpregnant URSA patients with the syndrome of liver depression and kidney deficiency,and the control group was 43 healthy unpregnant women.General data and stool samples were collected from two groups.Characterizing the composition of the fecal microbiota using bacterial 16S rRNA gene sequencing.The sequencing results were analyzed for diversity and species.TCM syndrome score and DASS-42 were collected from the URSA group,and the relationship between these scores and gut microbiota was analyzed.Results ①Beta diversity analysis shown that the gut microbiota of URSA patients with the syndrome of liver depression and kidney deficiency is different from that of healthy unpregnant women.②At the phylum level,Firmicutes were the most abundant in both groups.Compared with the normal group,the levels of Bacteroidetes and Proteobacteria in the URSA group were higher,and the levels of Actinobacteria were lower.At genus level,the dominant bacteria in URSA group are Faecalibacterium,Bacteroides,Megamonas,Bifidobacterium,Prevotella_9.③In the dominant bacteria of URSA group:Glucerabacter was positively correlated with age,Faecalibacterium was positively correlated with the number of abortions,Catenibacterium was negatively correlated with depression,anxiety,stress,DASS total score,Megasphaera was negatively correlated with depression,TCM syndrome score;In the dominant bacteria of normal group:Erysipelotrichaceae_UCG-003 was positively correlated with stress,the number of abortions,Bifidobacterium was negatively correlated with TCM syndrome score.Conclusion The gut microbiota composition was different between URSA patients with the syndrome of liver depression and kidney deficiency and healthy nonpregnant women,at the phylum and genus levels,the differences in gut microbiota between the two groups were observed,and the differential gut microbiota was associated with URSA patients′TCM syndrome score,suggesting that gut microbiota may be used as an indicator for the diagnosis and treatment of URSA with the syndrome of liver depression and kidney deficiency in the future,which is of clinical significance.

The Value of Micro-Vascular Flow Imaging in Evaluating the Difference of En-dometrial Micro-Flow Vascularization Index between Recurrent Spontaneous Abortion and Normal Reproductive Age Women / 实用妇产科杂志

Objective:To investigate the clinical value of micro-vascular flow(MV-flow)imaging in evaluating the difference of endometrial micro-flow vascularization index(ⅥMV)between recurrent spontaneous abortion and normal reproductive age women.Methods:From June 2022 to June 2023,87 patients with unexplained recurrent spontaneous abortion in West China Second University Hospital,Sichuan University were selected as the abortion group,including 51 patients with 2 miscarriages,26 patients with 3 miscarriages,and 10 patients with≥4 miscar-riages.In addition,90 normal women of childbearing age who did not have a history of miscarriage and visited our hospital during the same period were selected as the healthy group.Endometrial ⅥMV was measured by transvag-inal ultrasound using MV-flow imaging technology in mid-luteal phase of the two groups.The mean values of en-dometrial ⅥMV in 177 women was measured repeatedly within and between observers.The endometrial ⅥMVand clinical data were compared between the two groups.The differences of endometrial ⅥMV and clinical data in pa-tients with different miscarriage times in the abortion group were compared simultaneously.Results:There was no statistically significant difference in age,body mass index,follicle stimulating hormone and luteinizing hormone be-tween the healthy group and the abortion group(P＞0.05).The ⅥMV of endometrium in healthy group was higher than that in abortion group,and the difference was statistically significant(6.10％vs.3.70％,P＜0.05).In the abortion group,endometrial ⅥMV in patients with 2 miscarriages(5.30％)was higher than that in patients with 3(3.25％)miscarriages and≥ 4(3.30％)miscarriages,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in endometrial ⅥMV between patients with 3 miscarriages and ≥4 miscarriages(P＞0.05).The intraobserver and interobserver correlation coefficients of endometrial ⅥMV were 0.978 and 0.945,respectively.Conclusions:MV-flow imaging technology can effectively evaluate the difference of endometrial ⅥMV between recurrent spontaneous abortion and normal childbearing age women,and endometri-al ⅥMV may decrease with the increase of miscarriage frequency.

Knowledge, Attitude, and Practice of Brazilian Physicians about Immediate Postpartum and Postabortion Intrauterine Device Insertion / Conhecimento, atitude e prática de médicos brasileiros sobre inserção de dispositivo intrauterino no pós-parto e pós-aborto imediatos

Abstract Objective To assess the knowledge, attitude, and practice of Brazilian physicians about immediate postpartum and postabortion intrauterine device insertion. Methods Cross-sectional online survey involving physicians on duty in public Brazilian hospitals. Participants answered an anonymous questionnaire with close-ended questions to assess their knowledge, attitude, and experience on the immediate postpartum and postabortion insertion of copper intrauterine devices. Results One hundred twenty-seven physicians working in 23 hospitals in the 5 geographic regions of Brazil completed the questionnaire. Most were female (68.5%) and worked in teaching hospitals (95.3%). The mean (standard deviation) knowledge score (0-10 scale) was 5.3 (1.3); only 27.6% of the participants had overall scores ≥7.0. Most physicians (73.2%) would insert a postpartum intrauterine device in themselves/family members. About 42% of respondents stated that they had not received any training on postpartum or postabortion intrauterine device insertion. In the past 12 months, 19.7%, 22.8%, and 53.5% of respondents stated they had not inserted any intrauterine device during a cesarean section, immediately after a vaginal delivery, or after an abortion, respectively. Conclusion Most study participants have a positive attitude toward the insertion of intrauterine devices in the immediate postpartum period, but they have limited knowledge about the use of this contraceptive method. A large percentage of respondents did not have previous training on postpartum and postabortion intrauterine device insertion and had not performed any such insertions in the last 12 months. Strategies are needed to improve the knowledge, training, and experience of Brazilian physicians on immediate postpartum and postabortion intrauterine device insertion.

Resumo Objetivo Avaliar o conhecimento, atitude e prática de médicos brasileiros sobre a inserção de dispositivos intrauterinos no pós-parto e pós-aborto imediatos. Métodos Estudo transversal com inquérito online envolvendo médicos plantonistas de hospitais públicos brasileiros. Os participantes responderam a um questionário anônimo com perguntas fechadas para avaliar seu conhecimento, atitude e experiência sobre a inserção de dispositivos intrauterinos de cobre no pós-parto e pós-aborto imediatos. Resultados Cento e vinte sete médicos de 23 hospitais localizados nas 5 regiões do Brasil preencheram o questionário. A maioria era do sexo feminino (68,5%) e trabalhava em hospitais de ensino (95,3%). O escore médio (desvio padrão) de conhecimento (escala 0-10) foi 5,3 (1,3); apenas 27,6% tiveram escore ≥7,0. A maioria (73,2%) faria inserção de dispositivo intrauterino no pós-parto imediato em si mesma/familiares. Cerca de 42% dos participantes declararam não ter recebido nenhum treinamento sobre inserção de dispositivos intrauterinos no pós-parto ou pós-aborto imediatos. Nos últimos 12 meses, 19,7%, 22,8% e 53,5% declararam não ter inserido nenhum dispositivo intrauterino durante uma cesárea, após um parto vaginal ou um aborto, respectivamente. Conclusão A maioria dos participantes tem uma atitude positiva em relação à inserção de dispositivos intrauterinos no pós-parto imediato, porém tem um conhecimento limitado sobre esse método. Uma grande porcentagem dos respondentes não teve treinamento sobre inserção de dispositivos intrauterinos no pós-parto ou pós-aborto imediatos e não fez nenhuma inserção desse tipo nos últimos 12 meses. São necessárias estratégias para melhorar o conhecimento, o treinamento e a experiência dos médicos brasileiros sobre a inserção de dispositivos intrauterinos no pós-parto e pós-aborto imediatos.

Construction of meaning in pregnancy loss: qualitative study with brazilian couples / Construção de significados na perda gestacional: estudo qualitativo com casais brasileiros / Construcción de significados en la pérdida gestacional: estudio cualitativo con parejas brasileñas

We investigated the process of meaning construction in pregnancy loss in 11 Brazilian couples. The reports were submitted to inductive and deductive thematic analysis using the categorization system from the integrative model of meaning construction in grief. Regarding the original dimensions of the model (Sense-making of death, benefit from the experience of loss, and identity change), there was a lack of meaning for death, perception of strengthened bonds within the couple as a benefit, and parenting as an identity project. We propose an additional dimension (Meaning-making process) that includes gender differences, lack of social recognition, and emotional intensity of the experience. As for coping strategies, spirituality and the search for peers were identified, especially in social media. After a pregnancy loss, the process of meaning construction proved similar to that of other types of loss, validating this experience. We discuss the implications of the category system used in this study. (AU)

Investigou-se o processo de construção de significados na perda gestacional em 11 casais brasileiros. Os relatos foram submetidos à análise temática indutiva e dedutiva, utilizando o sistema de categorização do modelo integrativo de construção de significado no luto. Em relação às dimensões originais do modelo (Sentido para a morte, benefício na experiência de perda e modificação da identidade), constatou-se falta de sentido para a morte, fortalecimento de vínculo do casal como benefício e parentalidade enquanto projeto identitário. Foi proposta uma dimensão adicional (Processo de construir significado) que incluiu diferenças de gênero, falta de reconhecimento social e intensidade emocional da experiência. Enquanto estratégias de enfrentamento, identificou-se espiritualidade e busca por iguais, especialmente nas mídias sociais. O processo de construir significados na perda gestacional mostrou-se semelhante ao de outros tipos de perdas, validando esta experiência. Foram discutidas as implicações do sistema de categorias utilizado. (AU)

Se investigó el proceso de construcción de significados en la pérdida gestacional en 11 parejas brasileñas. Los informes fueron sometidos a un análisis temático inductivo y deductivo, usando el sistema de categorización del modelo integrador de construcción de significado en el duelo. En cuanto a las dimensiones originales del modelo (Significado para la muerte, beneficio en la experiencia de pérdida, cambio de identidad), se encontró falta de significado para la muerte, fortificación de lazos de la pareja como un beneficio y la parentalidad como un proyecto de identidad. Se ha propuesto una dimensión adicional (Proceso de construcción de significado) que incluye diferencias de género, falta de reconocimiento social e intensidad emocional de la experiencia. Como estrategias de afrontamiento, se identificó la espiritualidad y la búsqueda de los iguales, especialmente en las redes sociales. El proceso de construir significado en la pérdida gestacional demostró ser similar al de los otros tipos de pérdida, validando esta experiencia. Son discutidas las implicaciones del sistema de categorías utilizado. (AU)