Applicability of Seven Glomerular Filtration Rate Evaluation Formulas in Dose Adjustment of High Concentration of Methotrexate Chemotherapy in Children with ALL / 中国实验血液学杂志

OBJECTIVE@#To investigate the diagnostic efficacy of seven glomerular filtration rate (GFR) evaluation formulas Schwartz2009, Schwartz1976, Counahan-Barratt, Filler, CKD-EPIscysc, Cockrofi-Gault, CKD-EPIScysC-Scr in high concentration of methotrexate (HDMTX) chemotherapy dose adjusted cut-off point (GFR ≤85 ml/min) in children with acute lymphoblastic leukemia (ALL).@*METHODS@#One hundred and twenty-four children with ALL were included in the study. GFR determined by renal dynamic imaging (sGFR) was used as the standard to evaluate the accuracy, consistency of eGFR calculated by seven formulas and sGFR, and the diagnostic efficacy of each formula when the sGFR ≤85 ml/min boundary.@*RESULTS@#All of the accuracy of eGFR estimated by Schwartz2009 were greater than 70% in the 0-3, >4 and ≤6, >6 and ≤9, >9 and ≤16 years old group and male group, and the consistency exceeded the professional threshold. When the sensitivity of the ROC curve sGFR ≤85 ml/min was 100% of CKD-EPIscysc in the 0-3, >3 and ≤4 years old group, Filler in the >3 and ≤4 years old group, and Cockrofi-Gault in the >6 and ≤9 years old group, the specificity was 73.02%, 78.95%, 78.95%, 69.32%, respectively, and the AUC under the ROC curve was the largest (P<0.05).@*CONCLUSION@#Schwartz2009 formula predicts the highest accuracy of eGFR in the 7 glomerular filtration rate. CKD-EPIscysc, Filler, and Cockrofi-Gault formulas have more guiding signi-ficance for the adjustment of HDMTX chemotherapy in pre-adolescence in children with ALL when sGFR ≤85 ml/min.

Effects of acteoside on hypoxia/reoxygenation-induced cardiomyocyte damage by regulating the Rnd 3/NF-κB pathway / 中国药房

OBJECTIVE To explore the effects of acteoside on hypoxia/reoxygena tion（H/R）-induced cardiomyocyte damage by regulating Rho family GTPase 3（Rnd3）/nuclear factor κB（NF-κB）pathway. METHODS The H 9c2 cardiomyocyte were divided into control group （no administration ，no modeling ），H/R group （only modeling ），H/R+AS-L group ，H/R+AS-M group ， H/R+AS-H group （10，30，90 μmol/L acteoside for above 3 groups firstly ，and then modeling ），H/R+pcDNA group [transfecting pcDNA （empty vector ） firstly，and then modeling] ，H/R + pcDNA-Rnd 3 group [overexpression of Rnd 3 by transfecting pcDNA-Rnd3（Rnd3 overexpression vector ）firstly，and then modeling] ，H/R+AS-H+si-NC group [transfecting si-NC （negative control）firstly，and then giving 90 μmol/L acteoside and modeling]，H/R+AS-H+si-Rnd3 group [inhibiting overexpression of Rnd 3 by transfecting si-Rnd 3 （Rnd3 small interfering RNA ） firstly，and then giving 90 μ mol/L acteoside and modeling]. After corresponding treatment ，the apoptotic rate ，release of lactate dehydrogenase （LDH），malondialdehyde（MDA）level，the activity of superoxide dismutase （SOD），the level of tumor necrosis factor α（TNF-α），interleukin 1β（IL-1β）and interleukin- 6（IL-6）， mRNA and protein expression of Rnd 3 and NF-κB subunit p65（NF-κB p65），the expression of aspartate proteolytic enzyme 3 （Cleaved Caspase- 3）protein and Cleaved Caspase- 9 protein were detected. RESULTS Different concentrations of acteoside could reduce the apoptotic rate of H/R-induced H 9c2 cardiomyocyte，the protein expressions of Cleaved Caspase- 3 and Cleaved Caspase-9，mRNA and protein expressions of NF-κB p65，the levels of LDH release and MDA ，TNF-α，IL-1β and IL-6，while increase the activity of SOD and mRNA and protein expressions of Rnd 3（P＜0.05），in a dose-dependent manner. Overexpression of Rnd 3 could decrease the apoptotic rate of H 9c2 cardiomyocyte，protein expressions of NF-κB p65，Cleaved Caspase- 3 and Cleaved Caspase- 9， the levels of LDH release ， MDA， TNF-α，IL-1β and IL-6，while increase the protein expression of Rnd 3 and the activity of SOD （P＜0.05）. The inhibition overexpression of Rnd 3 could weaken the inhibitory effects of acteoside on H/R-induced apoptosis of H 9c2 cardiomyocyte， oxidative stress and inflammatory reaction （P＜0.05）. CONCLUSIONS Acteoside could regulate Rnd 3/NF-κ B pathway by promoting the expression of Rnd 3 and inhibiting the expression of NF-κB p65，inhibit cardiomyocyte apoptosis ，oxidative stress and inflammation reaction so as to relieve the H/R-induced cardiomyocyte damage.

Biofluid Biomarkers of Alzheimer's Disease: Progress, Problems, and Perspectives / 神经科学通报·英文版

Since the establishment of the biomarker-based A-T-N (Amyloid/Tau/Neurodegeneration) framework in Alzheimer's disease (AD), the diagnosis of AD has become more precise, and cerebrospinal fluid tests and positron emission tomography examinations based on this framework have become widely accepted. However, the A-T-N framework does not encompass the whole spectrum of AD pathologies, and problems with invasiveness and high cost limit the application of the above diagnostic methods aimed at the central nervous system. Therefore, we suggest the addition of an "X" to the A-T-N framework and a focus on peripheral biomarkers in the diagnosis of AD. In this review, we retrospectively describe the recent progress in biomarkers based on the A-T-N-X framework, analyze the problems, and present our perspectives on the diagnosis of AD.

Identification of microRNAs targeting vitamin D receptor and their effect on parathyroid hormone secretion in secondary hyperparathyroidism / 南方医科大学学报

OBJECTIVE@#To identify the miRNAs targeting vitamin D receptor (VDR) gene and their effect on parathyroid hormone (PTH) secretion in secondary hyperparathyroidism.@*METHODS@#Primary parathyroid cells with secondary hyperparathyroidism were isolated by collagenase digestion and cultured. The miRNAs targeting VDR were screened by bioinformatics methods and full transcriptome sequencing, and dual-luciferase reporter assay was used to verify the targeting relationship between VDR and the screened miRNA. The effects of overexpression or inhibition of the candidate miRNA on VDR mRNA and protein expressions and PTH secretion were evaluated using qRT-PCR and Western blotting. The expression levels of the candidate miRNAs and VDR mRNA in clinical specimens of parathyroid tissues were verified by qRT-PCR, and the expression of VDR protein was detected by immunohistochemistry.@*RESULTS@#We successfully isolated primary parathyroid cells. Dual-luciferase reporter assay verified the targeting relationship of hsa-miR-149-5p, hsa-miR-221-5p, hsa-miR-222-3p, hsa-miR-29a-5p, hsa-miR-301a-5p, hsa-miR-873-5p, hsa-miR-93-3p with VDR, and among them, the overexpression of hsa-miR-149-5p and hsa-miR-301a-5p significantly increased PTH secretion in the parathyroid cells. In patients with secondary hyperparathyroidism, hsa-miR-149-5p was highly expressed in the parathyroid tissues (P=0.046), where the expressions of VDR mRNA (P=0.0267) and protein were both decreased.@*CONCLUSION@#The two miRNAs, hsa-miR-149-5p and hsa-miR-301a-5p, may promote the secretion of PTH in patients with secondary hyperparathyroidism by down-regulating the expression of VDR gene.

Cultivation and characterization of primary human parathyroid cells from patients with severe secondary hyperparathyroidism / 南方医科大学学报

OBJECTIVE@#To establish an cell model of hyperparathyroidism by isolation, in vitro culture, and identification of parathyroid cells from patients with secondary hyperparathyroidism (SHPT).@*METHODS@#The parathyroid gland tissues obtained from 10 patients with SHPT were dissociated by collagenase digestion for primary culture of the parathyroid cells. Morphological changes and growth characteristics of the cells were assessed by microscopic imaging and cell counting. The mRNA and protein expression levels of parathyroid hormone (PTH), calcium-sensing receptor (CaSR), and glial cells missing 2 (GCM2) in the primary and passaged cells were determined by immunofluorescence, qRT-PCR, and Western blotting.@*RESULTS@#Primary cultures of parathyroid cells were successfully obtained. The cells exhibited a high expression of PTH shown by immunofluorescence assay and had a population doubling time of approximately 71.61 h. PTH secretion in the second-passage (P2) cells was significantly lower than that in the primary (P0) and first-passage (P1) cells (P < 0.001). Despite a significant downregulation of CaSR mRNA (P=0.017) and protein (P=0.006) in P1 cells as compared with P0 cells, no significant differences were found in mRNA and protein expressions of PTH or GCM2 between the two cell generations.@*CONCLUSION@#Primary cultures of parathyroid cells isolated from SHPT patients by collagenase digestion show similar biological properties to the cells in vivo.

Clinical observation on wound measurement grid and perforator flap design / 中华显微外科杂志

Objective:To investigate the application of self-designed wound measuring grid in the measurement of wound and the design of perforator flap.Methods:From February 2018 to February 2020, 31 cases of soft tissue defects of limbs were repaired by free transfer of perforator flap. During the operation, the self-designed membrane with measurement grid was used to measure the wound surface. The flaps were designed and harvested according to the accurate measurement of the wound. The flaps were reviewed at hospital clinic during follow-up.Results:All patients entered 3-15 months of follow-up with an average of 8 months. All 31 flaps survived, of which 2 flaps encountered vascular crisis and were rescued after surgical exploration. There was no infection of flaps and all flaps had stage I healing. The flaps were satisfactory in appearance with the sensation recovery to S 2 in 21 cases and S 3 in 10 cases. Only linear scars were left on the donor sites. Conclusion:The membrane with a measurement grid can accurately measure a wound, and help the design of the flap according to the measured size and profile of the wound. It can reduce the operation time and the risk as well as to improve the operation efficiency. The clinical application is satisfactory. Large scale and multi-centre studies are required to further prove the benefit of the measurement grid.

Establishment and clinical evaluation of dry fluorescent luminescencemethod for detection of antibodies to hepatitis C virus / 中国输血杂志

【Objective】 To establish a dry fluorescent luminescence method for the detection of antibodies to hepatitis C virus (HCV) and evaluate its clinical application. 【Methods】 Anti-HCV antibody was detected by double-antigen sandwich dry fluorescent luminescence method established using multi-epitope chimeric antigen. The established method was used to detect national reference samples(positive 20, negative 20), and a total of 349 clinical samples, including 108 HCV patients, 36 patients with other diseases and 205 healthy individuals, which were tested in parallel with enzyme-linked immunoassay (ELISA) to evaluate the performance of the established method. 【Results】 The concordance rate of positive and negative(each 20) reference samples were both 100% (20/20), and the CV of precision reference sample was 9.16%, which met the requirements of national reference samples. In clinical performance evaluation, the AUC value was 0.984, and the sensitivity and specificity of the dry fluorescent luminescence method were 96.30% (104/108) and 96.27% (233/241). The overall concordance rate between dry fluorescent luminescence method and ELISA was 97.71% (341/349) (Kappa=0.952). 【Conclusion】 The dry fluorescence luminescence method of HCV antibody is simple and rapid, with high sensitivity and high specificity, and can be used in clinical application.

Advances in the application of retinal angiography in cerebral small vessel disease / 中华神经科杂志

With the aging of population, cerebral small vessel disease has attracted more and more attention. A growing body of literature has confirmed that retinal vascular changes can be used as a potential marker for the prediction of cerebral small vessel disease. The retina is recognized as a window into cerebrovascular and systemic vascular conditions. Combining traditional fundus photograph and fundus fluorescein angiography with optical coherence tomography angiography, the retinal vascular system of patients with cerebral small vessel disease can be comprehensively analyzed. This paper summarizes and analyzes the application of retinal angiography technology in different image types of cerebral small vessel disease and makes a review, in order to provide reference for the early diagnosis and prevention of cerebral small vessel disease.

The correlation between renal function and the total cerebral small vessel disease score in elderly patients with a mild stroke / 中华老年医学杂志

Objective:To investigate the relationship between renal function and the total cerebral small vessel disease(CSVD)score in elderly patients with a mild stroke.Methods:Patients with a mild stroke(National Institutes of Health Stroke Scale score≤3)and aged 60 years and above hospitalized in our hospital from March to December 2019 were consecutively enrolled.Total CSVD scores were evaluated based on enlarged perivascular spaces, cerebral microbleeds, white matter hyperintensities of presumed vascular origin and lacunes of presumed vascular origin.The estimated glomerular filtration rate(eGFR)was derived by using the formula of chronic kidney disease epidemiology collaboration based on serum creatinine(CKD-EPI Scr). The relationship between eGFR and the total CSVD score was analyzed. Results:Of the 152 patients enrolled, 35, 38, 39, 28 and 12 had total CSVD scores of 0, 1, 2, 3 and 4, respectively.The age of patients increased and eGFR decreased with the increase of total CSVD scores(CSVD from 0 to 4, [(67.43±6.59), (68.42±6.83), (72.18±7.94), (76.46±7.75) vs.(79.92±6.17)years old, F=12.018, P<0.001]; [(92.94±12.45)ml·min -1·1.73m -2, (90.52±8.62)ml·min -1·1.73m -2, (89.45±8.48)ml·min -1·1.73m -2 and(83.90±7.19)ml·min -1·1.73m -2vs.(79.16±7.77)ml·min -1·1.73m -2, F=7.210, P<0.001]. Spearman correlation analysis showed that eGFR was negatively correlated with the total CSVD score( r=-0.399, P<0.001). After adjusting for risk factors including age, gender and hypertension, multivariate ordinary regression analysis showed that decreased eGFR was an independent risk factor for the total CSVD score( OR=0.957, 95% CI: 0.924-0.990, P=0.012). Conclusions:In elderly patients with a mild stroke, eGFR is an independent risk factor for the total CSVD score, which shows an increased burden as eGFR decreases.

Retrospective investigation and analysis of off-label drug use for tic disorder in a tertiary women’s and children’s hospital / 药学实践杂志

Objective To analyze the current situation of off-label drug use for tic disorder in a tertiary maternity and child hospital, so as to promote clinical safe and rational drug use. Methods Through the hospital information system, the pediatric outpatient prescriptions diagnosed with tic disorder from July 2019 to August 2020 were selected, and the prescriptions of off-label use was evaluated according to the 2020 off-label drug management regulations. Results A total 1251 pediatric prescriptions diagnosed with tic disorder were collected. The incidence of off-label drug use was 29.58%. The main types of off-label were over-indications and over-age. The main varieties of off-label drug use were risperidone tablets (47.84%) and aripiprazole tablets (43.74%). Conclusion The off-label use of drug for tic disorder in pediatric outpatient department of our hospital is relatively common，and it is necessary to standardize the management of off-label drug use to ensure rational drug use.

Study on job satisfaction of human organ donation coordinators in Fujian province during the normalization period of epidemic prevention and control / 器官移植

Objective To analyze the status of job satisfaction of human organ donation coordinators in Fujian province during the normalization period of novel coronavirus pneumonia (COVID-19) epidemic prevention and control and put forward corresponding suggestions. Methods The job satisfaction of human organ donation coordinators in Fujian province was investigated by online questionnaires. The correlation analysis of all dimensions of the overall job satisfaction of human organ donation coordinators was carried out, and the influencing factors of the overall job satisfaction were analyzed. Results The overall job satisfaction of human organ donation coordinators was (2.9±0.8), which was a relatively low score. The job promotion satisfaction was (4.7±1.3), (2.0±1.4) for the job pay and benefits satisfaction, and (2.0±1.3) for the job communication satisfaction. The job pay and benefits satisfaction was positively correlated with job communication satisfaction (r=0.653, P < 0.05). Multiple factors differed in job satisFfaction. The overall job satisfaction of human organ donation coordinators was associated with gender, nature of job, working years, average monthly income, age, educational background and nature of post. Conclusions The job satisfaction of human organ donation coordinators is relatively low in Fujian province during the normalization period of COVID-19 epidemic prevention and control. Flexible and diverse methods should be employed from the government and hospital levels to further improve security policies for human organ donation coordinators.

The assay of monohydroxy carbamazepine, the active metabolite of oxcarbazepine, in human plasma by HPLC / 药学实践杂志

Objective To establish an assay method for monohydroxy carbamazepine, the active metabolite of oxcarbazepine, in human plasma. Methods Ornidazole was used as the internal standard. Plasma samples were processed with methanol and analyzed by HPLC. The column was ZORBAX Eclipse XDB-C18(150 mm×4.6 mm, 5 μm) with the mobile phase of water-acetonitrile (80∶20, V/V) at a flow rate of 1.0 ml/min. Dual wavelength detection is applied. The detection wavelength of monohydroxy carbamazepine was set at 192 nm and ornidazole at 318 nm. Results There was an excellent liner relationship for monohydroxy carbamazepine from 2 to 50 μg/ml(r= 0.998 6). The limit of quantification was 2 μg/ml with the range of accuracy between 95.57% and 100.59%. The RSD of intra-day and inter-day precisions were less than 15%. The average extraction recovery rate of MHC and internal standard were in the range of 89.62% to 98.76%. The RSD of stability was less than 6%. Conclusion This method is specific, sensitive, and easy to operate. It is suitable for the clinical assay of monohydroxy carbamazepine in human plasma.

Case study of pharmaceutical care provided by clinical pharmacists for the department of neurology / 药学实践杂志

Objective To provide reference for clinical pharmacists to participate in rational drug use through case study. Methods Clinical pharmacists participated in the optimization of treatment plan and performed pharmaceutical care for the patients according to their own characteristics, drug interactions, compatibility contraindications and adverse drug reactions. Results Clinical pharmacists provided pharmaceutical care for the patients with cerebrovascular diseases, Parkinson's disease, encephalitis and other diseases in the Department of Neurology by using pharmaceutical expertise, retrieved evidence-based support from literature and participating in the formulation of treatment plans. Those achieved individualized drug treatment, improve patient compliance, reduced the occurrence of unreasonable usage and dosage, inappropriate drug combination and improper drug selection, the treatment of adverse drug reactions, drug safety, and rational drug use. Conclusion Clinical pharmacists need to use their sound professional ability and good communication skills to help doctors make individualized drug delivery plans to ensure the safety, effectiveness and economy of drug treatment.

Altered integrity of hepatocyte tight junctions in rats with triptolide-induced cholestasis / 中国天然药物

Triptolide (TP), an active component of Tripterygium wilfordiiHook. f. (TWHF), has been widely used for centuries as a traditional Chinese medicine. However, the clinical application of TP has been restricted due to multitarget toxicity, such as hepatotoxicity. In this study, 28 days of oral TP administration (100, 200, or 400 μg·kg

Effect of acupuncture on vascular endothelial function in patients of polycystic ovary syndrome with different glucose tolerance status / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture on vascular endothelial function in patients of polycystic ovary syndrome (PCOS) with impaired glucose tolerance (IGT) and normal glucose tolerance (NGT).@*METHODS@#A total of 140 patients with PCOS were divided into an IGT group (70 cases, 11 dropped off) and a NGT group (70 cases, 9 cases dropped off). The patients in the two groups were treated with full-cycle acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Tianshu (ST 25), etc. once every other day, 3 times a week, for 3 months. Before and after treatment, TCM symptom score, insulin resistance index [including fasting plasma glucose (FPG), 2-hour blood glucose (2hPG), fasting serum insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR)] and vascular endothelial related factors [including asymmetric dimethylarginine (ADMD), endothelin-1 (ET-1), malondialdehyde (MDA), nitric oxide (NO)] were compared between the two groups; in addition, the obese subgroup and non-obese subgroup of the two groups were further compared.@*RESULTS@#Compared before treatment, the TCM symptom scores, ADMD, ET-1 and MDA after treatment were decreased (@*CONCLUSION@#Acupuncture could improve vascular endothelial function in PCOS patients, IGT patients have better efficacy than NGT patients, and obese patients have better efficacy than non-obese patients.

Effect of bloodletting at tip of ear with different amounts on pain in patients with early-stage stye: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the curative effect between bloodletting at tip of ear with different amounts combined with western medication and western medication alone for early-stage stye.@*METHODS@#A total of 108 patients with early-stage stye were randomly divided into a 50 μL group (36 cases, 4 cases dropped off), a 100 μL group (36 cases, 2 cases dropped off) and a western medication group (36 cases, 5 cases dropped off). The patients in the western medication group were treated with levofloxacin eye drops and levofloxacin hydrochloride eye gel. Based on the treatment of the western medication group, the patients in the 50 μL group were treated with 50 μL bloodletting (about 3 drops) at tip of ear while the patients in the 100 μL group were treated with 100 μL bloodletting (about 6 drops) at tip of ear; the bloodletting was given once a day for 3 days. After treatment, the changes of visual analogue scale (VAS) and clinical effect were observed, and the patients were followed up by telephone on the 8th day.@*RESULTS@#After treatment, the VAS score in each group was reduced (0.05). One week after the onset of the disease, all the patients in the 50 μL group and 100 μL group were cured, and one patient in the western medication group was not cured, and treated with routine surgery.@*CONCLUSION@#Based on the conventional western medication treatment, bloodletting at tip of ear can significantly reduce the pain of stye, and the effect of 100 μL bleeding is better than 50 μL.

Effect of transjugular intrahepatic portosystemic shunt on the liver and the heart / 临床肝胆病杂志

Transjugular intrahepatic portosystemic shunt (TIPS) is a minimally invasive technique for the treatment of portal hypertension in liver cirrhosis. With the gradual maturity of TIPS technique and the continuous improvement of stent materials, the indications for TIPS are gradually expanded, the incidence rate of complications gradually decreases, and the treatment outcome is getting better and better. The impact of TIPS on the main organs of patients has attracted more and more attention in recent years, and this article reviews the effect of TIPS on the liver and the heart.

Analysis of adverse reactions in 312 cases of gemcitabine / 药学实践杂志

Objective Based on the data of gemcitabine adverse reactions (ADR), the characteristics and patterns of ADR occurrence were analyzed. The guidance for the rational clinical use of gemcitabine was provided. Methods From our information system, the patients treated by gemcitabine chemotherapy from September 2008 to September 2018 were selected and their related ADRs were summarized and statistically analyzed by using SPSS 18.0. Results Among the 750 cases, there were 312 ADRs related to gemcitabine treatment, of which the incidence of ADR was higher in female patients than in male patients (48.68% vs 36.77%) and the highest incidence in the age group of 50-69 years (44.14%). The patients with lower status (KPS) scores were more sensitive to chemotherapeutic drugs, and more likely to develop ADR. During the combination therapy, gemcitabine+paclitaxel chemotherapy had the highest incidence of ADR (61.54%) and the highest incidence of ADR in thymic carcinoma (62.50%), followed by hematological and reproductive system tumors (58.62% and 57.14%, respectively); ADR involvement in organs/systems is mainly caused by hematological toxicity. The bone marrow suppression is common, followed by digestive system damage. The major clinical symptoms were nausea and vomit. Conclusion Gemcitabine-related ADR has a large individualized difference and is affected by many factors. Chemotherapy should be used according to individual conditions to improve clinical safety and rational use of drugs.

The effect of sunshine on blood level of Vitamin D and microalbuminuria in early stage diabetic nephropathy patients / 上海预防医学

Objective To evaluate the effect of increasing sunshine time or 1, 25(OH)2D3 supplement on improving Vitamin D blood level and reduction of microalbuminuria in early stage diabetic nephropathy (DN) patients. Methods A total of 150 early stage type 2 DN patients with serum 25(OH)D3 lower than 15 mg/L were included.The patients were divided into sunshine group (n=50), 1, 25(OH)2D3 supplement group (n=50), and control group (n=50).After three-month treatment, serum 25(OH)D3 level and urinary albumin to creatinine ratio(ACR)were compared among these three groups. Results Before treatment, there were no differences in serum 25(OH)D3, ACR, HbA1c among the three groups.After three-month treatment, serum 25(OH)D3 level was significantly improved in sunshine group, and ACR was reduced significantly in both sunshine group and 1, 25(OH)2D3 group. Conclusion Increasing sunshine time can improve Vitamin D level and reduce microalbuminuria in early stage diabetic nephropathy patients.

Effect of combined treatment with acupuncture, moxibustion and medication on endometrial receptivity and expression of serum HOXA10 in polycystic ovary syndrome of kidney deficiency and blood stagnation / 中国针灸

OBJECTIVE@#To compare the clinical effect of the combined treatment of acupuncture, moxibustion, Chinese herbal medicine and western medication and simple western medication on polycystic ovary syndrome (PCOS) of kidney deficiency and blood stagnation pattern and explore the effect on endometrial receptivity and the expression of serum homeobox gene A10 (HOXA10).@*METHODS@#A total of 60 patients with PCOS of kidney deficiency and blood stagnation pattern were randomized into a combined treatment group and a western medication group, 30 cases in each one. In the western medication group, on the fifth day of menstruation, clomiphene citrate tablets were taken orally, 50 mg each time, once daily, consecutively for 5 days. On the day when the follicle diameter was ≥ 18 mm, chorionic gonadotrophin for muscular injection, a dose of 10 000 U was given. Before sleep, the aspirin enteric-coated tablets were taken orally, 50 mg (except during menstruation). In the combined treatment group, on the base of the treatment as the western medication group, acupuncture and moxibustion were adopted and the Chinese herbal for tonifying the kidney and activating blood circulation was taken orally. The acupoints were Guanyuan (CV 4), Qihai (CV 6), Zusanli (ST 36), Sanyinjiao (SP 6), Zigong (EX-CA 1), etc. Acupuncture was remained for 30 min each time, once every two days and discontinued during menstruation. Chinese herbal was given from the 3rd day of menstruation till the onset of the next menstruation, one dose each day. After consecutive treatment for 3 menstrual cycles in the two groups, the real-time polymerase chain reaction (RT-PCR) method was adopted to determine the expression of serum HOXA10 before and after treatment in the patients of the two groups. The endometrial thickness at ovulatory phase, uterine arterial flow 7 days after ovulation [including uterine arterial pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV)/end diastolic velocity (EDV), meaning S/D], pregnancy rate and the score of Chinese medicine symptoms before and after treatment were compared in the patients between the two groups.@*RESULTS@#① After treatment, the expression of serum HOXA10 was higher than that before treatment in the patients of the two groups (@*CONCLUSION@#The combined treatment with acupuncture, moxibustion and medication effectively improves endometrial receptivity and uterine arterial flow in the patients with PCOS of kidney deficiency and blood stagnation pattern and increases pregnancy rate. The therapeutic effect is better than the simple western medication and its mechanism is probably related to the regulation of serum HOXA10 expression.