Changes in Rehmanniae Radix processing and their impact on ovarian hypofunction: potential mechanisms of action.

Objective: This study evaluates the research developments concerning Rehmanniae Radix in ovarian hypofunction diseases. It explores the processing methods of Rehmanniae Radix, the variations in its compounds before and after processing, the mechanism of Rehmanniae Radix and its active compounds in improving ovarian function, and the advancements in clinical applications of traditional Chinese medicine (TCM) compound that include Rehmanniae Radix. Methods: Comprehensive literature search was conducted using databases such as China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, National Science and Technology Library, the Pharmacopoeia of the People's Republic of China, Pubmed, and the Web of Science Database. The search utilized the following Medical Subject Headings (MeSH) and keywords: "Rehmanniae Radix," "Drying Rehmannia Root," "Rehmannia glutinosa," "Rehmanniae Radix Praeparata," "Traditional Chinese Medicine Processing," "Pharmacological Effects," "Ovarian Aging," "Diminished ovarian reserve," "Premature ovarian insufficiency," "Premature Ovarian Failure," "Ovarian hypofunction diseases". Results: The ancient Chinese medical books document various processing techniques for Rehmanniae Radix. Contemporary research has identified changes in its compounds processing and the resultant diverse therapeutic effects. When processed into Rehmanniae Radix Praeparata, it is noted for its ability to invigorate the kidney. TCM compound containing Rehmanniae Radix is frequently used to treat ovarian hypofunction diseases, demonstrating significant clinical effectiveness. The key changes in its compounds processing include cyclic dilute ether terpene glycosides, phenylethanol glycosides, sugars, and 5-hydroxymethylfurfural. Its pharmacological action is primarily linked to the improvement of granulosa cell proliferation, antioxidative and anti-aging properties, and modulation of the immune and inflammatory microenvironment. Furthermore, Rehmanniae Radix also offers therapeutic benefits for cardiovascular and cerebrovascular diseases, osteoporosis and cognitive dysfunction caused by low estrogen levels. Thereby Rehmanniae Radix mitigates both the short-term and long-term health risks associated with ovarian hypofunction diseases. Conclusion: Processed Rehmanniae Radix has shown potential to improve ovarian function, and its compound prescriptions have a definite effect on ovarian dysfunction diseases. Therefore Rehmanniae Radix was garnering interest for both basic and clinical research, with promising application prospects as a future therapeutic agent for ovarian hypofunction diseases. However, further studies on its toxicology and the design of standardized clinical trials are necessary to fully establish its efficacy and safety.

Exosomes: potential diagnostic markers and drug carriers for adenomyosis.

Adenomyosis is a common benign gynecological disorder and an important factor leading to infertility in fertile women. Adenomyosis can cause deep lesions and is persistent and refractory in nature due to its tumor-like biological characteristics, such as the ability to implant, adhere, and invade. The pathogenesis of adenomyosis is currently unclear. Therefore, new therapeutic approaches are urgently required. Exosomes are nanoscale vesicles secreted by cells that carry proteins, genetic materials and other biologically active components. Exosomes play an important role in maintaining tissue homeostasis and regulating immune responses and metabolism. A growing body of work has shown that exosomes and their contents are key to the development and progression of adenomyosis. This review discusses the current research progress, future prospects and challenges in this emerging therapeutic tool by providing an overview of the changes in the adenomyosis uterine microenvironment and the biogenesis and functions of exosomes, with particular emphasis on the role of exosomes and their contents in the regulation of cell migration, proliferation, fibrosis formation, neovascularization, and inflammatory responses in adenomyosis.

Chinese patent medicines combined with hormone replacement therapy for premature ovarian failure: A Bayesian network meta-analysis.

Objective: The objective of this study was to compare the efficacy differences between Chinese patent medicines combined with hormone replacement therapy (HRT) in the treatment of premature ovarian failure (POF) by the Bayesian network meta-analysis (NMA) method. Methods: Randomized controlled trials (RCTs) reporting Chinese patent medicine combined with HRT for POF included Medline (via PubMed), Embase, Cochrane Library, China National Knowledge Infrastructure Database (CNKI), Wanfang Database (Wanfang), VIP Database (VIP), and China Biology Medicine Database (CBM) from the inception of the databases to July 2022. Two researchers independently screened the articles, extracted data, and evaluated the quality. The literature that met the inclusion criteria was screened out, the quality and risk of bias of the included studies were assessed according to the Cochrane 5.1 manual and RevMan 5.4, and NMA was performed using Stata 15.0 and R software. Results: Sixty-four RCTs involving 5,675 individuals containing 12 oral Chinese patent medicines combined with HRT were enrolled into the current NMA. The results showed that when compared with patients using only HRT, the total clinical response rate is greater in patients using HRT combined with one of these 12 oral Chinese patent medicines. Among them, Zuogui pills + HRT [odds ratio (OR) = 3.92; 95% credible interval (CrI) = 0.86, 23.84; SUCRA = 73.76%] is most likely to be the best intervention, and the suboptimal intervention is Guishen pills + HRT (OR = 3.22, 95% CrI = 1.16, 9.44, SUCRA = 70.60%). Conclusion: Chinese patent medicines combined with HRT were more effective than HRT alone in the treatment of POF. Zuogui pills are good at decreasing follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and more effective in the improvement of total clinical response rate; Xuefu Zhuyu capsule is also good at decreasing FSH. Ziheche capsule is an expert in improving estradiol level; Kuntai capsule shows the lowest incidence of adverse reactions. However, the quality of the literature included in this study is relatively low, so it may affect the results of the study. Therefore, higher quality and multi-center trial would be necessary for supporting these results. Systematic review registration: [www.crd.york.ac.uk/prospero], identifier [CRD42022350587].

U-shaped association between serum free triiodothyronine and recurrence of atrial fibrillation after catheter ablation.

PURPOSE: Thyroid dysfunction affects the outcomes of atrial fibrillation (AF) catheter ablation. However, it remains unclear if the variations in thyroid function, especially in the triiodothyronine levels, are associated with AF recurrence in euthyroid subjects. This study investigated the associations of thyroid hormone levels with arrhythmia recurrence after AF catheter ablation in euthyroid patients. METHODS: A total of 1115 consecutive AF patients who underwent catheter ablation were prospectively enrolled and had their thyroid function measured prior to the procedure. The serum free triiodothyronine (FT3), free tetraiodothyronine (FT4), and thyroid-stimulating hormone (TSH) levels were assessed as predictors of recurrence and were adjusted for potential confounders. The subjects were divided into five quintile groups according to the FT3, FT4, and TSH levels, respectively. RESULTS: After a median follow-up of 723 days (interquartile range, 180-1070), 47.2% of patients experienced recurrence. After multivariate adjustment, subject in the lowest and highest FT3 quintiles showed increased risk of recurrence (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.26-2.03, P < 0.01, and HR 1.47, 95% CI 1.16-1.87, P < 0.01, respectively), compared to the median quintile of FT3 levels. Regarding the FT4 level, the highest quintile group showed a higher risk of recurrence (HR 1.27, 95% CI 1.01-1.60, P = 0.04). The TSH levels were not associated with AF recurrence. CONCLUSIONS: Both high and low FT3 levels were associated with AF recurrence after catheter ablation. High-normal FT4 levels were also related to AF recurrence; however, no association was found between normal TSH levels and AF recurrence.

Differential Proteomics Analysis of Endometriosis in Blood Stasis Syndrome.

OBJECTIVE: To investigate the innate characters of 3 endometriosis (EMT) syndromes, blood stasis (BS), qi stagnation and blood stasis (QSBS) as well as Shen (Kidney) deficiency and blood stasis (KDBS) in terms of proteomics, lay a molecular biological basis for the differentiation of various blood stasis syndromes of EMT, establish a EMT microscopic syndrome differentiation and diagnosis system in terms of proteomics, discover the evolution principles and therapeutic targets of these EMT syndromes, and search their signifificant molecular markers and genetic intervention targets. METHODS: Six specimens from the ectopic and entopic endometrium tissues of patients with EMT in each syndrome, BS, QSBS as well as KDBS, in the early proliferative phase of the menstrual cycle, and 6 specimens from normal endometrium tissues in the early proliferative phase of the menstrual cycle were obtained. Three groups were formed in each syndrome by mixing two random specimens in equal amount, and then their respective two-dimensional electrophoresis graphs were obtained after total protein extraction. Finally, the detected differences in protein expression were identifified through matrix-assisted laser desorption Ionization-time of flflight mass spectrometry (MALDI-TOF/MS) and protein database. RESULTS: The results of differential proteins expressed in each syndrome were shown as follows: BS syndrome had 2 differential proteins in entopic endometrium and 1 differential protein in ectopic endometrium; KDBS syndrome had 3 in entopic endometrium and 3 in ectopic endometrium; and QSBS syndrome had 3 in entopic endometrium and 4 in ectopic endometrium. It was found out that annexin was highly expressed in both entopic and ectopic endometrium of KDBS syndrome; and myosin light chain 3 was highly expressed in both entopic and ectopic endometrium of QSBS syndrome. CONCLUSION: There are differential protein expressions among the 3 EMT syndromes, which might be the inner origin of syndrome characters, and these differential proteins might be the candidate biomarkers for the pathogenesis of various EMT syndromes.

[Advantages and evidences research on Chinese medicine for treatment of pelvic inflammatory disease].

Pelvic inflammatory disease is an infectious disease. At present, Western medicine is mainly treated with antibiotics. However, the situation of antibiotics abuse is so grim that the potential risks such as the imbalance of bacteria, the resistance of bacteria, the production of super bacteria and the increase of adverse reactions are becoming more and more serious. Therefore, it is urgent to find a way to supplement or substitute antibiotics for the treatment of this disease. Traditional Chinese medicine treatment of the disease is effective and has its unique advantages. This paper mainly discusses the advantages and evidences of traditional Chinese medicine (TCM) treatment of pelvic inflammatory disease, to further prove the effectiveness and safety of TCM treatment and to provide medical evidence of reducing antibiotics use.

[Effects of cotton straw returning on soil organic carbon, nitrogen, phosphorus and potas-sium contents in soil aggregates]. / 棉花秸秆还田对土壤团聚体有机碳及氮磷钾含量的影响.

To clarify the effects of cotton straw returning on the composition and contents of nu-trients in different particle sizes of aggregates, two treatments with or without cotton straw returning were tested in continuous three years. After three years straw treatments, we collected undisturbed soil within 0-5, 5-10, 10-20 and 20-30 cm soil layers, and to measure the composition, soil organic carbon, nitrogen, phosphorus and potassium contents in different particle sizes of aggregates classified using dry sieving. Returning cotton straw into the field significantly increased particle contents of 2-5 mm and >5 mm aggregates in 0-5 cm soil layer, while the content of <0.25 mm micro-aggregates was decreased. Cotton straw returning significantly improved soil organic carbon, nitrogen, and potassium contents by 19.2%, 14.2% and 17.3%, respectively, compared to no returning control. In 5-10 cm soil layer, cotton straw returning increased the contents of 2-5 mm and >5 mm aggregates, reduced the content of <0.25 mm micro-aggregate, but significantly increased contents of soil organic carbon, available nitrogen and potassium by 19.6%, 12.6% and 23.4%, compared to no straw returning control. In 10-20 cm soil layer, cotton straw returning significantly reduced the content of <0.25 mm micro-aggregates, and significantly enhanced soil organic carbon, nitrogen, and potassium contents by 8.4%, 10.9% and 11.5%, compared to the control. However, in 20-30 cm soil layer, cotton straw returning only increased soil available potassium content by 12.0%, while there were no significant changes in particle size, organic carbon, nitrogen and phosphorus contents. We concluded that cotton straw returning could significantly improve the structure of surface soil by increasing the number of macro-aggregates, contents of organic carbon, available nitrogen and potassium in aggregates, while decreasing micro-aggregate content. The enhancement of the contribution of macro-aggregates to soil fertility by returning cotton straw could improve soil physical structure, fertility and then increase cotton yield.

[Effects and safety of varying doses of guizhi fuling capsule in patients with primary dysmenorrhea: a multi-center, randomized, double-blind, placebo-controlled clinical study].

To evaluate the effects and safety of varying doses of Guizhi Fuling capsule on treating primary dysmenorrhea. From August 2010 to March 2011, 240 subjects (aged 18-30) with primary dysmenorrheal, were enrolled in 8 sites. They were randomized into Guizhi Fuling capsule high dose group, low dose group and placebo control group, 80 cases in each group. These patients were treated for three consecutive menstrual cycles, then were followed up in another three consecutive menstrual cycles. Visual analogue scales (VAS) was used to determine the pain intensity. During the treatment, the high-, low-dose and placebo groups efficiency on pain relief are 68.42%, 67.57% and 47.89% respectively. Guzhi Fuling (included high- and low- dose group) significantly relieves the pain compared to placebo. In follow-up, Guzhi Fuling groups are still superior to the placebo group (73.68%, 72.97% and 53.52%). During the treatment, pain duration reduces 57.88% in high dose group, while 46.17% in low dose group, and 30.40% in placebo group. In follow-up, pain lasting time decrease 67.93%, 53.56%, 47.46%, respectively. Guizhi Fuling significantly reduces the pain duration compared to placebo and high-dose is better than low-dose. The efficacy of Guzhi Fuling (high- and low-dose) displays certain dosage-effect relationship. Among these group, no serious adverse event was reported. Guizhi Fuling capsule at high or low dose significantly relieves the pain, improves symptoms, reduces the duration of pain, and has a better overall treatment effect and long-term treatment effect in patients with primary dysmenorrhea.

[Effect of Neiyi Kangfu suppository on expressions of cytochrome C and survivin in ectopic and eutopic endometrium in rats with endometriosis].

OBJECTIVE: To explore the different effects of rectal application of Neiyi Kangfu Suppository (NYKFS) on the expressions of cytochrome C (Cyt C) and Survivin in ectopic and eutopic endometrium in endometriosis (EMT) model rats. METHODS: EMT rats were randomly divided into 6 groups, the high- and low-dose NYKFS groups, the Danazol Capsule (DN) group, the Dan'e Fukang Soft Extract (DFE) group, the model group and the blank group. The expressions of Cyt C and Survivin were measured using immunohistochemical SP staining method. RESULTS: (1) After treatment, the IOD value of Cyt C in ectopic endometrium significantly increased in the high-dose and low-dose NYKFS groups respectively to 6.08 +/- 0.35 and 6.23 +/- 0.35, which was significantly higher than that in the model group (5.07 +/- 0.70) and DFE group (5.98 +/- 1.02) respectively (P < 0.05, P < 0.01); while those of Survivin in ectopic endometrium was significantly decreased to 5.73 +/- 0.93 and 5.62 +/- 0.93 and was significantly lower than that in the model group (6.01 +/- 1.16, P < 0.05 or P < 0.01). (2) The lowered eutopic endometrial level of Cyt C in EMT rats after treatment was significantly higher in the two NYKFS groups than that in the model group (P < 0.05); while that of eutopic endometrial Survivin was insignificantly different between the NYKFS groups and the model group or the blank group (P > 0.05). CONCLUSION: NYKFS plays its role in inducing apoptosis by increasing the expression of Cyt C and decreasing the expression of Survivin in ectopic endometrium, but it up-regulates expression of Cyt C, has no obvious effect on Survivin expression in eutopic endometrium.

[Pretest survey on the Chinese menopause rating scale].

OBJECTIVE: To select the items from the Chinese menopause rating scale (CMRS) through pre-testing those people with menopausal syndromes. METHODS: 293 people were surveyed in Guangzhou in 2005, among which 196 people with menopausal syndromes and others without. Psychometrics methods were employed to develop the scale. The item pools were all round. Methods used would include: focus group discussion and interviews, subjective evaluation method and Delphi method, to preliminarily screen the items. Data on scales measured from 196 cases with and 97 subjects without menopausal syndromes during the menopausal period, were collected. Again, seven statistical methods were employed to select the items. RESULTS: The 40-items scale for menopausal syndrome was formed to include: a) three domains: somatic (18-items), psychological (14-items) and social (5-items); b) one general appraisal item; c) two lie-test items. CONCLUSION: The Chinese menopausal syndrome scale we used seemed to possess good content validity, feasibility and intra-class reliability.