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Objective: To investigate the value of uterine morphological parameters and endometrial T2 signal intensity (T2-SI) in evaluating the degree of the fibrotic repair secondary to endometrial injury. Methods: From Sep. 2018 to Feb. 2023, this study prospectively enrolled 29 patients with fibrotic repair secondary to severe endometrial injury (severe group), 17 patients with fibrotic repair secondary to mild to moderate endometrial injury (mild to moderate group), and 40 healthy women of reproductive age (control group) in Nanjing Drum Tower Hospital. The length of uterine cavity (LUC), length of cervix and isthmus (LCI), width of upper uterine cavity (WUUC) and width of lower uterine cavity (WLUC) were measured using magnetic resonance imaging. T2-SI of endometrium and subcutaneous fat of buttocks were measured, and endometrial normalized T2-SI (nT2-SI; T2-SI of endometrium/T2-SI of subcutaneous fat of buttocks) was calculated. Statistical analyses of data were performed using one-way analysis of variance, Mann-Whitney U test, intraclass correlation coefficient, Spearman rho test, area under the receiver operating characteristic curve (AUC). Results: LUC, WUUC, WLUC and endometrial nT2-SI of severe group [(19.7±3.5) mm, (26.9±6.4) mm, (7.9±1.4) mm, 0.73±0.11, respectively] were significantly lower than those of the control group (all P<0.01), while LCI and WUUC/LUC [(51.3±7.3) mm and 1.38±0.34] were significantly higher than those of the control group (all P<0.001). LUC and WLUC of severe group were significantly lower than those of mild to moderate group [(32.4±5.1) mm and (8.8±1.2) mm; all P<0.05], while LCI and WUUC/LUC were significantly higher than those of mild to moderate group [(41.8±8.6) mm and 0.94±0.16; all P<0.001]. LUC and endometrial nT2-SI of mild to moderate group were significantly lower than those of the control group [ (32.4±5.1) vs (35.3±3.5) mm, 0.68±0.13 vs 0.80±0.12; all P<0.01]. LUC, WUUC, WLUC and endometrial nT2-SI were significantly negatively correlated to the degree of the fibrotic repair secondary to endometrial injury (Spearman rho:-0.794, -0.441, -0.471 and -0.316, respectively; all P<0.05), while LCI and WUUC/LUC were significantly positively correlated to the degree of the fibrotic repair secondary to endometrial injury (Spearman rho: 0.481 and 0.674, respectively; all P<0.05). LUC and WUUC/LUC showed high value in distinguishing severe group from the control group or mild to moderate group (all AUC>0.9, all P<0.001). Conclusion: As noninvasive and quantitative biomarkers, uterine morphological parameters and endometrial nT2-SI could evaluate the degree of the fibrotic repair secondary to endometrial injury.
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Humanos , Femenino , Útero , Endometrio , Estado de Salud , Hospitales , Curva ROCRESUMEN
Objective: To simulate and evaluate the scraping and grinding work of workers with different spinal anteversion angles, and to explore the effects of different anteversion angles on the erector spinae muscles of scrapers. Methods: In November 2019, 16 male college student volunteers were recruited to simulate workers' scraping and grinding work. The parameters were 25°, 15 times/min, 15°, 30 times/min, 5°, 60 times/min respectively. The surface electromyography (sEMG) was used to collect the electromyographic signals of the erector spinae muscles, and the surface electromyographic characteristics of the erector spinae muscles were evaluated with Borg Scale. Results: There were significant differences between the maximum voluntary contraction percentage (MVE%) of the left and right erector spinae muscles groups in the three groups with different spinal anteversion angles (F(left)=13.41, P(left)<0.001; F(right)=4.74, P(right)=0.005) , and the EMG amplitude was higher at 25°, 15 times/min. At 15°, 30 times/min, MVE% of the left side was significantly higher than that of the right side (t=2.58, P=0.021) . There was significant difference in the mean power frequency (MPF) of the right erector spinae muscle in the three groups (F=9.42, P<0.001) , but there was no significant difference in the MPF of the left erector spinae muscle (F=0.30, P=0.823) . The fitting line showed that the left erector spinae muscle showed a downward trend at 5°, 60 times/min (t=-5.39, P=0.012) . Conclusion: Scrapers are less likely to be fatigued when the posture is 15°, 30 times/min, but they are more likely to be fatigued when working at 5°, 60 times/min.
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Humanos , Masculino , Electromiografía , Músculo Esquelético/fisiología , Músculos/fisiología , Postura/fisiologíaRESUMEN
Fetal movement counting is one of the common methods for fetal prenatal monitoring. The changes of the normal pattern of fetal movements(FM)indicate abnormal fetal status in uterus.Studies have found that reduced fetal movement is the primary sign of fetal distress,which is associated with adverse pregnancy outcomes such as stillbirth,placental insufficiency,and fetal growth restriction.Increased fetal movement after 32 week's gestation is regular,but a single episode of vigorous FM increases risk of stillbirth.Clinically,fetal safety is preliminarily evaluated by counting numbers of FM to find abnormalities of fetus early and decrease adverse pregnancy outcomes,which is economical,convenient,and simple.However,this method is subjective,due to the different sensitiveness of pregnant women.
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Objective To observe the effects of different doses of sinomenine on toll-like receptor (TLR) 2, TLR4 and myeloid differentiation factor 88 (Myd88) in cartilage of rabbit knee osteoarthritis model; To discuss its mechanism of action. Methods Knee osteoarthritis model was established by Hulth method. Experimental rabbits were randomly divided into control group, model group, sinomenine low-, medium-and high-dose groups. Blank group received no processing. Model group, sinomenine low-, medium-and high-dose groups received intra-articular injection of normal saline and sinomenine 0.2 mL (5 mg), 0.35 mL (8.75 mg) and 0.5 mL (12.5 mg) respectively, for 10 times. Real-time fluorescence quantitative PCR and Western blot were used to detect m RNA and protein expressions of TLR2, TLR4 and My D88 in cartilage. Results m RNA and protein expressions of TLR2, TLR4 and MyD88 in model group significantly increased compared with control group (P<0.01); compared with model group, m RNA and protein expressions of TLR2, TLR4 and My D88 in sinomenine medium-and high-dose groups decreased significantly (P<0.05, P<0.01). Conclusion Sinomenine can inhibit the cartilage immune response of rabbit knee osteoarthritis by down-regulating expressions of key molecules in the TLR/My D88 pathway.
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Vascular endothelial growth factor (VEGF) plays an important role in the periodic changes of the endometrium under physiological conditions. Under the regulation of various cytokines in different phases of the menstrual cycle, VEGF subtypes bind to their respective tyrosine kinase receptors (VEGFR1, VEGFR2, VEGFR3) , Nrp1 and Nrp2 to participate in physiological processes of the endometrium, such as angiogenesis, changes of vascular permeability, proliferation and migration of endothelial cells and non-endothelial cells, etc. This article summarizes the research progress of the function of various VEGF subtypes in the normal periodontal changes of the endometrium.
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<p><b>OBJECTIVE</b>To observe the effect of parathyroid hormone (PTH)(1-34) on the expression of matrix Gla protein (MGP) and Wnt/β-catenin signaling pathway and elucidate the possible molecular mechanism of PTH (1-34) in the prevention and treatment of osteoporosis.</p><p><b>METHODS</b>MG63 cells treated with PTH (1-34) at 10(-9), 10(-8), and 10(-7) mol/L, alone or in combination with Wnt/β-catenin signaling pathway inhibitors DKK-1 (200 ng/ml) were examined for mRNA and protein expressions related with Wnt/β-catenin signaling with real-time PCR and Western blotting. The cell differentiation after the treatment was assessed with alkaline phosphatase (ALP) staining and cell viability assay.</p><p><b>RESULTS</b>PTH (1-34) significantly increased the expression of MGP in a dose-dependent manner in MG63 cells (P<0.05 or P<0.01). PTH treatment obviously enhanced ALP activity in the cells, and this effect was suppressed by DKK-1. Combined treatment with DKK-1 partially blocked PTH-induced enhancement of ALP activity (P<0.05). PTH promoted the expression of MGP and enhanced LRP5, β-catenin, and Runx2 expressions in Wnt/β-catenin signaling pathway at both protein and mRNA levels (P<0.05 or P<0.01). DKK-1 partially blocked the effect of PTH (1-34) on Wnt/β-catenin signaling pathway (P<0.05) without affecting MGP expression.</p><p><b>CONCLUSION</b>PTH (1-34) significantly increases the expressions of MGP and proteins in the Wnt/β-catenin signaling pathway. Wnt/β-catenin signaling pathway and MGP mediate the regulation of osteogenosis by PTH.</p>
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Humanos , Fosfatasa Alcalina , Metabolismo , Proteínas de Unión al Calcio , Metabolismo , Diferenciación Celular , Línea Celular Tumoral , Supervivencia Celular , Proteínas de la Matriz Extracelular , Metabolismo , Péptidos y Proteínas de Señalización Intercelular , Farmacología , Osteogénesis , Osteoporosis , Hormona Paratiroidea , Farmacología , Reacción en Cadena en Tiempo Real de la Polimerasa , Vía de Señalización WntRESUMEN
Objective To investigate the seroprevalence of Cytomegalovirus (CMV) infection and ages of the children in primary for better understanding the status of CMV infection in China with evidence-based medicine.Methods Total 837 children randomly selected from Nanjing Children's Hospital,from Jun.to Sep.in 2011,including 513 boys and 324 girls,aged from 1 day to 8 years,with mean age of 3.6 years old,were recruited.Serum samples were tested for CMV IgM,CMV IgG,and CMV IgG avidity index using commercial enzyme-linked immunosorbent assay kits.Results Of the total serum samples from 837 children,690 cases were CMV IgG positive.The overall seroprevalence of CMV IgG was 82.4%,with 83.2% (427/513 cases) and 81.2% (263/324 cases) in boys and girls,respectively.There was no significant difference in the seroprevalence of CMV IgG between boys and girls (x2 =0.584,P =0.445).Of the 92 infants less than 6 months old,86 cases were CMV IgG positive,and the positive rate was 93.5%.The prevalence gradually declined in infants after 7 months old,fell to the lowest level of 66.7% at age of 9 months,and then constantly maintained around 80.0% from 1 to 8 years old (x2 =15.4,P < 0.001).CMV IgM in 352 serum samples were tested,and 23 (6.5%) cases were CMV IgM positive.The positive rate peaked in infants at age of 2-3 months (7/12 cases,58.3%),then decreased over the age and none of the children older than 6 years were IgM positive (x2 =5.1,P <0.001).Furthermore,the CMV IgG avidity index assay was performed in all 23 cases of IgM positive individuals to estimate the primary CMV infection rate.The results showed low avidity index (< 30%) in 13 infants,the primary infection rate was 56.5% (13/23 cases).Most subjects with primary infection (n =7,53.8%) were younger than 1 year old.Conclusions The current seroprevalence of CMV IgG in children in China was around 80.0%,lower than that in adults,and the primary CMV infection mostly occurred before 3 months of age.
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<p><b>OBJECTIVE</b>To analyze TRAPPC2 gene mutation in a family with X-linked spondyloepiphyseal dysplasia tarda and to provide genetic counseling and prenatal diagnosis.</p><p><b>METHODS</b>All of 4 exons of the TRAPPC2 gene and their flanking sequences in the proband and her father were analyzed with polymerase chain reaction and direct DNA sequencing. Genomic DNA of the probands' fetus was extracted from amniotic fluid sampled at 18th gestational week. Gender of the fetus was determined by the presence of SRY gene. The sequence of fetal TRAPPC2 gene was also analyzed.</p><p><b>RESULTS</b>A c.209G>A mutation was identified in exon 4 of the TRAPPC2 gene in the proband and her father. The fetus of was determined to be a male and also have carried the c.209G>A mutation.</p><p><b>CONCLUSION</b>A c.209G>A mutation of TRAPPC2 exon 4 probably underlies the clinical manifestations in this family. The proband is a carrier, and her fetus is a male carrying the same mutation. Prenatal diagnosis is an effective method for the prevention of the disease.</p>
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Femenino , Humanos , Embarazo , Secuencia de Bases , Asesoramiento Genético , Enfermedades Genéticas Ligadas al Cromosoma X , Diagnóstico , Embriología , Genética , Datos de Secuencia Molecular , Osteocondrodisplasias , Genética , Mutación Puntual , Diagnóstico PrenatalRESUMEN
<p><b>BACKGROUND</b>Multiple osteochondromas (MO), an inherited autosomal dominant disorder, is characterized by the presence of multiple exostoses on the long bones. MO is caused by mutations in the EXT1 or EXT2 genes which encode glycosyltransferases implicated in heparin sulfate biosynthesis.</p><p><b>METHODS</b>In this study, efforts were made to identify the underlying disease-causing mutations in patients from two MO families in China.</p><p><b>RESULTS</b>Two novel EXT1 gene mutations were identified and no mutation was found in EXT2 gene. The mutation c.497T > A in exon 1 of the EXT1 gene was cosegregated with the disease phenotype in family 1 and formed a stop codon at amino acid site 166. The fetus of the proband was diagnosed negative. In family 2, the mutation c.1430-1431delCC in exon 6 of the EXT1 gene would cause frameshift and introduce a premature stop codon after the reading frame being open for 42 amino acids. The fetus of this family inherited this mutation from the father.</p><p><b>CONCLUSIONS</b>Mutation analysis of two MO families in this study demonstrates its further application in MO genetic counseling and prenatal diagnosis.</p>
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Adulto , Preescolar , Femenino , Humanos , Masculino , Pueblo Asiatico , Genética , Exostosis Múltiple Hereditaria , Genética , Mutación , N-Acetilglucosaminiltransferasas , GenéticaRESUMEN
<p><b>OBJECTIVE</b>To provide genetic diagnosis and counseling for a 2-year-old girl with typical Rett syndrome through analyzing the methyl-CpG binding protein 2 (MECP2) gene.</p><p><b>METHODS</b>Potential mutation of the MECP2 gene was screened by DNA sequencing and multiplex ligation-dependent probe amplification (MLPA) analysis of members of the family as well as normal controls. Lymphocyte culture for karyotype analysis was carried out for the patient to exclude chromosomal abnormalities.</p><p><b>RESULTS</b>The karyotype of the girl was normal. No variation of the MECP2 gene was detected in the patient by direct sequencing. A heterozygosis variation, c.1072G>A in exon 4 of the MECP2 gene was detected in a normal female control, which was not found in other controls. The son and daughter of the female control were respectively heterozygous and homozygous carriers of the same mutation. By MLPA analysis, a heterozygosis deletion of exon 3 and part of exon 4 was detected in the patient. cDNA amplification and sequencing confirmed the presence of a 1176 bp deletion (c.27-1202del1176). The same deletion was not detected in the parents.</p><p><b>CONCLUSION</b>A large deletion in MECP2 gene was detected with MLPA in a patient featuring typical Rett syndrome. The same deletion was missed by sequencing analysis. With cDNA sequencing, the breakage point of the mutation can be mapped precisely.</p>
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Preescolar , Femenino , Humanos , Secuencia de Bases , Exones , Pruebas Genéticas , Genotipo , Cariotipificación , Proteína 2 de Unión a Metil-CpG , Genética , Mutación , Síndrome de Rett , GenéticaRESUMEN
<p><b>OBJECTIVE</b>To determine the relatively appropriate actuation time for ovarian super-stimulation of IVF-ET by comparing the influences of different down-regulation days of chorionic gonadotrophin releasing hormone agonist (GnRH-a) upon the follicular diameter, endometrial thickness and the levels of follicle- stimulating hormone (FSH) , luteinizing hormone (LH) and estradiol (E2).</p><p><b>METHODS</b>We adopted the long protocol of GnRH-a down-regulation in the midluteal phase for 42 patients undergoing IVF-ET. According to the time of GnRH-a down-regulation, we divided the patients into a 10 d, a 15 d and an 18 d group, measured their follicular diameters and endometrial thickness by B-mode ultrasonography, detected the levels of FSH, LH and E2 in the blood, and analyzed the influences of different days of GnRH-a down-regulation on the follicular diameter, endometrial thickness and sexual hormone levels. At 1, 7, 10 and 14 d of down-regulation, we compared the levels of FSH and LH in the blood before the injection of GnRH-a with those 2 and 3 h after it.</p><p><b>RESULTS</b>At 10, 15 and 18 d after down-regulation, the ovarian follicles with the diameter of 3-4 mm accounted for 16.8, 7.09 and 10.38% (P < 0.05, 10 d vs 15 d and 18 d), those with the diameter of 4.5-7.0 mm made up 80.24, 89.55 and 84.62% (P < 0.05, 15 d vs 10 d and 18 d), and those with the diameter of 7.5-10 mm constituted 2.96, 3.36 and 5%, respectively. Endometrial thickness was (7.73 +/- 2.48) mm in the 10 d group, significantly thicker than (5.41 +/- 0.79) mm and (5.24 +/- 0.85) mm in the 15 d and 18 d groups (P < 0.05). The FSH levels in the 10 d, 15 d and 18 d groups were (3.70 +/- 1.10), (3.51 +/- 0.72) and (3.47 +/- 0.61) mIU/ml, the LH levels were (1.23 +/- 1.00), (1.09 +/- 0.47) and (1.22 +/- 0.72) mIU/ml, and the E2 levels were 41.84 +/- 36.81, 32.84 +/- 14.32 and 9.50 +/- 8.23, respectively, with no significant differences among the three groups. At 1, 7, 10 and 14 d of down-regulation, both FSH and LH levels in the blood were increased at 2 and 3 h after GnRH-a injection, most significantly at 1 d (1.87 +/- 1.49 vs 13.33 +/- 7.81 for FSH, 1.06 +/- 1.13 vs 47.40 +/- 29.97 for LH, (P < 0.05).</p><p><b>CONCLUSION</b>In the long protocol of ovarian super-stimulation of IVF-ET, endometrial thickness and the levels of FSH, LH and E2 tended to be stable at 10 d of GnRH-a down-regulation. The percentage of the follicles with the diameter of 4.5-7.0 mm was higher at 15 d than at 10 d, but rose no more at 18 d except for an increased number of smaller follicles 3-4 mm in diameter. Therefore, appropriate prolongation of GnRH-a down-regulation can improve the synchronism of follicular development.</p>
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Adulto , Femenino , Humanos , Estradiol , Sangre , Hormona Folículo Estimulante , Sangre , Fase Folicular , Sangre , Hormona Liberadora de Gonadotropina , Metabolismo , Farmacología , Hormona Luteinizante , Sangre , Folículo Ovárico , Inducción de la Ovulación , ÚteroRESUMEN
<p><b>OBJECTIVE</b>To explore the effectiveness of ICSI in overcoming the high incidence of tripronucleates zygotes resulting from insemination in a previous IVF cycle.</p><p><b>METHODS</b>We retrospectively analyzed the matched-pair cycles in 37 patients with a > 35 % incidence of tripronucleate zygotes in an IVF cycle, with ICSI used in the subsequent cycle, evaluated the incidences of diploid (2PN) and triploid (3PN) zygotesand the number of normal embryos obtained, and compared the rates of clinical pregnancy and embryo implantation between the IVF and ICSI groups.</p><p><b>RESULTS</b>The mean age of the ICSI group was significantly older than that of the IVF group, while the ampules of gonadotropin and peak E2 showed no remarkable difference between the two. The numbers of follicles at hCG trigger, retrieved oocytes and mature oocytes were markedly lower in the former than in the latter. The percentage of 2PN was significantly higher while that of 3PN significantly lower after ICSI than after IVF (74.24% vs 34.42%; 11.57% vs 51.04%, P < 0.01), and more normal diploid embryos were obtained with ICSI (3.83 +/- 2.08 vs 2.52 +/- 1.71, P < 0.01). Four singletons were achieved in 31 IVF embryo transfer cycles, in comparison with 11 singletons and 3 twins in 36 ICSI embryo transfer cycles. The ICSI group showed significantly higher rates of clinical pregnancy and embryo implantation than the IVF group (38.89% vs 12.90%; 28.33% vs 7.41%, P<0.01).</p><p><b>CONCLUSION</b>For women with a high incidence o triploidy in a previous IVF cycle, ICSI can effectively increase the number of normal diploid zygotes.</p>
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Adulto , Femenino , Humanos , Masculino , Embarazo , Transferencia de Embrión , Métodos , Fertilización In Vitro , Métodos , Índice de Embarazo , Estudios Retrospectivos , Inyecciones de Esperma Intracitoplasmáticas , Resultado del TratamientoRESUMEN
<p><b>OBJECTIVE</b>To investigate the inhibitory effect of cinobufotalin (CBT) on the growth of xenograft endometrial carcinoma cell line ishikawa in nude mice, and its impact on the expression of ribonucleotide reductase subunit M2 (RRM2).</p><p><b>METHODS</b>Eleven nude mice with xenograft were randomly divided into two groups, the CBT group and the control group, which received intra-tumor injection of CBT and saline respectively for one week. The sizes of xenografts were measured before and after the treatment to calculate the inhibition ratio of tumor proliferation; the RRM2-mRNA and protein expressions in tumor tissue were measured by RT-PCR and Western blot respectively.</p><p><b>RESULTS</b>After treatment, the size of xenografts in the CBT group was (0.1314 +/- 0.0304) cm3, which was significantly lower than that in the control group (0.360 0 +/- 0.1145) cm3, (P < 0.05), the tumor proliferation inhibition ratio being 43.46%. The differences of RRM2 mRNA and protein expression levels between the two group were significant (P = 0.019 and P = 0.001).</p><p><b>CONCLUSION</b>CBT significantly inhibits the growth of the xenografts of endometrial carcinoma Ishikawa in nude mice, and the action mechanism is possibly associated with the inhibition on RRM2 expression.</p>
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Animales , Femenino , Humanos , Ratones , Antineoplásicos , Farmacología , Bufanólidos , Farmacología , Línea Celular Tumoral , Proliferación Celular , Neoplasias Endometriales , Genética , Metabolismo , Patología , Materia Medica , Farmacología , Ratones Endogámicos BALB C , Ratones Desnudos , ARN Mensajero , Genética , Metabolismo , Ribonucleósido Difosfato Reductasa , Genética , Metabolismo , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
<p><b>BACKGROUND AND OBJECTIVE</b>Letrozole is an aromatase inhibitor that is used in the treatment of estrogen-sensitive tumors such as endometrial carcinoma, however, its therapeutic effect is still to be further improved. It is reported that curcumin has antitumor capability and can enhance the sensitivity of tumor cells to anticancer agents. This study was to investigate the inhibitory effect of letrozole combination with curcumin on the implanted endometrial tumor growth.</p><p><b>METHODS</b>Nude mice were implanted with endometrial carcinoma RL-952 cells. All tumor-bearing mice were randomly divided into 5 groups: control(without treatment), Let(1) (letrozole, 1 microg/d), Let(10) (letrozole, 10 microg/d), Cur [ curcumin, 300 mg/kg.d)], and Let + Cur group [10microg/d letrozole + 50mg/ (kg.d) curcumin]. The tumor growth was monitored. Tumor cells apoptosis was detected in both control and treated groups. The expressions of bcl-2 mRNA and bcl-2 protein were detected using RT-PCR and Western blot, respectively.</p><p><b>RESULTS</b>Fifty mice were successfully implanted with the endometrial tumor. Treatment with letrozole markedly inhibited tumor growth; the inhibitory effect was further enhanced by the combination of letrozole and curcumin. The inhibitory rates in Let (1), Let (10), the Cur, and the Let + Cur groups were 15.95%, 22.49%, 21.57%, and 35.89%, respectively. Treatment with curcumin inhibited the expression of bcl-2 in tumor cells at the mRNA and protein levels. The apoptosis rates in the control group and the four experimental groups mentioned above were 16.97%, 32.90%, 35.80%, 34.16%, and 47.24%, respectively. Tumor cells apoptosis were observed in mice treated with either letrozole or curcumin; however, combination of letrozole and curcumin further enhanced the inhibitory rate in tumor growth.</p><p><b>CONCLUSIONS</b>Treatment with letrozole or curcumin could inhibit the xenografted endometrial tumor growth by inducing apoptosis in tumor cells. Combination of letrozole and curcumin further enhanced the inhibitory effect of tumor growth.</p>
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Animales , Femenino , Humanos , Ratones , Adenocarcinoma , Metabolismo , Patología , Apoptosis , Ciclo Celular , Línea Celular Tumoral , Curcumina , Farmacología , Sinergismo Farmacológico , Neoplasias Endometriales , Metabolismo , Patología , Ratones Endogámicos BALB C , Ratones Desnudos , Trasplante de Neoplasias , Nitrilos , Farmacología , Proteínas Proto-Oncogénicas c-bcl-2 , Genética , Metabolismo , ARN Mensajero , Metabolismo , Distribución Aleatoria , Receptores de Estrógenos , Metabolismo , Triazoles , Farmacología , Carga Tumoral , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
<p><b>OBJECTIVE</b>To analyze the pregnancy outcomes of repeated IVF-ET cycles.</p><p><b>METHODS</b>We retrospectively analyzed 702 repeated IVF-ET cycles (503 cases) performed in our center from 2006 to 2008, among which 191 cycles (Group A) had failed previously in other hospitals and 511 (Group B) in ours, focusing on the relationship of pregnancy outcomes with the number of repeated IVF-ET cycles and the age of the patients.</p><p><b>RESULTS</b>In Group A, there were no significant differences in pregnancy rates among the patients with 1, 2 or > 2 previously failed cycles (56.56% vs 66.67% vs 61.54%), while the numbers of oocytes obtained were significantly decreased (8.51 +/- 4.60 vs 8.48 +/- 3.32 vs 4.86 +/- 2.96) and the serum levels of follicle stimulating hormone (FSH) remarkably increased ([7.31 +/- 3.66] mIU/mL vs [6.83 +/- 2.35] mIU/mL vs [11.58 +/- 11.40] mIU/mL) in those with > 2 previous failures. In Group B, the results of the first IVF-ET cycle in our center showed that the number of oocytes obtained and the E2 level on the day of hCG injection were markedly decreased in the patients with 2 previously failed cycles (6.66 +/- 4.58 vs 9.59 +/- 4.30 and 2 396.87 +/- 1 602.02 vs 4 061.17 +/- 2 255.63), and so were the pregnancy rate, oocyte number, intimal thickness and essential FSH level in those with > 2 previous failures, but no significant differences were found in the rate of pregnancy, number of oocytes obtained, number of embryos transplanted and rate of abortions in those with 1 previous failure. The pregnancy and implantation rates of the repeated IVF-ET cycles were significantly reduced in the female patients aged < 38 years and with > 3 previously failed cycles, as well as in those aged > 38 years and with 1 - 4 previous failures, but not in those aged < 38 years and with < 3 previous failures in Group B.</p><p><b>CONCLUSION</b>The pregnancy outcome of repeated IVF-ET cycles was not correlated with the number of the cycles, but maybe directly with different protocols in different reproductive centers. The rate of pregnancy was obviously decreased in patients that underwent over 4 repeated IVF-ET cycles, but had no obvious correlation with the number of cycles in those that received 1 - 3 cycles in the same reproductive center. The age of the patient influences the results of repeated IVF-ET cycles, and both pregnancy and implantation rates may decrease in those aged > 38 years.</p>
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Adulto , Femenino , Humanos , Masculino , Embarazo , Transferencia de Embrión , Métodos , Fertilización In Vitro , Resultado del Embarazo , Índice de Embarazo , Estudios RetrospectivosRESUMEN
<p><b>BACKGROUND</b>The second-trimester maternal serum screening in twin pregnancy is still controversial, as the serum marker levels in twins are not as clear as those in singletons. This study aimed to evaluate the relationship between the levels of the second-trimester maternal serum free beta-human chorionic gonadotropin (free beta-HCG) and alpha-fetoprotein (AFP) in normal twin and singleton pregnancies and to estimate feasible analysis methods for utilizing these markers in second trimester screening for twin pregnancy.</p><p><b>METHODS</b>On the basis of a prospective population-based study of second-trimester maternal serum screening, the concentrations of maternal serum AFP and free beta-HCG of 195 normal twin pregnancy and 26,512 singleton controls at gestational weeks 15 to 20 were measured by time-resolved fluoroimmunoassay in one laboratory. The levels of markers were compared between the twins and singletons using weight-correction and gestational age-specific model.</p><p><b>RESULTS</b>According to the research protocol, 95 communities were randomly sampled, which covered the whole Jiangsu province, the east of China. A total of 26 803 pregnant women (98%), from the target population accepted prenatal screening for maternal serum AFP, beta-HCG detection, and all babies were followed up for at least six months. There were 197 (0.73%) twin pregnancies, of which one case had fetal trisomy 18, and one case with fetal anencephaly. The others were normal twin pregnancy. From a total enrollment of 26 803 women participants, 26 512 women with normal singleton pregnancies were selected as the model controls. The other 291 pregnancies, including trisomy 21, neural tube defect (NTD), trisomy 18, and other fetal abnormalities, were excluded. No significant differences were found in the medians of gestational age-specific maternal serum free beta-hCG and AFP in normal twin pregnancy comparing with twice those in model controls with the exception of the medians for free beta-hCG during the 16th gestational week (P = 0.012).</p><p><b>CONCLUSION</b>The weight-correction and gestational age-specific levels of Chinese Han population maternal serum free beta-hCG and AFP in normal twins were twice the levels as those in the singleton controls during the 17-19 gestational weeks.</p>
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Adulto , Femenino , Humanos , Embarazo , Gonadotropina Coriónica Humana de Subunidad beta , Sangre , Sangre , Segundo Trimestre del Embarazo , Gemelos , alfa-FetoproteínasRESUMEN
<p><b>OBJECTIVE</b>To study the changes of MAPK and Akt signaling pathways in hearts and placentas of aborted fetuses with congenital heart disease (CHD), and investigate their roles in the pathogenesis of CHD.</p><p><b>METHODS</b>Ten aborted fetuses with severe CHD (CHD group) and 7 gestational age-matched non-cardiac malformation aborted fetuses (control group) were enrolled. Western blot analysis was undertaken to assess the expression of p38, p38alpha, p-p38, MEF2, ERK, p-ERK, Akt, p-Akt(Ser473) and p-Akt(Thr308) in left ventricles and placentas of the fetuses, while semi-quantitative reverse transcription polymerase chain reaction analysis was used to detect the expression of p38alpha isoforms mRNA in hearts.</p><p><b>RESULTS</b>Compared with the heart samples of the control group, the protein expression levels of p38 and its alpha isoform in 4 cases, p-p38 in 6 cases, MEF2 in 2 cases, p-ERK in 8 cases, Akt in 4 cases, p-Akt(Ser473) and p-Akt(Thr308) in 8 cases decreased, while the protein expression levels of p-p38 in 2 cases and p-Akt(Thr308) in 1 case increased. P-p38 protein level in 3 cases and p-ERK protein level in 2 cases decreased in placentas compared with the control group. The changes of protein expression of MAPK and Akt signaling pathway in hearts were not consistent with those in placentas in the CHD group. The expression of p38alpha isoform2 mRNA showed descent tendency in 4 heart samples with CHD, while the expression of other three p38alpha isoforms mRNA was reduced in only 1 sample compared with the control group.</p><p><b>CONCLUSIONS</b>Dysfunction of MAPK and Akt signaling pathways is tissue-specific in aborted fetuses with CHD. The perturbed two signaling pathways in hearts may contribute to the pathogenesis of human CHD.</p>
Asunto(s)
Femenino , Humanos , Embarazo , Feto , Metabolismo , Cardiopatías Congénitas , Metabolismo , Sistema de Señalización de MAP Quinasas , Fisiología , Miocardio , Metabolismo , Fosfatidilinositol 3-Quinasas , Fisiología , Placenta , Metabolismo , Proteínas Proto-Oncogénicas c-akt , Fisiología , Transducción de Señal , Fisiología , Proteínas Quinasas p38 Activadas por Mitógenos , FisiologíaRESUMEN
<p><b>OBJECTIVE</b>To evaluate the safety of early rescue intracytoplasmic sperm injection (ICSI) for complete failure of in vitro fertilization (IVF).</p><p><b>METHODS</b>We conducted early rescue ICSI for 105 conventional IVF cycles and follow-up evaluation of the clinical outcomes.</p><p><b>RESULTS</b>A total of 64 neonates were born, and no significant differences were found in the sex ratio, birth weight and birth defects.</p><p><b>CONCLUSION</b>Early rescue ICSI can significantly improve the clinical outcome in patients with complete IVF failure, but does not increase the clinical risk.</p>
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Adulto , Femenino , Humanos , Recién Nacido , Masculino , Embarazo , Fertilización In Vitro , Estudios de Seguimiento , Infertilidad Femenina , Terapéutica , Periodo Posparto , Índice de Embarazo , Inyecciones de Esperma Intracitoplasmáticas , Insuficiencia del Tratamiento , Resultado del TratamientoRESUMEN
<p><b>BACKGROUND</b>Up to date, there is few satisfactory pharmacotherapy, except for aspirin and heparin, to stop the preeclampsia progression. Although the mechanism of preeclampsia is poorly understood, it has been proven to be associated with coagulation activation. Researches on prophylactic and therapeutic application of anticoagulants may benefit the clinical aspects of preeclampsia individuals. This study aimed to evaluate the effects of Danshensu on maternal syndrome in phosphatidylserine/phosphatidylcholine (PS/PC) microvesicle induced-mouse model.</p><p><b>METHODS</b>Sixty-six preeclampsia-like pregnant mice, induced by PS/PC microvesicle administration, were randomly divided into six groups. From days 5.5 to 16.5 of pregnancy, each group was respectively treated as follows: a) mice in group C (n = 12, control group) were injected with 100 microl of filtered phosphate-buffered saline into the tail vein every day; b) group PE (n = 15, preeclampsia model group) were injected in the same way with 100 microl of filtered PS/PC vesicle suspension; c) group H (n = 9, group treated with heparin) were injected with 1 unit heparin together with PS/PC vesicle suspension; d) group A (n = 10, group treated with aspirin) were injected with 20 microg/g aspirin-DL lysine as well; e) group LD (n = 10, group treated with low-dose Danshensu) were injected with 10 microg/g Danshensu; and f) group HD (n = 10, group treated with high-dose Danshensu) were injected with 30 microg/g Danshensu. Systolic blood pressure, total urinary protein levels, blood tests for some hemostatic function parameters (mean platelet counts, plasma antithrombin III activity (AT-III), D-D dimmer levels, and thrombin time), fibrin deposition by phosphotungstic acid hematoxylin staining, and thrombomodulin expression by immunohistochemistry staining in placentas were examined as indices for maternal syndrome.</p><p><b>RESULTS</b>Heparin showed significant effects on maternal syndrome of preeclampsia such as hypertension and proteinuria, and different doses of Danshensu also presented the certain effects. High-dose Danshensu and aspirin all demonstrated better effects than low-dose Danshensu on decreasing blood pressure to normal level, while high-dose Danshensu demonstrated better effects than aspirin and low-dose Danshensu on decreasing proteinuria to normal level. As to Danshensu's effects on hemostatic function, high- and low-dose Danshensu's marked effects on increasing the plasma AT-III activity were the same as that of aspirin and inferior to that of heparin. High-dose Danshensu's better effect on elevating the platelet counts was superior to low-dose Danshensu and aspirin. Low-dose Danshensu's obvious effect on decreasing D-D levels was close to heparin and superior to high-dose Danshensu and aspirin. High- and low-dose Danshensu's significant effects on reduced thrombin time level are same to heparin. Different anticoagulants all played improvement roles in placental fibrin depositions, but heparin and high-dose Danshensu's roles on lowering thrombomodulin expression in placentas were superior to low-dose Danshensu and aspirin. However, anticoagulant function of high-dose Danshensu was still inferior to heparin. We found long-term use of heparin and aspirin, in spite of low-dose administration, could raise the risk of bleeding such as placental abruption and intestinal hemorrhage. But no any side effect was observed in mice treated with different doses of Danshensu in our study.</p><p><b>CONCLUSIONS</b>Danshensu has proven to be effective and safe in ameliorating the prognosis of maternal syndrome in a preeclampsia mouse model. We suggest long-term provision of low-dose Danshensu in pregnancy, leading to an improvement of preeclampsia syndrome with considerable maternal safety.</p>
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Animales , Femenino , Ratones , Embarazo , Anticoagulantes , Usos Terapéuticos , Aspirina , Usos Terapéuticos , Modelos Animales de Enfermedad , Heparina , Usos Terapéuticos , Lactatos , Usos Terapéuticos , Ratones Endogámicos ICR , Fosfatidilcolinas , Fosfatidilserinas , Placenta , Metabolismo , Preeclampsia , Distribución Aleatoria , Trombomodulina , MetabolismoRESUMEN
<p><b>OBJECTIVE</b>To screen and diagnose Down's syndrome during mid-term pregnancy to reduce the number of babies with Down's syndrome.</p><p><b>METHODS</b>With the multi-level of stratified cluster sampling, twenty thousand and eight hundred and three women at 15-20 weeks gestation were screened by maternal serum AFP and beta-hCG using the time resolved fluoroimmunoassay (TRFIA). Then the screened high-risk women were diagnosed by amniocentesis, cell culture and chromosome analyses. The born children were diagnosed by follow-up and peripheral blood chromosome analyses.</p><p><b>RESULTS</b>Six fetuses were diagnosed by serum screening and amniotic fluid chromosome analyses, and 3 born children were diagnosed by follow-up and peripheral blood chromosome analyses. Nine cases of Down's syndrome were detected in total, with the positive prenatal screen rate being 67% (6/9).</p><p><b>CONCLUSION</b>The prenatal screening and diagnosis can reduce the birth of Down's syndrome patients and improve the population quality. However, the diagnosis accuracy still needs to be improved to further reduce the false negative rate and prevent misdiagnosis.</p>