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Table of Contents
October-December 2017
Volume 1 | Issue 4
Page Nos. 189-249
Online since Wednesday, February 7, 2018
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ORIGINAL ARTICLES
Caulis sargentodoxae prescription inhibits angiogenesis-related cytokines in a rat endometriosis model
p. 189
Meng-Fei Zhuang, Yang Cao, Yan Shi, Lin Yu, Ya-Nan Niu, Ting-Ting Zhang, Zhao-Gui Sun
DOI
:10.4103/2096-2924.224911
Background:
To determine the efficacy of the Caulis Sargentodoxae prescription, which is an empirical formula of Chinese herbs and has definite curative effects on endometriosis.
Methods:
The Caulis Sargentodoxae prescription on the growth of ectopic endometria was studied with a rat endometriosis (EMS) model. The EMS model was established by autoplastic transplantation. To study the curative effects of Chinese medicine on EMS in comparison with western medicine, gestrinone and an angiogenesis inhibitor were introduced. The rats were randomly divided into seven groups: normal group, model group, ovariectomized group, gestrinone (western medicine) group, Caulis Sargentodoxae prescription (Chinese medicine) group, apatinib (inhibitor) group, and combination (Chinese medicine + inhibitor) group. After administration for 21 days, the growth inhibitory rates of ectopic endometria in the treatment groups were evaluated, and the levels of vascular endothelial growth factor (VEGF) and VEGF receptor-2 (VEGFR2) were detected by ELISA in the serum and peritoneal fluid, as well as in the ectopic endometrial tissues by real-time polymerase chain reaction and Western blotting.
Results:
The growth inhibitory rates of ectopic endometria in the treatment groups were significantly higher (
P
< 0.05). In the Caulis Sargentodoxae prescription group, the levels of angiogenesis-related factors, including VEGF and VEGFR2, were reduced in the serum and peritoneal fluid compared with the model group (
P
< 0.05). In addition, the positive expression of VEGF and VEGFR2 in ectopic endometria significantly decreased in the Caulis Sargentodoxae prescription group both at mRNA and protein levels.
Conclusions:
VEGF and VEGFR2 levels in the serum and peritoneal fluid can be used as a clinical reference for endometriotic pathogenesis and treatment, and the Caulis Sargentodoxae prescription has reliable therapeutic effects on EMS for its target-action ability to decrease angiogenesis.
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CCL2 enhances the viability of human chorionic trophoblast cell line HTR-8/SVneo Cells by inhibiting Interleukin-24 Expression
p. 198
Jun Shao, Yin-Yan He, Da-Jin Li, Ming-Qing Li
DOI
:10.4103/2096-2924.224918
Background:
To investigate the regulatory effect of interleukin-24 (IL-24) on cell viability of human chorionic trophoblast cell line (HTR-8/SVneo cells).
Methods:
Immunohistochemical staining was used to detect the expression of IL-24 and its receptors IL-20R1, IL-20R2, and IL-22R1 in villus tissue at early normal pregnancy. The effect of thymic stromal lymphopoietin (TSLP) and chemokine CCL2 on the expression of IL-24 in human chorionic trophoblast cell line HTR-8/SVneo cells was analyzed by In-cell Western. In addition, the effect of recombinant human IL-24 (rhIL-24) and CCL2 on the viability of HTR-8/SVneo cells was analyzed by MTT assay.
Results:
IL-24 and its receptors showed a strong positive staining in trophoblasts at early normal pregnancy. Compared with control group, expression of IL-24 in HTR-8/SVneo cells was significantly inhibited after
in vitro
stimulation of recombinant human CCL2 protein (rhCCL2) (
P
< 0.001). The viability of HTR-8/SVneo cells was significantly decreased after treatment with rhIL-24 (
P
< 0.001). In contrast, anti-IL-24 neutralizing antibody significantly enhanced the viability of HTR-8/SVneo cells (
P
< 0.01). In addition, rhCCL2 (100 μg/L); enhanced the viability of HTR-8/SVneo cells (
P
< 0.01)
in vitro
, but this effect was inhibited by treatment with rhIL-24.
Conclusions:
CCL2 enhances the viability of human trophoblast cell line HTR-8/SVneo cells
in vitro
by inhibiting the secretion of IL-24, which may be beneficial to blastocyst implantation and placental development.
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Analysis of factors influencing the cumulative pregnancy outcome of
In Vitro
fertilization-embryo transfer in women aged 35 years and older with normal ovarian reserve
p. 204
Meng Zhang, Tao Bu, Hai-Qing Tian, Xia Li, Xiao-Hui Wan, Xin-Min Mao, Qing-Li Wang, Xiao-Lin La
DOI
:10.4103/2096-2924.224913
Background:
To investigate the factors associating with the cumulative clinical pregnancy outcome of
in vitro
fertilization-embryo transfer (IVF-ET) in women aged 35 years and older with normal ovarian reserve.
Methods:
A total of 358 patients undergoing IVF-ET at the Department of Reproductive Medicine, the First Affiliated Hospital of Xinjiang Medical University between January 2014 and June 2016 were analyzed by the Kaplan–Meier method and Cox proportional hazards model.
Results:
The probability of pregnancy in women 35–37 years of age and 38–40 years of age was 75.9% (95% confidence interval [
CI
]: 75.1%–76.7%) and 66.9% (95%
CI
: 65.6%–68.2%), respectively, and it was 37.8% (95%
CI
: 34.7%–41.1%) in women aged 40 years and older. Univariate analysis (hazard ratio [
HR
]: 2.50, 95%
CI
: 1.647–3.774) and multivariate analysis (
HR
: 2.17, 95%
CI
: 1.427–3.268) showed a correlation between the number of retrieved oocytes and successful pregnancy.
Conclusions:
The number of retrieved oocytes plays a key role in the pregnancy outcome of women aged 35 years and older with normal ovarian reserve. We recommend the number of retrieved oocytes be increased for women aged 35 years and older with normal ovarian reserve.
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Effect of weight loss on
In Vitro
fertilization treatment outcome
p. 210
Jing-Yan Song, Shan Xiang, Zhen-Gao Sun
DOI
:10.4103/2096-2924.224915
Background:
To assess the effect of weight loss in overweight and/or obese women on the
in vitro
fertilization (IVF) treatment outcome before IVF cycles by a systematic review and meta-analysis of clinical trials.
Methods:
Systematic review and meta-analysis of randomized controlled trials (RCTs) and cohort studies were conducted. Systematic literature searches were conducted, and all randomized trials that evaluated the impact of weight loss in IVF treatment cycles were included in the study. Study selection, quality estimation, and data extractions were performed independently and in duplicate.
Results:
A total of 924 patients were enrolled in seven studies; the effects of weight loss on the IVF treatment outcome before the IVF treatment cycle were assessed. The clinical pregnancy rate (risk ratio [
RR
]: 1.61, 95% confidence interval [
CI
]: 1.15–2.27), miscarriage rate (
RR
: 0.56, 95%
CI
: 0.34–0.93), and live birth rate (
RR
: 1.86, 95%
CI
: 1.41–2.45) had a statistically significant difference between the intervention and control group. No significant differences were observed in the number of oocytes retrieved (weighted mean difference [WMD]: 0.84, 95%
CI
: −0.12–1.79), gonadotropin consumption (WMD: 2.59, 95%
CI
: −6.61–1.42), or the duration of stimulation (WMD: −0.46, 95%
CI
: −1.64–0.71).
Conclusions:
Before IVF treatment, obese and overweight women should lose weight by physical activity and/or dietary management because weight loss can improve pregnancy rate, reduce miscarriage rate, and meliorate live birth rate. At the same time, further prospective RCTs are required to establish which methods of weight loss are most suited to this purpose, as well as determining whether cut points for body mass index need to be recommended before accessing IVF.
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Induction of ovulation with clomiphene citrate combined with bromocriptine in polycystic ovary syndrome patients with infertility: A prospective, randomized, and controlled clinical trial
p. 216
Hai-Yun Guan, Wei Zhang, Bing-Qing Huang
DOI
:10.4103/2096-2924.224917
Background:
To investigate the therapeutic effects of bromocriptine (BCT) combined with clomiphene citrate (CC) in the induction of ovulation in polycystic ovary syndrome (PCOS) patients with infertility.
Methods:
A prospective, randomized, and controlled clinical trial was performed on 100 PCOS patients with infertility. Patients were randomly divided into two groups (
n
= 50), patients in control group were treated with 50 mg CC from day 3 to day 7 of the menstrual cycle, and those in observation group (CC + BCT) were given 50 mg of CC from day 3 to day 7 of the menstrual cycle along with 2.5 mg of BCT daily for the full cycle. Patients in both groups were treated for one cycle. Blood was extracted from patients on day 3 of the menstrual cycle, the day of human chorionic gonadotrophin (hCG) injection, and day 7 after hCG injection to measure serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E
2
), total testosterone (T) and progestin (P). Vaginal ultrasound was used to determine the thickness of endometrium and follicle size and count.
Results:
There was no significant difference in basal hormone levels between two groups. The success rate of ovulation induction in control group and observation group was 72.0% and 75.4%, respectively, no significant difference was found between two groups (
P
> 0.05). The ongoing pregnancy rate (18.4%) in observation group was significantly higher than that in control group (8.0%). On the day of hCG injection, no significant differences in the levels of FSH, E
2
, and P were found between two groups, while LH was lower, and levels of PRL and T were significantly lower in observation group than those in control group (all
P
= 0.00). On day 7 after hCG injection, no significant differences in the levels of E
2
and P were found between two groups, while PRL level was significantly lower in observation group than that in control group, and the endometrial thickness in observation group (10.20 ± 1.92 mm) was significantly higher than that in control group (9.22 ± 1.88 mm) (
P
= 0.01).
Conclusions:
Compared with the use of CC alone, BCT combined with CC can increase the success rate of ovulation induction-assisted pregnancy in PCOS patients, decrease the levels of PRL, LH, and T and increase the endometrial thickness in implantation window. Those data suggest that dopamine agonist BCT may reduce the pituitary hormone and androgen levels, reduce endometrial vascular resistance, and increase endometrial blood supply to improve the infertility outcomes of PCOS patients with infertility.
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Dysbiosis of gut microbiota contributes to chronic stress in endometriosis patients
via
activating inflammatory pathway
p. 221
Jing Xu, Ke Li, Lin Zhang, Qi-Yu Liu, Yun-Ke Huang, Yu Kang, Cong-Jian Xu
DOI
:10.4103/2096-2924.224916
Background:
Gut microbiota can interact with the central nervous system through the gut–brain axis, thus affecting the host's chronic stress level, such as anxiety and depression. Current researches show that patients with endometriosis often have a high level of chronic stress, which will in turn aggravate endometriosis by activating the β-adrenergic signaling pathway. Therefore, we wondered whether the gut microbiota associates with the chronic stress level in endometriosis patients, which may provide new insights on how to improve treatment.
Methods:
We grouped the endometriosis patients into the chronic stress group and the control group with questionnaires such as generalized anxiety disorder-7 and patient health questionnaire-9 and collected patients' fecal specimens and tissue specimens. Gut microbiota compositions were analyzed by the 16SrRNA gene sequencing-based method, and immunohistochemistry was performed to detect the activation of inflammatory pathways in endometriosis tissues.
Results:
We found that in patients with endometriosis, the dysbiosis of gut microbiota was associated with their stress levels. Furthermore, the levels of
Paraprevotella
,
Odoribacter
,
Veillonella
, and
Ruminococcus
were significantly reduced in chronic stressed endometriosis patients, suggestive of a disease-specific change of gut microbiota at the genus level. Compared to the healthy women, the expression levels of inflammatory cytokines, nuclear factor-κB p65, and cyclooxygenase-2 increased in the chronic stressed endometriosis patients, indicating that the dysbiosis of gut microbiota may activate the inflammatory pathway of gut–brain axis.
Conclusions:
We hypothesized that these new disease-specific changes of gut microbiota in chronic stressed patients with endometriosis may be a new examination target of chronic stress level. These changes may also provide new insights for psychological intervention, thus reducing the stress level and improving the prognosis of endometriosis patients.
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The influence of sperm DNA damage and semen homocysteine on male infertility
p. 228
Kang-Sheng Liu, Feng Pan, Ya-Jun Chen, Xiao-Dong Mao
DOI
:10.4103/2096-2924.224910
Background:
To explore the relationship of sperm DNA fragmentation index (DFI) , serum and seminal plasma homocysteine (Hcy), and semen parameters in patients with severe spermatogenetic dysfunction.
Methods:
A total of 77 infertile males treated in our hospital for severe spermatogenetic dysfunction from January 2016 to November 2017 were recruited. The involved patients were divided into two groups: oligozoospermia (SOM group, 35 cases) and asthenozoospermia (OAT group, 42 cases). The control group (NM group) contained 31 healthy males without reproductive dysfunctions. All the participants involved were tested in the items below: spermatozoa parameters, spermatozoa DFI, serum Hcy level and seminal plasma Hcy level, concentration of seminal plasma malondialdehyde (MDA), and total antioxidant capacity (TAC).
Results:
Between the SOM group and NM group, there were significantly difference in sperm concentration, motility and vitality, concentration of MDA, and TAC. The spermatozoa DFI and Hcy levels in SOM group were significantly higher than those of the NM group. Sperm DFI was positively correlated with serum Hcy level (
r
= 0.083,
P
< 0.05). Serum Hcy level was negatively correlated with sperm concentration (
r
= −0.186,
P
< 0.05) and sperm vitality (
r
= −0.216,
P
< 0.05). The serum Hcy level was not correlated with sperm Hcy level (
r
= 0.103,
P
> 0.05).
Conclusions:
The elevated Hcy level and spermatozoa DFI may be important factors of the severe spermatogenetic dysfunction, which can be used as semen index to evaluate sperm quality and male fertility.
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Effects of cryopreservation on human sperm glycocalyx
p. 233
Yan-Cheng Wu, Ai-Jie Xin, Hui Lu, Hua Diao, Li Cheng, Yi-Hua Gu, Bin Wu, Sheng-Ce Tao, Zheng Li, Hui-Juan Shi, Yong-Lian Zhang
DOI
:10.4103/2096-2924.224914
Background:
To study the effects of cryopreservation on human sperm glycocalyx.
Methods:
The lectin binding profilings of sperm after freeze-thaw were compared by lectin microarray.
Results:
CryoSperm™ and direct fumigation were confirmed to be the optimized cryoprotectant and method by comparing the sperm recovery rate. In 91 lectins, 33 lectins were significantly changed after sperm cryopreservation. Among them, 9 lectins greatly decreased and 24 lectins mainly increased. The binding signals of MAA, PSA, ABA, and AIA were verified by FACS, and the results were consistent with that of lectin microarray.
Conclusions:
Sperm glycocalyx had significant changes after cryopreservation. The sialic acid, playing an important role in protecting sperm, was greatly lost, which exposed the inner carbohydrates. Thus, the glycocalyx damage due to the cryopreservation might be one of the reasons for low sperm fertility.
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REVIEW ARTICLE
Recent progress in identifying genetic and epigenetic contributions to epilepsy
p. 239
Zi-Ying Hu, Hong-Yan Wang, Yi Wang
DOI
:10.4103/2096-2924.224912
Epilepsy is a serious disorder of the central nervous system characterized by recurrent seizures. There are many known causes of epilepsy, including genetic factors, brain damage, and environmental factors, but the pathogenic mechanisms are largely unknown. Numerous factors, including genetic mutations, brain damage, and environmental insults, have been implicated in the etiology of epilepsy, but the cause for individual epilepsy patients is often unknown. Research on inherited forms of epilepsy has identified mutations in genes encoding ion channels or neurotransmitter receptors. Family-based studies of inherited forms of epilepsy have previously identified mutations in genes encoding ion channels and neurotransmitter receptors. With a deepening understanding of the underlying cellular pathways, researchers have identified epilepsy candidate genes that function in synaptic vesicle trafficking, chromatin remodeling, transcription, and mammalian target of rapamycin (mTOR) signaling. More recently, genes involved in synaptic vesicle transport, chromatin remodeling, and transcription, as well as the mTOR signaling pathway, have also been implicated in inherited forms of the disorder. In addition, recent advances in DNA sequencing and genomic technologies have identified chromosomal copy number variants and epigenetic modifications as possible contributing factors in inherited epilepsy. In this review, we focus on the established and potential contributions of genes, chromosomal abnormalities, and epigenetic modifications to the development of epilepsy.
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