Background: Although umbilical cord mesenchymal stem cell (UCMSC) infusion has been proposed as a promising strategy for the treatment of acute lung injury (ALI), the parameters of UCMSC transplantation, such as infusion routes and doses, need to be further optimized. Methods: In this study, we compared the therapeutic effects of UCMSCs transplanted via intravenous injection and intratracheal instillation on lipopolysaccharide-induced ALI using a rat model. Following transplantation, levels of inflammatory factors in serum; neutrophils, total white blood cells, and lymphocytes in bronchoalveolar lavage fluid (BALF); and lung damage levels were analyzed. Results: The results indicated that UCMSCs administered via both intravenous and intratracheal routes were effective in alleviating ALI, as determined by analyses of arterial blood gas, lung histopathology, BALF contents, and levels of inflammatory factors. Comparatively, the intratracheal instillation of UCMSCs was found to result in lower levels of lymphocytes and total proteins in BALF, whereas greater reductions in the serum levels of tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β) were detected in rats receiving intravenously injected stem cells. Conclusions: Our findings in this study provide convincing evidence to indicate the efficacy of UCMSC therapy in the treatment of ALI mediated via different delivery routes, thereby providing a reliable theoretical basis for further clinical studies. Moreover, these findings imply that the effects obtained using the two assessed delivery routes for UCMSC transplantation are mediated via different mechanisms, which could be attributable to different cellular or molecular targets.

Ethnopharmacological relevance: Marveled at the discovery of artemisinin, the world's expectations for traditional Chinese medicine are rising. He's Yangchao formula (HSYC) is a traditional Chinese herbal formula with the effects of tonifying kidney and essence, and reconciling yin and yang. It has been clinically proven to have antiovarian aging effects. Age is the primary cause of diminished ovarian reserve and assisted reproductive failure in women, whether HSYC has the potential to improve in vitro maturation of oocytes from advanced maternal age (AMA) mice has yet to be determined.Aim of the study: This study aims to evaluate the efficacy and possible mechanism of HSYC in promoting in vitro maturation of oocytes from AMA mice.Materials and methods: The GV oocytes were obtained from young and aged mice. The GV oocytes from young mice were cultured in drops of M16 medium, and the GV oocytes from AMA mice were randomly divided four groups: Vehicle group (cultured in 90% M16 medium +10% blank serum), Low HSYC group (cultured in 90% M16 medium + 10% Low HSYC-medicated serum), High-HSYC group (cultured in 90% M16 medium +10% High HSYC-medicated serum), and Quercetin group (cultured in M16 medium supplemented with 10 & mu;M quercetin). The rates of first polar body extrusion, reactive oxygen species (ROS), intracellular calcium, and mitochondrial membrane potential levels in each groups were observed. In addition, expression levels of mitochondrial function, autophagy, DNA damage, and antioxidant-related proteins were assessed. Results: Supplementation of HSYC in vitro alleviated age-associated meiotic progression defects in maternally aged oocytes. Importantly, HSYC supplementation eliminated the age-related ROS accumulation to suppress DNA damage and autophagy during the in vitro maturation of maternally aged oocytes. Meanwhile, the mitochondrial function was improved after HSYC treatment, as manifested by higher mitochondrial membrane potential and lower Ca2+ levels. Furthermore, we found that HSYC supplementation during in vitro maturation of maternally aged oocytes upregulated the expression level of SIRT3, a crucial protein in regulating mitochondrial function. Consistently, the expression levels of the SOD2, PCG1 & alpha;, and TFAM were increased, while the SOD2 acetylation level was decreased, which further proved its antioxidant function. Conclusions: HSYC supplementation promotes in vitro maturation of oocytes from AMA mice mainly via improving mitochondrial function and alleviating oxidative stress. The mechanism may be related to the regulation of SIRT3-dependent deacetylation of the SOD2 pathway.

Objective This study aimed to explore the perceptions of women who have undergone unsuccessful in vitro fertilization (IVF) in Hangzhou, Zhejiang Province, China, and to explore how treatment failure has impacted their lives and relationships, thereby enabling the public to understand the unique experiences of these women. Design A descriptive qualitative approach was employed, with purposive sampling used to recruit participants from the gynecological department of a traditional Chinese medicine clinic at a large tertiary hospital in Zhejiang province. Twelve women undergoing IVF treatment was involved in the study. Data were collected through face-to-face semi-structured interviews, which were transcribed verbatim. Conventional content analysis methods were used to analyze the data. Results Following analysis, three main categories emerged: 1) The Psychological Experience of Initial Miscarriage from IVF Treatment, 2) The Psychological Experience of Repeated Treatment Failure, and 3) Interpersonal experiences and challenges. Women experiencing initial failure from IVF treatment reported emotions such as surprise, doubt, sadness, disappointment, and embarrassment. They perceived the process as harder than expected, leading to unexpected daily life challenges and difficulties in achieving success. As unsuccessful attempts persisted, they endured psychological suffering and lived in the shadow of repeated treatment failures. Doubts, perplexity, and anxiety grew, making reproduction seem like an insurmountable obstacle in their lives. In their interpersonal experience, women often felt guilt toward family, faced social isolation, and found it challenging to discuss IVF openly everywhere. They encountered a lack of understanding from others but also found mutual sympathy and support among people who shared similar experiences. Conclusions The study provided an insight into the suffering of Chinese women undergoing IVF treatment, highlighting the challenges of overcoming treatment failures. The findings not only inform Chinese infertile women considering IVF treatment but also contribute to the development of more effective support services by healthcare providers.

[目的]研究加味五子衍宗方(Jiawei Wuzi Yanzong Prescription,JWYP)凝胶制剂对少弱精子症小鼠睾丸生精细胞和支持细胞损害的修复作用,探讨JWYP凝胶制剂经皮渗透贴敷的疗效及其作用机制.[方法]将JWYP超细粉碎微粒与凝胶均匀混合,配制成凝胶贴敷制剂.24只雄性BALB/c小鼠随机分为经皮渗透组、灌胃染毒组、贴敷治疗组和对照组,经皮渗透组以荧光素钠(fluorescein sodium,FS)作为荧光染色剂,均匀混合标记JWYP凝胶制剂并贴敷于小鼠腹壁,扩散4～8 h后荧光显微镜观察其活体荧光成像;灌胃染毒组采用邻苯二甲酸(2-乙基己基)酯[di-(2-ethylhexyl)phthalate,DEHP]灌胃染毒法建立小鼠少弱精子症模型,将DEHP溶于食用大豆油并以20 mg/(kg·d)的剂量连续灌胃30 d染毒;贴敷治疗组将配制好的JWYP凝胶制剂贴敷于小鼠腹壁,每周5 d贴敷给药,连续4周,贴敷给药期间同步予以DEHP连续灌胃染毒;对照组小鼠同期以标准饲料添加食用大豆油同步喂养.检测各组小鼠睾丸的湿重和体积,采用光镜和透射电镜观察各组小鼠睾丸细胞的组织学形态结构,并同步检测小鼠睾丸细胞线粒体呼吸链复合物(mitochondrial respiratory chain complex,MRC)活性.[结果]经皮渗透组小鼠腹壁皮下及腹膜腔内均显示有较强的荧光分布.与对照组比较,灌胃染毒组小鼠睾丸湿重和体积差异无统计学意义(P>0.05),贴敷治疗组小鼠睾丸湿重差异无统计学意义(P>0.05),睾丸体积明显增大(P<0.05).光镜和透射电镜观察显示,与对照组比较,灌胃染毒组小鼠睾丸生精细胞层形态结构基本正常,但细胞排列松散,管腔内无成熟精子生成,生精细胞空泡样变性退化,支持细胞的胞质内可见凋亡小体样结构;贴敷治疗组小鼠睾丸生精细胞层形态结构正常,支持细胞细胞排列密集,管腔内可见成熟精子,胞质内富含线粒体、溶酶体等细胞器.灌胃染毒组小鼠睾丸细胞MRC-Ⅰ、Ⅲ、Ⅳ的活性检测值明显低于对照组(P<0.05),贴敷治疗组小鼠睾丸细胞MRC-Ⅲ、Ⅳ的活性检测值明显高于灌胃染毒组(P<0.05).[结论]JWYP凝胶制剂可通过贴敷给药的方式经皮渗透至小鼠皮下组织和腹腔,对DEHP连续灌胃染毒所致少弱精子症小鼠的睾丸损害具有治疗效果,其作用机制可能与增加细胞内线粒体和溶酶体等细胞器的数量,提高MRC活性,进而促进小鼠睾丸生精细胞和支持细胞的增殖再生有关.

Endometrial cancer is the most common gynecological malignancy, affecting up to 3% of women at some point during their lifetime (Morice et al., 2016; Li and Wang, 2021). Based on the pathogenesis and biological behavioral characteristics, endometrial cancer can be divided into estrogen-dependent (I) and non-estrogen-dependent (II) types (Ulrich, 2011). Type I accounts for approximately 80% of cases, of which the majority are endometrioid carcinomas, and the remaining are mucinous adenocarcinomas (Setiawan et al., 2013). It is generally recognized that long-term stimulation by high estrogen levels with the lack of progesterone antagonism is the most important risk factor; meanwhile, there is no definite conclusion on the specific pathogenesis. The incidence of endometrial cancer has been on the rise during the past two decades (Constantine et al., 2019; Gao et al., 2022; Luo et al., 2022). Moreover, the development of assisted reproductive technology and antiprogestin therapy following breast cancer surgery has elevated the risk of developing type I endometrial cancer to a certain extent (Vassard et al., 2019). Therefore, investigating the influence of estrogen in type I endometrial cancer may provide novel concepts for risk assessment and adjuvant therapy, and at the same time, provide a basis for research on new drugs to treat endometrial cancer.

仲景学说来源于东汉末年张仲景所著的《伤寒杂病论》,是中医基础理论与临床实践紧密结合的产物,根据疾病发生、发展及转归的整体过程,在辨证论治理论指导下的各种调养方法,包括未病先护、辨证施护、用药调护、饮食护理及病后调护五个部分[1,2].

目的 观察辨证取穴择时耳穴压豆治疗胎动不安病不寐症患者的疗效及安全性.方法 将70例胎动不安患者随机分为对照组和治疗组,各35例,对照组采用在中药处方中另加15 g酸枣仁,治疗组在此基础上辨证取穴耳穴压豆并择时按压耳穴,干预前后用匹兹堡睡眠质量指数(PSQI)量表和中医症候积分量表评分,2个疗程后评估疗效,待患者孕12周时随访,调查胚胎存活情况.结果 干预后,两组PSQI评分各单项积分、总分及中医症候积分较前均有明显下降,且治疗组低于对照组,差异有统计学意义(P<0.05);对照组孕12周继续妊娠25例(71.4％),治疗组孕12周继续妊娠27例(77.1％);两组患者孕12周继续妊娠率比较,差异无统计学意义(P>0.05);对照组痊愈7例,显效9例,有效13例,无效6例,总有效率82.8％(29/35),治疗组痊愈12例,显效15例,有效5例,无效3例,总有效率91.5％(32/35),治疗组疗效明显优于对照组(P<0.05).结论 采用辨证取穴择时耳穴压豆治疗胎动不安病不寐症可改善胎动不安的临床症状并提高患者睡眠质量,疗效显著,安全性高.

体外受精-胚胎移植技术在为不孕不育患者带来受孕希望的同时,仍有15％～20％的患者因子宫内膜过薄等原因导致反复移植失败[1].笔者根据月经周期不同阶段脏腑盛衰、气血阴阳消长的变化规律,借鉴顺应女子血海盈亏有期和"肾主生殖"的周期疗法,对薄型子宫内膜反复体外受精-胚胎移植失败的患者在传统中西医结合治疗的基础上采用火龙灸序贯疗法辅助治疗,探讨其通过补肾活血改善子宫内膜厚度和血流动力学的作用.

目的 探讨基于调周理论的火龙灸对寒湿凝滞型痛经患者的中医护理效果,分析其最佳介入时机.方法 采用便利抽样法,选取2020年1月—2022年6月在杭州市某三级甲等中医院妇科门诊就诊的寒湿凝滞型痛经患者作为研究对象.利用双因素两水平的析因设计,采用SPSS 25.0统计学软件生成随机数字表进行随机分组,共4组,每组30例.对照组(A1B1组)采用常规护理,试验组1(A2B1组)于排卵后第8、11天行火龙灸,试验组2(A1B2组)于行经期第1、4天行火龙灸,试验组3(A2B2组)于排卵后第8、11天及行经期第1、4天均行火龙灸.以1个月经周期为1个疗程,共3个疗程.比较4组干预前、干预后患者痛经症状评分、疼痛视觉模拟量表(Visual Analog Scale,VAS)评分的差异.结果 经单因素方差分析显示,干预后,4组痛经VAS评分、痛经症状评分比较,差异均具有统计学意义(F=7.798,P＜0.001;F= 9.859,P＜0.001).经LSD事后多重比较显示,试验组3与试验组2及对照组的痛经VAS评分、痛经症状评分比较,差异具有统计学意义(P＜0.05);试验组3与试验组1的痛经症状评分比较,差异具有统计学意义(P＜0.05);经析因分析,经前期、行经期行火龙灸对痛经VAS评分、痛经症状评分的主效应均显著(P＜0.05),但经前期与行经期行火龙灸技术对痛经VAS评分、痛经症状评分无交互作用(P＞0.05).结论 基于调周理论的火龙灸能有效改善寒湿凝滞型痛经患者的痛经症状,缓解患者疼痛,且经前期为最佳介入时间.

目的:分析多元化中医辨证管理方案在提升中医妇科护理管理质量中的作用.方法:医院中医妇科自2021年7月起对患者实施多元化中医辨证管理方案,2021年1-6月为实施前,2021年7-12月为实施后,实施前后各随机选择40例患者为研究对象,研究期间护理人员共16名,比较实施前后的管理效果.结果:实施后护理人员的业务技术水平、护理管理质量评分、患者护理总满意率等,均显著高于实施前(P＜0.05).实施后不良事件发生率与护患纠纷发生率等,均显著低于实施前(P＜0.05).结论:多元化中医辨证管理方案有利于提升中医妇科的护理管理质量,可起到显著性应用价值,能够提高护理人员业务技术水平,改善护理管理质量,且可以降低患者不良事件发生率与护患纠纷发生率,患者对于该种模式较满意,具有显著的应用效果.

随着我国不孕症人口数量的攀升,越来越多的夫妇将生育的希望转向体外受精-胚胎移植术(in vitro fertilization-embryo transfer,IVF-ET).IVF-ET术给不孕症妇女带来了最后的希望,然而通过这种方法生育是一条漫长而曲折的道路,从取卵到移植再到受孕,她们不仅要经历着大量药物、检查、手术等对身体的影响,还要承受着治疗结局的不确定性所带来的心理压力[1].研究报道IVF-ET的受孕成功率为20％～50％,活产率仅为19.8％～22.1％[2].可见其中的高自然流产率.自然流产给IVF-ET妊娠妇女带来了一系列的不良心理反应,如愤怒、自责、社交隔离等,增加了罹患心理疾病的风险[3],影响了不孕症夫妇的婚姻和生活质量[4],因此有必要对IVF-ET妊娠后流产的妇女深入探讨,了解她们的内心体验,不良情绪的产生,影响以及调适策略.故本次研究采用描述性质性研究方法探讨IVF-ET妊娠流产后妇女的心理体验,旨在了解流产事件给移植妇女带来的心理感受、影响以及调适方法.

黄体酮相关性硬结是接受黄体酮注射患者最常见的并发症,其形成不仅会影响舒适度及形象,还会影响药物的吸收,甚至中断治疗方案.既往相关研究多聚焦于防治措施[1]的探索、注射方法的改进[2],但临床实践发现其发生率仍处于较高水平.本次研究旨在分析黄体酮相关性硬结形成的影响因素.现报道如下.

目的:探讨中药热奄包对体外受精-胚胎移植术(IVF-ET)后患者黄体酮相关性硬结的预防作用.方法:采用便利抽样法,选取2020年7月至2021年1月在杭州市某三级甲等医院妇科住院的行IVF-ET患者作为研究对象,按1:1的比例随机分为观察组、对照组,每组31例(62个臀部).两组均采用常规护理,观察组在对照组的基础上在注射后4h采用中药热奄包外敷,每天1次,每次30min,共14d.在入院时、入组第7d、入组第14d时观察研究对象臀部硬结发生率、臀部疼痛视觉模拟评分(VAS).结果:与对照组相比,观察组在干预7d、干预14d时黄体酮针剂相关性硬结发生率较低,组间比较均有统计学意义(P<0.05);与对照组相比,观察组干预14d的疼痛评分较低,组间比较有统计学意义(P<0.05).结论:中药热奄包外敷能有效降低黄体酮针剂相关性硬结的发生率及疼痛程度,且安全可行.

当前,集群企业知识学习是理论和实务界共同关注的热点议题,但现有文献较少从超网络嵌入视角对这一议题进行实证研究.选取软件集群企业为调研对象,实证研究超网络嵌入、边界拓展与知识学习绩效三者间的关联,结果表明:组织边界拓展和知识边界拓展对于知识学习绩效具有正向影响,并且知识边界拓展的影响更为显著.此外,验证了边界拓展在超网络嵌入与知识学习绩效之间的部分中介效应,丰富了知识管理理论,并对知识学习实践具有指导价值.

BACKGROUND: Escaping cell death pathways is an important event during carcinogenesis. We previously identified anti-TNFα-induced apoptosis (ATIA, also known as vasorin) as an antiapoptotic factor that suppresses reactive oxygen species (ROS) production. However, the role of vasorin in lung carcinogenesis has not been investigated. METHODS: Vasorin expression was examined in human lung cancer tissues with immunohistochemistry and database analysis. Genetic and pharmacological approaches were used to manipulate protein expression and autophagy activity in human bronchial epithelial cells (HBECs). ROS generation was measured with fluorescent indicator, apoptosis with release of lactate dehydrogenase, and cell transformation was assessed with colony formation in soft agar. RESULTS: Vasorin expression was increased in human lung cancer tissues and cell lines, which was inversely associated with lung cancer patient survival. Cigarette smoke extract (CSE) and benzo[a]pyrene diol epoxide (BPDE)–induced vasorin expression in HBECs. Vasorin knockdown in HBECs significantly suppressed CSE-induced transformation in association with enhanced ROS accumulation and autophagy. Scavenging ROS attenuated autophagy and cytotoxicity in vasorin knockdown cells, suggesting that vasorin potentiates transformation by impeding ROS-mediated CSE cytotoxicity and improving survival of the premalignant cells. Suppression of autophagy effectively inhibited CSE-induced apoptosis, suggesting that autophagy was pro-apoptotic in CSE-treated cells. Importantly, blocking autophagy strongly potentiated CSE-induced transformation. CONCLUSION: These results suggest that vasorin is a potential lung cancer–promoting factor that facilitates cigarette smoke–induced bronchial epithelial cell transformation by suppressing autophagy-mediated apoptosis, which could be exploited for lung cancer prevention.

Understanding the mechanisms for cellular aging is a fundamental question in biology. Normal red blood cells (RBCs) survive for approximately 100 days, and their survival is likely limited by functional decline secondary to cumulative damage to cell constituents, which may be reflected in altered metabolic capabilities. To investigate metabolic changes during in vivo RBC aging, labeled cell populations were purified at intervals and assessed for abundance of metabolic intermediates using mass spectrometry. A total of 167 metabolites were profiled and quantified from cell populations of defined ages. Older RBCs maintained ATP and redox charge states at the cost of altered activity of enzymatic pathways. Time-dependent changes were identified in metabolites related to maintenance of the redox state and membrane structure. These findings illuminate the differential metabolic pathway usage associated with normal cellular aging and identify potential biomarkers to determine average RBC age and rates of RBC turnover from a single blood sample.

INTRODUCTION: The efficacy of chemotherapeutic agents in killing cancer cells is mainly attributed to the induction of apoptosis. However, the tremendous efforts on enhancing apoptosis-related mechanisms have only moderately improved lung cancer chemotherapy, suggesting that other cell death mechanisms such as necroptosis could be involved. In this study, we investigated the role of the necroptosis pathway in the responsiveness of nonsmall cell lung cancer (NSCLC) to chemotherapy. METHODS: In vitro cell culture and in vivo xenograft tumor therapy models and clinical sample studies are combined in studying the role of necroptosis in chemotherapy and mechanism of necroptosis suppression involving RIP3 expression regulation. RESULTS: While chemotherapeutic drugs were able to induce necroptotic cell death, this pathway was suppressed in lung cancer cells at least partly through downregulation of RIP3 expression. Ectopic RIP3 expression significantly sensitized lung cancer cells to the cytotoxicity of anticancer drugs such as cisplatin, etoposide, vincristine, and adriamycin. In addition, RIP3 suppression was associated with RIP3 promoter methylation, and demethylation partly restored RIP3 expression and increased chemotherapeutic-induced necroptotic cell death. In a xenograft tumor therapy model, ectopic RIP3 expression significantly sensitized anticancer activity of cisplatin in vivo. Furthermore, lower RIP3 expression was associated with worse chemotherapy response in NSCLC Patients. CONCLUSION: Our results indicate that the necroptosis pathway is suppressed in lung cancer through RIP3 promoter methylation, and reactivating this pathway should be exploited for improving lung cancer chemotherapy.

由于生活环境及社会环境等各方面影响下很多的患者求子之路异常艰辛,患者的孕育来之不易使得其在各个方面都异常紧张、焦虑,对于存在胎动不安等情况的患者迫切需要入院接受治疗,因此护士需要主动对患者进行心理生理护理,让患者了解疾病相关知识、并告知其疾病相关知识以及相关注意事项以调整患者焦虑心态才能有效提高孕妇的保胎效果[1].随着应用程序(APP)平台的普及,通过在APP平台上推送大量的健康知识包括入院相关宣教、 疾病相关知识、饮食指导、相关药物的作用疗效等以及患者出院后的相关指导,可以帮助患者更好地了解疾病的各个方面(包括治疗的情况以及生活起居等相关注意事项)[2]. 本文选择2017年6月至2018年6月在我院妇科进行保胎的孕妇100例作为研究对象, 分析将APP平台应用于入院患者的健康宣教当中,获得良好的效果,现报告如下.

目的:分析中医特色护理质量评价体系在中医妇科护理管理中的应用效果.方法:医院中医妇科于2017年1月起构建和实施中医特色护理质量评价体系,并对中医特色护理质量评价体系应用于护理服务前后的结果进行分析.结果:实施中医特色护理质量评价体系后,护士的中医护理工作各项考核评价得分,均显著高于实施前(P＜0.05).结论:将中医特色护理质量评价体系应用于中医妇科质量管理,贯彻了全新的中医护理质量管理理念,加快了中医护理临床专科建设,使护理质量有了质的飞跃.

目的:分析育龄女性避孕节育现状及其影响因素.方法:选取杭州市中医院、省妇幼保健医院、邵逸夫医院2018年5月-2019年5月就诊的581名育龄女性进行避孕节育问卷调查,并分析影响因素.结果:581名育龄女性的避孕节育知识得分为8.4±3.1分,高中以上学历、接受过避孕节育宣教、妊娠≥2次、丈夫避孕态度积极的被调查女性避孕节育知识得分较高(P＜0.05),女性节育方式主要为避孕套210例(36.1％)、宫内节育器169例(29.1％)、口服避孕药96例(16.5％)、输卵管结扎56例(9.6％)、输精管结扎7例(1.2％)、避孕针剂12例(2.1％),未采取任何措施31例(5.3％).避孕知识低水平者选择避孕套及未采取避孕措施比例最高.结论:本次调查的育龄女性避孕节育水平处于中等水平,应加强对育龄女性避孕节育知识的宣传教育,同时加强对丈夫避孕知识的宣教,促进避孕措施的落实,降低非意愿妊娠的发生.