To explore the material basis and network mechanism of the Guizhi Fuling pills in the treatment of endometriosis and endometrial polyps based on network pharmacology and machine learning. The effective constituents and targets of the Guizhi Fuling pills were obtained based on the TCMSP and SymMAP databases. Endometrial polyps disease genes were retrieved by GenCards and OMIM databases. The active component-common disease target was obtained using Venn Diagram, which was uploaded to the STRING database and Cytoscape software to construct the protein interaction network and analyze its molecular biological mechanism. Random walk with restart was run on the compound network and protein-protein interaction network to detect core compounds, targets, and the stability of the relapse network. Then, the biological function and pathway enrichment analysis of the core targets were carried out with the help of the DAVID database, and the key targets of the pathway were further obtained. Finally, molecular docking verification was conducted. A total of 30 disease targets were obtained. According to gene ontology analysis, the treatment of endometriosis and endometrial polyps with Guizhi Fuling pills mainly focused on biological processes such as rhythm process, mechanical stimulation response, DNA binding regulation, and other biological processes. The signaling pathways are mainly concentrated in apoptosis, TNF signaling pathway, IL-17 signaling pathway, toll-like receptor signaling pathway, VEGF signaling pathway, estrogen signaling pathway, nuclear factor-kappa B signaling pathway, hepatitis signaling pathway, etc. Then, the 10 effective components and 10 target proteins were further verified by molecular docking. The results showed that β-sitosterol, luteolin, and quercetin were the most closely connected with the target NR3C1 and MMP9, respectively, which may be the key compounds and core target proteins in the "different diseases and the same treatment" of the Guizhi Fuling pills. The mechanisms of its comorbidity mainly involved estrogen, tumor, inflammation, immune response, and other signaling pathways, and were closely related to several biological processes. It can provide research direction for further research on the mechanism of "treating different diseases with the same treatment" of the Guizhi Fuling pills.

To analyze and evaluate the correlation between different lipid metabolism levels and endometriosis. The literatures on lipid metabolism and endometriosis published in databases were searched and collected. The search was conducted up to December 2023. The meta-analysis was conducted using Review Manager 5.4.1 software, with odds ratios (ORs) or standardized mean difference (SMD), confidence intervals (CIs), and heterogeneity (I2) being calculated. The literature bias was evaluated by drawing funnel plot. Five hundred and eighty-four literatures were retrieved, and finally, 7 literatures were included in this study. Meta-analysis showed that the level of total cholesterol (TC) in endometriosis groups was higher than control group [SMD = 1.70, 95%CI (0.60-2.80), p = 0.003], while triglyceride (TG) [SMD=-0.24, 95%CI (-0.68-0.21), p = 0.300], low-density lipoprotein (LDL) [SMD = 0.22, 95%CI (-0.34 - 0.78), p = 0.440] and high-density lipoprotein (HDL) [SMD = 0.06, 95%CI (-0.14 - 0.25), p = 0.550] was not statistically significant. Sensitivity analysis indicated that the combined effect size results were stable and reliable [SMD = 1.70, 95%CI (0.60-2.80), p = 0.030]. Funnel plot results showed publication bias. Patients with endometriosis have abnormal blood lipid level, and higher TC level may be a risk factor for endometriosis. The impact of blood lipid metabolism on endometriosis may provide new insights into the pathogenesis and treatment prognosis of endometriosis.

INTRODUCTION:The human papillomavirus (HPV) vaccine is crucial in preventing cervical cancer, and a significant number of women in 135 countries worldwide may have unknowingly received the vaccine during peri-pregnancy or pregnancy due to a lack of regular pregnancy testing. Previous studies on the safety of pregnancy outcomes with vaccination before and after pregnancy have not reached definitive conclusions. Thus, we subdivided the vaccination time frame and conducted an updated study to further examine whether exposure to the HPV vaccine during pregnancy or the periconceptional period increases the likelihood of adverse pregnancy outcomes. MATERIAL AND METHODS:The clinical trials and cohort studies published before August 1, 2023, were retrieved from PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials. The Newcastle-Ottawa Scale and Cochrane risk of bias assessment tool were adopted to evaluate the risk of bias in the included studies. In addition, the quality assessment was carried out using the Review Manager 5.4 Software, and a meta-analysis was conducted using the Stata 16 Software. RESULTS:Eleven studies were located. The results showed that receiving 4vHPV during the periconceptional or gestational period had no relationship with an increased risk of spontaneous abortion, stillbirth, preterm birth, birth defects, small for gestational age, and ectopic pregnancy. Neither receiving 2vHPV nor 9vHPV was associated with a higher risk of stillbirth, preterm birth, birth defects, small for gestational age, and ectopic pregnancy; however, receiving 2vHPV during the period from 45 days before last menstrual period (LMP) to LMP and 9vHPV during the period from 90 days before LMP to 45 days after LMP seemed to be related to an increased risk of spontaneous abortion (RR = 1.59, 95% CI: 1.04-2.45, RR = 2.04, 95% CI: 1.28-3.24). CONCLUSIONS:In conclusion, the likelihood of an elevated risk of spontaneous abortion caused by HPV vaccination during the periconceptional or gestational period could not be completely ruled out. Given the lack of evidence, further research is needed to examine the effect of HPV vaccination on spontaneous abortion.

Purpose To explore the possible pharmacological mechanisms of Danbai Granules (DBG) against sequelae of pelvic inflammatory disease (SPID) by the method of network pharmacology and molecular docking combined with experimental validation. Methods Firstly, biologically active compounds, targets of DBG, and related targets of SPID were collected from public databases. The protein– protein interaction (PPI) network, Gene GO and KEGG enrichment analysis were carried out via R language to find the potential biological processes and pathways of DBG against SPID. Subsequently, molecular docking was used to calculate the affinity between the top six targets and the top ten compounds, respectively. Finally, the above analysis results were verified by in vivo experiments. Results A total of 106 crossover genes were selected from 220 potential medicine genes and 952 SPID-related genes. PPI network analysis indicated that IL-6, IL-1β, VEGFA, CASP3, PTGS2, JUN, etc., were core targets. GO and KEGG enrichment analysis revealed that PI3K-Akt, AGE–RAGE, IL-17, TNF, HIF-1 and Toll-like receptors signaling pathways were the main signaling pathways. Molecular docking showed that 15 pairs of target-ingredient combinations have good binding activity. The animal experiments showed that DBG administration inhibited the expression of TLR4/MyD88/NF-κB p65 signaling pathway-related proteins expression, altered the high expression of IL-6, IL-1β, and low level of IL-4, IL-10, thereby relieving the pelvic inflammation of SPID. Conclusion Through the network pharmacology and molecular docking, our findings predicted the active ingredients and potential targets of DBG in treating SPID. The experimental verification preliminarily revealed that DBG may inhibit the inflammatory response of SPID rats by regulating the TLR4/MyD88/NF-κB p65 signaling pathway. which provides a theoretical basis for the study of the pharmacodynamic material basis and mechanism of DBG against SPID at the comprehensive level.

Vulva lichenoid diseases belong to the categories of "vulva pruritus" and "vulva erosion" in traditional Chinese medicine， mainly manifested as chronic vulva pruritus or even pain， patients are often accompanied by abnormal psychological states，such as anxiety and depression. There is a vicious cycle between pruritus， scratching and pressure， which is a typical physical and mental disease and internal and external comorbidities. In terms of treatment， only by breaking this cycle can there be a better clinical effect. The theory of the unity on form and spirit originated from the Huangdi Neijing， which is of great significance in the treatment. "Form" is the body， "spirit" is the mind. During the occurrence and development of this disease， "form damage" refers to physical symptoms such as itching， and "spirit injury" refers to abnormal mental state，such as anxiety and depression. Because of mutual cause and effect， form damage and spirit injury become aggravation in the cycle stage. Therefore， for the treatment of form and spirit disease， we should pay attention to the harmony of form and spirit. This disease is internally caused by the dysfunction of internal organs and externally by local skin lesions， so the treatment should be a combination of internal and external treatment. External washing with traditional Chinese medicine can relieve local itching symptoms to cure the form， combined with oral treatment with syndrome differentiation of traditional Chinese medicine to regulate the spirit， which can treat both the symptoms and the root cause of the disease. Supplemented by traditional Chinese emotional therapy and life conditioning， only by adjusting the form to nourish the spirit and adjusting the spirit to guard the form can the symptoms of the disease be effectively alleviated. Finally， the state of keeping the spirit and form in full shape can be achieved， which provides a new clinical idea for the diagnosis and treatment of vulva lichenoid diseases.

Objective To analysis the research status and development trend of traditional Chinese medicine in the treatment of endometrial cancer through bibliometrics. Methods The relevant literatures on the treatment of endometrial cancer by traditional Chinese medicine collected from CNKI, Wanfang Data, and VIP from inception to December 2021 were searched by computer. Cite Space 5.8 software was used to analyze the number of articles published, the cooperation between authors and institutions, the co-occurrence of keywords, clustering and emergence, and corresponding maps were drawn to explore the research hotspots and trends in this field. Results A total of 162 literatures were included, and the number of publications showed an increasing trend. A total of 303 authors were included in the collaborative network atlas, and the largest team was a multi-person team represented by Xue Xiaoou. A total of 156 institutions were included in the atlas of institutional cooperation network, and Dongzhimen Hospital, Beijing University of Chinese Medicine published the most papers. Key words cluster graph showed that the hot spots of traditional Chinese medicine in the treatment of endometrial cancer mainly focus on related disease research, traditional Chinese medicine pathogenesis and syndrome type, traditional Chinese medicine clinical experience, curative effect observation, and traditional Chinese medicine mechanism research.Conclusion Research on the treatment of endometrial cancer by traditional Chinese medicine has been on the rise, and the research hotspot tends to be traditional Chinese medicine, prescription and medicine, clinical observation, and mechanism research. It is suggested to strengthen institutional cooperation in the future, carry out high-quality clinical research, and mechanism research, and further explore the clinical application value of traditional Chinese medicine in the treatment of endometrial cancer.

目的 探讨乌丹丸对寒凝血瘀型子宫内膜异位症(endometriosis,EMs)大鼠自噬信号轴磷脂酰肌醇-3-激酶(phosphatidylinositol-3-kinase,PI3K)/蛋白激酶 B(protein kinase B,PKB 又称Akt)/雷帕霉素靶分子(mammalian target of rapamycin,mTOR)及相关分子表达的影响.方法 随机将49 只雌性SD大鼠分为假手术组、模型组、乌丹丸高、中、低剂量组、散结镇痛胶囊组、地诺孕素组,每组7 只,采用冰水浴联合自体子宫内膜移植法建立寒凝血瘀EMs大鼠模型.假手术组及模型组每天给予10 mL/kg生理盐水灌胃,乌丹丸高、中、低剂量组分别给予2.4 g/kg、1.2 g/kg、0.6 g/kg灌胃,散结镇痛胶囊组每天给予0.48 g/kg灌胃,地诺孕素组每天给予0.2 mg/kg灌胃,各组持续用药28 日.应用蛋白免疫印迹法和免疫组化法检测异位内膜组织自噬信号轴PI3K、p-Akt、p-mTOR蛋白以及相关自噬分子LC3、Beclin-1 蛋白表达.结果 与假手术组比较,模型组大鼠异位内膜组织PI3K/Akt/mTOR蛋白表达上调,Beclin-1、LC3 蛋白表达下调(P<0.01).中药干预后,乌丹丸高、中剂量组、散结镇痛胶囊组和地诺孕素组异位内膜上PI3K/Akt/mTOR蛋白表达降低,而Beclin-1、LC3蛋白表达升高,与模型组比较差异有统计学意义(P<0.01,P<0.05).结论 PI3K/Akt/mTOR信号通路参与子宫内膜异位症发生,乌丹丸可能通过下调PI3K/Akt/mTOR通路蛋白的表达,激活自噬相关蛋白LC3、Beclin-1 表达,促进细胞自噬,治疗子宫内膜异位症.

子宫内膜异位症(EMs)患者常伴焦虑、抑郁,二者之间的"破窗效应"不容忽视.以心肾与脾枢为组成的"两极一枢"与EMs焦虑、抑郁的发展过程密切相关,笔者从"两极一枢"结合微炎症状态论述了 EMs伴焦虑、抑郁的相关机理,得出"中枢斡旋失司,两极坎离未济"是EMs伴焦虑、抑郁的重要病机的结论,治以补中寓行、交通坎离,从而达到治疗EMs及改善患者焦虑、抑郁的目的.

目的:采用网络药理学的方法预测三棱-莪术药对治疗子宫内膜异位症(EMT)的主要活性成分、靶点及信号通路,探讨其作用机制.方法:通过中药系统药理学数据库与分析平台(TCMSP)检索三棱-莪术药对的中药化学成分,以口服生物利用度(OB)≥30％、类药性(DL)≥0.18为阈值筛选潜在的活性化合物;通过TCMSP查询活性化合物对应的靶标;运用GeneCards和人类孟德尔遗传数据库(OMIM)预测疾病靶点;利用韦恩图找到活性成分靶点和疾病靶点的交集靶点;使用Cytoscape 3.7.2软件构建疾病-药物-有效成分-靶点蛋白质-蛋白质相互作用(PPI)网络;采用String在线数据库和Cyto-scape软件绘制交集靶点PPI网络;最后借助R软件和Bioconductor生物信息软件包进行基因本体(GO)功能富集分析及京都基因和基因组百科全书(KEGG)通路富集分析,并使用Cytoscape软件绘制靶点-信号通路网络图.结果:筛选得到三棱-莪术活性成分8个,对应靶点77个,EMT相关靶点1600个,交集靶点34个.GO功能富集分析结果显示三棱-莪术药对可影响1054个生物学过程、22个细胞组分和65个分子功能.KEGG通路富集分析得到91条通路,三棱-莪术药对治疗EMT主要与雌激素信号通路、IL-17信号通路、AGE-RAGE信号通路、甲状腺激素信号通路、P53信号通路等有关.结论:三棱-莪术药对治疗EMs具有多靶点、多途径、多通路的特点.

DATA REPORT article Front. Reprod. Health, 11 July 2022Sec. Assisted Reproduction https://doi.org/10.3389/frph.2022.886277

Objective To explore whether omega-3 fatty acid supplementation is associated with lower risk of preterm delivery. Methods Searching the RCTs which were compared preterm birth between women with omega-3 fatty acid supplementation and without before December 2019 on Medline, EMBASE and Cochrane's Library, then performing a meta-analysis. Results 26 trials were identified, included 20124 women. There was almost no association between omega-3 fatty acid supplementation and lower risk of preterm delivery (risk ratio 0.92, 95% confidence interval 0.85 to 1.01,I-2 = 9%), gestational duration (0.30, -0.05 to 0.64,I-2 = 48%). In subgroup analyses, preterm delivery lower rate occurred in groups with mixed DHA and EPA supplementation not only DHA supplementation groups (P for interaction = 0.02); The dose of equivalent greater than 1 g made a higher reduction in preterm birth significantly. Conclusions Omega-3 fatty acid supplementation was not associated with reduced risk of preterm delivery compared with placebo or no treatment during pregnancy. Relationship between Omega-3 fatty acid supplementation and other pregnant outcomes need more evidence and clinical studies.

Background: This study sought to explore the anti-inflammatory mechanism of Wuyao (radix linderae)Danshen (salviae miltiorrhiza) in endometriosis (EMS) based on network pharmacology and molecular docking. Methods: The active constituents of Wuyao-Danshen were collected and identified using the Traditional Chinese Medicine Systems Pharmacology Database, and used to predict and identify the protein targets. The EMS targets and anti-inflammatory targets were obtained from Genecards, Online Mendelian Inheritance in Man, and Drugbank. The Search Tool for the Retrieval of Interacting Genes/Proteins database was used to analyze the protein interactions (PPIs) and core targets, and a target PPI network was constructed by importing the software of Cytoscape. The Metascape database was used to conduct enrichment analyses of the Gene Ontology (GO) functions and the Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathways for the key anti-inflammatory targets of EMS. Finally, Autodock Vina software was used to verify the results of the active ingredients and key anti-inflammatory targets. Results: There were 8 active components in Wuyao, 65 in Danshen, and 591 corresponding protein targets in Danshen, and 375 in Wuyao, including luteolin, quercetin, vancomyl alcohol, and salvianol. One thousand and six hundred eighty-nine disease targets, 1,216 anti-inflammatory targets, and 144 key anti-inflammatory targets were identified, including the (signal transduction and transcriptional activator 3) STAT3, phosphatidyl inositol-3 kinase regulates subunit 1 (PIK3R1) and mitogen-activated protein kinase 1 (MAPK1) protein kinase B. Three hundred and fifty-three biological processes (BPs), 21 cellular components, and 25 molecular functions (MFs) were enriched with GO functions, and 108 KEGG pathways were enriched and analyzed, including the MAPK and PI3K-Akt signaling pathways. Molecular docking confirmed that luteolin, coumarin, and quercetin could bind to the key target proteins (i.e., STAT3, PIK3R1, and MAPK1). Conclusions: Based on network pharmacology and molecular docking, Wuyao-Danshen was found to act on EMS through anti-inflammatory targets and related signaling pathways. Our findings provide a basis for further research.

目的:观察化瘀散结灌肠液对子宫内膜异位症(EMT)盆腔痛模型大鼠核因子 κB通路、炎症介质及氧化应激因子的影响,探讨化瘀散结灌肠液治疗EMT盆腔痛的机制.方法:40只雌性SD大鼠,按随机数字表法选取6只为假手术组,其余大鼠通过自体子宫内膜移植法联合雌激素加缩宫素注射建立EMT盆腔痛大鼠模型,选取30只造模成功的大鼠按随机数字表法分为模型组、阳性对照组及化瘀散结灌肠液低剂量灌肠组、化瘀散结灌肠液中剂量灌肠组、化瘀散结灌肠液高剂量灌肠组,每组6只.灌肠给药4周后,观察扭体反应,并进行病理观察,检测血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、超氧化物歧化酶(SOD)、丙二醛(MDA)的表达及异位病灶组织核因子κB蛋白的表达水平.结果:与模型组比较,化瘀散结灌肠液低剂量灌肠组、化瘀散结灌肠液中剂量灌肠组、化瘀散结灌肠液高剂量灌肠组大鼠扭体次数显著减少(P<0.05),血清中IL-1β、TNF-α、MDA含量显著降低(P<0.05),SOD含量显著增高(P<0.05),异位病灶组织中核因子κB蛋白表达显著降低(P<0.05).结论:化瘀散结灌肠液可能通过抑制氧化应激反应抑制核因子κB通路的激活,从而减少炎症介质释放,缓解EMT盆腔痛.

目的 探讨宫颈高危型人乳头瘤病毒(HR-HPV)感染患者的中医证素分布特征,为其临床辨证论治提供客观依据.方法 采用流行病学研究方法,收集210例宫颈HR-HPV感染患者的四诊及相关信息,通过因子分析方法提取相关证候要素.结果 通过因子分析共提取14个公因子,累积方差贡献率为75.99％.结果 表明,宫颈HR-HPV感染者病位证素主要为胞宫、脾、肾、肝、心,病性证素主要为湿、热、阳虚、气虚、气滞、阴虚、血瘀.结论 本研究因子分析结果在一定程度上反映了宫颈HR-HPV感染的主要证素特点,对该病的证候研究有一定参考价值.

Abstract Backgrounds: Diminished ovarian reserve (DOR) contributes significantly to female infertility. And embryo quality is one of the decisive factors in the success of pregnancy. However, the factors that influence embryo quality in aged DOR patients are not well established. In this retrospective study, we analyzed the medical records of infertile women with DOR (aged ≥35 years old) who underwent assisted reproductive technique (ART) in our reproductive center to reveal the possible correlation between clinical characteristics and embryo quality. Methods: A total of 1063 infertile patients with DOR and aged ≥35 years old who underwent in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) were selected as subjects in the Reproductive Center of Dalian Medical Women and Children's Medical Center from January 2015 to April 2021. Patients were divided into two groups according to whether they obtained high-quality embryos (N=561 cases) or poor-quality embryos (N=502 cases). The baseline conditions of the 2 groups and the possible influencing factors of embryo quality were compared by Student's t test, Mann-Whitney U test, the chi-square or Fisher’s exact test. Multifactorial binary logistic regression analysis was created to identify statistically significant factors that can affect quality embryos in infertile women with DOR aged ≥35 years old. Finally, all patients were divided into 3 groups according to homocysteine (Hcy) levels, including subgroup A with Hcy ≤ 8 mmol/L, subgroup B with 8＜Hcy ≤15mmol/L and subgroup C with Hcy≥15mmol/L. And general indicators among three groups were compared by one-way anova with Dunnett’s multiple comparisons. And indicators related to embryo quality (number of utilizable embryos and high-quality embryos, the high-quality embryo rate) were compared by chi-square test. Results: A total of 1063 patients with DOR were included, 561 in the high-quality embryo group and 502 in the poor-quality embryo group There was significant difference in infertility years between high-quality embryo group and poor-quality embryo group (P < 0.05) except for female partner's age, male partner's age, BMI, primary and secondary infertility composition ratio, assisted reproduction method, and presence of coeliac disease) (P > 0.05). The result of univariate analysis showed that there were statistically significant differences in the starting dose of Gonadotrophin (Gn), duration of stimulation, the serum level of Hcy, the number of retrieved oocytes, the number of two pronuclei (2PN) and the number of utilizable embryos(D3) (P<0.05). The multi-factor binary regression analysis showed that the level of Hcy [OR 95% CI:0.948(0.898 to 0.999, P<0.05] and duration of stimulation [OR 95% CI:0.939(0.884 to 0.997), P<0.05] were independent risk factors for high-quality embryos. The number of fertilized oocytes (2PN), utilizable embryos (D3) and high-quality embryo (D3) was statistically different among subgroup A, B and C stratified by Hcy concentration (p<0.05). And there was significant difference in the rate of high-quality embryos among three groups stratified by Hcy concentration (P<0.05). The rate of high-quality embryos was significantly lower in subgroup C when compared with subgroup A and B (adjusted P value < 0.05). And there was no difference in the rate of high-quality embryos between subgroup A and subgroup B (adjusted P value >0.05). Conclusions: Our study was the first time to show that serum Hcy levels and duration of stimulation influence the formation of high-quality embryos negatively in aged DOR women, and high Hcy levels (≥15mmol/L) significantly reduce the ratio of high-quality embryos in aged DOR women. Our study reveals for the first time that serum Hcy levels and stimulation duration are independent risk factors for quality embryos in DOR women aged ≥35 years. And, high serum Hcy levels (≥15 mmol/L) can pose a serious threat to aged women with DOR to obtain quality embryos, which deserves the focused attention of reproductive physicians.

目的:探讨丹白颗粒对湿热瘀结型盆腔炎后遗症的疗效及安全性.方法:选取2020年12月至2021年12月北京中医药大学东直门医院、山东省中医院等妇科门诊收治的湿热瘀结型盆腔炎后遗症患者120例作为研究对象,采用随机数字表法将受试者按照1:1的比例分组,经病例脱落后,最终纳入观察组(n=58)和对照组(n=59),共计117例.对照组采用盐酸左氧氟沙星胶囊联合甲硝唑片口服治疗,观察组在对照组的基础上加用丹白颗粒口服,2组均治疗2周.比较2组的临床疗效、视觉模拟评分法(VAS)评分、健康调查量表36(SF-36)、C反应蛋白(CRP)、红细胞沉降率(ESR)、阴道分泌物清洁度、下腹痛消失时间、带下恢复正常时间及不良事件发生率.结果:观察组的总有效率93.10％(54/58)明显高于对照组的79.66％(37/59)(P<0.05).治疗后2组患者下腹疼痛VAS评分、下腹痛及白带增多的症状消失时间及CRP、ESR均明显降低,SF-36量表评分明显升高(P<0.05),阴道分泌物清洁度明显改善(P<0.05).观察组各项指标均优于对照组(均P<0.05).2组不良反应的发生率差异无统计学意义(P>0.05).结论:在西医常规治疗的基础上联合丹白颗粒可提高湿热瘀结证盆腔炎后遗症的疗效,进一步减轻患者的症状体征和疼痛程度,改善阴道分泌物清洁度,降低炎症指标水平,提高患者生命质量,值得临床借鉴应用.

The objective of this study is to observe the effect of relieving pain of Huayu Sanjie enema liquid (HYSJ-EL) on endometriosis model rats and to explore its mechanism of action. Of 24 female Sprague Dawley rats, six were randomly selected as the sham operation group (normal control group). The remaining rats were used to establish rat models of endometriosis through autologous endometrial transplantation combined with estrogen injection. Successfully modeled rats were randomly divided into the model, indomethacin (Western medicine group), and HYSJ-EL (Chinese herbs group) treatment groups. The thermal pain threshold of rats was measured, and hematoxylin and eosin staining was used to observe pathological changes after sampling. Serum levels of prostaglandin E2 (PGE2), interleukin-6 (IL-6), macrophage inflammatory protein-2 (MIP-2), plasminogen activator inhibitor-1 (PAI-1), and transforming growth factor-β (TGF-β) were measured using an enzyme-linked immunosorbent assay (ELISA). Furthermore, the protein and mRNA expression levels of transient receptor potential vanilloid-1 (TRPV1) and tumor necrosis factor-α (TNF-α) in the endometrium and endometriotic lesions were measured using Western blotting and quantitative real-time PCR assays, respectively. Compared to the model group, the heat pain threshold of rats in the HYSJ-EL group was significantly increased (P<0.01), and the serum levels of PGE2, IL-6, MIP-2, PAI-1, and TGF-β were significantly decreased (P<0.01), as well as the expression of TRPV1 and TNF-α protein and mRNA in the tissue of the ectopic lesion was significantly decreased (P<0.05). These results indicate that the Huayu Sanjie enema liquid exerts analgesic effects on endometriosis by inhibiting inflammation, peripheral nerve sensitization, and pelvic adhesion.

Objective To explore the pharmacological mechanism of a Chinese patent drug (Kunling Pill (KLP)) on improving diminished ovarian reserve based on proteomic analysis. Methods A total of 18 patients divided into three groups (the normal ovary reserve (NOR), diminished ovary reserve (DOR), and KLP groups) undergoing assisted reproductive technology by standard ovarian stimulation protocols were recruited to collect follicular fluid. Data-independent acquisition mass spectrometry was used to identify differentially expressed proteins by nano-LC-MS/MS. Bioinformatic analysis was conducted to predict the functions and pathways of the identified proteins. Clinical, hormonal, and biochemical parameters were also analyzed in the three groups. Results A total of 144 differentially expressed proteins were screened out, including 56 proteins that were downregulated and 88 proteins that were upregulated in the DOR group compared with the NOR group, while 27 proteins were shared in the KLP-treated group. Among them, 10 proteins were upregulated and 17 proteins were downregulated in the KLP-treated group compared with the DOR group. The most enriched biological processes accounted for 28 GO terms, including cellular process, biological regulation, metabolic process, and regulation of biological process. Significant pathways were associated with fatty acid elongation, fatty acid degradation, fatty acid metabolism, nicotinate and nicotinamide metabolism, and valine, leucine, and isoleucine degradation. Conclusion Our study provides the proteome profiles of human follicular fluid from DOR patients treated by KLP. Functional analyses of proteome datasets revealed that core proteins (SAA1, MIF, and PRDX5) and related pathways (fatty acid metabolism, nicotinate and nicotinamide metabolism, and tyrosine and purine metabolism) are possible pharmacological mechanisms through which KLP improves DOR. Therefore, these findings may help better understand the complex mechanisms through which DOR is treated by the Chinese patent drug KLP.

总结郭志强教授治疗女性生殖道解脲支原体感染的经验。认为该病核心病机为湿热毒蕴兼虫蚀阴中，久病夹瘀、脏腑虚损，可从“毒、虫、瘀、虚”四个方面论治。治疗以祛邪补虚为总原则，详察病机，灵活用药；邪实为重时首当清热解毒祛湿，并兼顾杀虫止痒；久病夹瘀，少佐活血化瘀之品；脏腑虚损明显者，应注意顾护正气，根据正邪虚实适时转变攻补治疗方案，中“症”即止，逆转病势，同时治疗过程中重视药物煎法、夫妻同治、生活调摄相关因素。

Background: Diminished ovarian reserve (DOR) contributes significantly to female infertility. Embryo quality affects pregnancy outcome. However, the factors that influence pregnancy outcomes in DOR patients are not well established. In this study, we analyzed the medical records of infertile women with DOR who underwent ART to reveal the possible correlation between clinical characteristics and embryo quality. Methods: A retrospective cohort study was conducted using 3390 medical record data on IVF cycles from Dalian Municipal Women and Children’s Medical Center (Group) from January 2015 to December 2020. The data was divided into poor-quality embryos group and high-quality embryos group according to the embryo status. We summarized the demographic and clinical characteristics (age, infertility years, infertility type, AFC, and BMI), medical history, reproductive hormone parameters (AMH, FSH, LH, PRL, and E 2 ), and carbohydrate and lipid metabolic indexes (CHO, TG, LP, LDL, HDL, FINS, Glucose, and Hcy). To further evaluate the Hcy levels in patients with different embryo quality, we performe subgroup analysis. In order to further evaluate the Hcy levels of patients with different embryo quality, we conducted a subgroup analysis, which was divided into three subgroups: Hcy ≥15, 15> Hcy >8 and Hcy ≤8. A total of 1023patients with DOR were included in this study. Results: Of these, 483 cases were with high-quality embryos (the number of high quality embryo, number≥1), and 540 cases with poor-quality embryos (no high quality embryo, number=0). Demographic characteristics of the two groups were similar. However, the level of serum Hcy was significantly higher in the poor-quality embryo group compared with the high-quality embryo group (P < 0.05). In addition, the levels of serum AMH and PRL were statistically different between the two groups. Patients with serum Hcy ≥ 15 μmol/L were at higher risk of having poor-quality embryos (82.1%) compared to patients with serum Hcy less than 8 μmol/L (43.9%) and at 8~15 μmol/L (48.1%) (c2 =15.859, P < 0.001). Conclusion: The presented study demonstrated that high serum Hcy level is linked to poor-quality embryos. Moreover, Hcy coupled with age might be a sensitive marker for embryo quality after IVF.