Unexplained recurrent spontaneous abortion (URSA) is a severe challenge to reproductive females worldwide, and its etiology and pathogenesis have not yet been fully clarified. Abnormal intercellular communication between macrophages (Mφ) and decidual stromal cells (DSCs) or trophoblasts has been supposed to be the key to URSA. However, the exact molecular mechanisms in the crosstalk are not yet well understood. This study aimed to explore the potential molecule mechanism that may be involved in the communication between Mφ and DSC or trophoblast cells and determine their diagnostic characteristics by using the integrated research strategy of bioinformatics analysis, machine learning and experiments. First, microarrays of decidual tissue (GSE26787, GSE165004) and placenta tissue (GSE22490) in patients with URSA, as well as microarrays involving induced decidualization (GSE94644) and macrophage polarization in vitro (GSE30595) were derived from the gene expression omnibus (GEO) database. And 721 decidua-differentially expressed genes (DEGs), 613 placenta-DEGs, 510 Mφ polarization DEGs were obtained in URSA by differential expression analysis. Then, the protein-protein interaction (PPI) network was constructed, and the hub genes were identified by CytoHubba in Cytoscape software and validated by real-time PCR assay. Subsequently, immune enrichment analysis on decidua-DEGs and placenta-DEGs by ClueGO verified their regulation effects on Mφ. Besides, functional enrichment analysis was performed on Mφ polarization DEGs and the essential module genes derived from the weighted gene co-expression network analysis (WGCNA) to uncover the biological function that were related to abnormal polarization of Mφ. Furthermore, we screened out 29, 43 and 22 secreted protein-encoding genes from DSC-DEGs, placenta-DEGs and Mφ polarization DEGs, respectively. Besides, the hub secreted-protein-encoding genes were screened by CytoHubba. Moreover, we conducted functional enrichment analysis on these genes. And spearman correlation analysis between hub secreted-protein-encoding genes from donor cells and hub genes in recipient cells was performed to further understand the molecular mechanism of intercellular communication further. Moreover, signature genes with diagnostic value were screened from secreted protein-encoding genes by machine learning and validated by immunofluorescence co-localization analysis with clinical samples. Finally, three biomarkers of DSCs (FGF9, IL1R2, NID2) and three biomarkers of Mφ (CFB, NID2, CXCL11) were obtained. In conclusion, this project provides new ideas for understanding the mechanism regulatory network of intercellular communication involving macrophages at the maternal-fetal interface of URSA. Also, it provides innovative insights for the diagnosis and treatment of URSA.

Purpose: This bibliometric research aims to delineate global publication trends and emerging research interests in the use of acupuncture for breast cancer (BC)-related symptoms treatment over the past three decades. Furthermore, it identifies influential institutions, potential collaborative partners, and future research trends, thereby providing guidance for relevant, novel research directions. Methods: Scientific publications related to acupuncture for BC-related symptoms were gathered from the Web of Science Core Collection (WoSCC) from 1993 to 2023. Four software applications were principally used to analyze the resulting data: the "bibliometrix" package in the R environment (version 4.2.3), VOSviewer, CiteSpace6.1.R6, and the bibliometrics website. These applications were employed to evaluate different parameters. Results: A total of 621 papers on acupuncture in BC-related symptoms treatment were analyzed. The United States, China, and South Korea contributed the most, with Memorial Sloan Kettering Cancer Center, and Columbia University leading institutions. It is interesting to mention that Mao, Jun J. and Molassiotis, A. feature among the top 10 authors and co-cited authors. JAMA is the leading journal, with an ongoing focus on acupuncture's effectiveness. Keywords show that the initial research focus was mainly on "vasomotor symptoms", but in recent years there has been a gradual shift towards "pain", "chemotherapy-induced peripheral neuropathy (CIPN)", "electroacupuncture", and "non-specific effects". Conclusion: Acupuncture has demonstrated a unique value in the process of adjuvant treatment of BC-related symptoms, and has been shown to be effective in reducing pain, eliminating fatigue, and improving quality of life. The study of the mechanisms of acupuncture and the application of electroacupuncture are possible future research priorities in this field. This study offers a deep perspective on acupuncture for BC research, highlighting key points and future trends.

《金匮要略》载:"经为血,血不利则为水,名曰血分."张仲景认为,"血分""水分"关系密切,基于此创立了多首"血水同治"代表方,如温经利水的桂枝茯苓丸、活血利水的当归芍药散等.赵师探究血水同治法之精髓,运用此法治疗妇科杂病两则,效如桴鼓,现载之以飨同道.

Objective To explore the potential biological mechanisms of Houbao tang in the treatment of intrauterine adhesions(IUA)through network pharmacology and molecular docking.Methods The compounds of all herbal medicines in Houbao tang were screened and the related targets were predicted by Batman-TCM database.The targets of IUA were obtained from GeneCards,NCBIand DisGeNET databases.PPI network analysis,topology analysis and functional enrichment analysis were executed to obtain the common genes of Houbao tang and IUA by Venny software,and to construct the component-disease-pathway-target network.Finally,molecular docking prediction of compounds and targets was performed by AutoDock.Results A total of 1,868 drug targets of Houbao tang were screened and intersected with 1,842 targets related to IUA.Eventually,409 intersection targets were obtained.Further topological analysis yielded 106 key targets with high correlation coefficients of CREBBP,AKT1,TP53,SRC,etc.The shared targets of drug diseases were enriched to 3,785 biological processes including regulation of epithelial cell proliferation,128 molecular functions related to receptor ligand activity,signaling receptor activation,and 241 cell composition related to vesicle lumen and membrane area.KEGG pathway enrichment screening 184 signaling pathways.Molecular docking results showed that Melanin-JUN binding energy was minimal.Conclusion The anti-adhesive properties of Houbaotang through multiple target actions are analyzed using network pharmacology,and CREBBP,AKT1 and SMAD3 are screened as possible key targets of Houbao tang in the treatment of IUA,and fibrosis is regulated through several major signaling pathways such as PI3K-Akt,AGE-RAGE and TNF,which offer fresh concepts and techniques for in-depth research on the mechanism of action of Houbao tang in the treatment of IUA.

目的 结合妊娠天数探讨早孕期阴超下妊娠结构对于妊娠结局预测的价值.方法 回顾性分析2018年9月至2018年12月在本院就诊的妊娠早期妇女共436例,根据妊娠结局分为最终分娩人群(296例)和妊娠丢失人群(140例),分析早孕期妊娠结构出现时间对于妊娠结局预测的价值、界值及分布情况.结果 最终不同妊娠结局的卵黄囊、胚芽及胎心出现时间比较(P<0.05);空囊持续妊娠天数临界值为38?d,AUC=60.4,妊娠天数为44?d时,特异度和阳性预测值(PPV)为100％;有卵黄囊无胚芽持续妊娠天数临界值为43?d,AUC=68.3,妊娠天数为53?d时,特异度和阳性预测值(PPV)为100％;有胚芽无心搏持续妊娠天数临界值为50?d,AUC=94.9,特异度和阳性预测值(PPV)均为100％.结论 早孕期阴超指标结合妊娠天数预测妊娠结局具有一定意义.

文章主要介绍赵宏利"两步四法"治疗不全流产的经验.一是于胎殒早期,自拟"加味生化汤"及时"化瘀消癥,下胎益母";从"寒下、温下、燥下、补下"四法辨证,燮理阴阳,舒畅气血.二是胎堕完全,即借行经之力,加用活血利水方,以期"转经复原",并自拟"厚胞汤"填精养血,通补奇经.

孕12周前出现妊娠终止的早期流产,发生率达10 ％～15 ％,且随着孕周的增加而减少[1].如何尽早准确预测妊娠结局且避免盲目保胎是临床的重点也是难点.随着超声技术的普及和进步,阴超监测宫内妊娠的灵敏度和精确度已分别达到87 ％～99 ％和94 ％～99 ％[2].在妊娠早期利用阴超结果预测胚胎停育的研究逐步深入且广受探讨[3-5].