BACKGROUND:Recurrent pregnancy loss (RPL) is a common disease of reproductive dysfunction that severely impairs female health. Jianwei Shoutai Pills (JSP), a classical prescription of Chinese medicine, have been widely used in the treatment of RPL. However, the effective components and mechanisms of JSP haven't been sufficiently illustrated. PURPOSE:To explore the effective components and mechanisms of JSP in treating RPL. METHODS:Effects of JSP on PRL were evaluated in CBA/J × DBA/2 mice model with pregnancy loss rates, morphology of placenta and embryos, as well as hormone levels. Then effective component was identified according to JSP components, plasma and placenta JSP-derived components analyzed by ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) and Chinmedomics. Furthermore, the effects of the active component were evaluated using the CBA/J × DBA/2 mouse model. Its potential mechanism of action was predicted through network pharmacology and molecular docking, and subsequently validated by surface plasmon resonance (SPR) and western blot analysis. RESULTS:JSP could well alleviate RPL in the CBA/J × DBA/2 mice model. Moreover, combining with JSP components, plasma and placenta JSP-derived components analysis, sweroside was the only overlapped component and considered as the effective component of JSP according to the good effects on RPL mice model. Network pharmacology identified 83 targets as the hub targets of sweroside in the treatment of RPL, and most genes were enriched in cAMP signaling pathway. SPR analysis indicated that sweroside is capable of binding to the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Subsequently, western blot results demonstrated a significant upregulation of proteins enriched in the cAMP signaling pathway following sweroside administration, suggesting the activation of this pathway. CONCLUSION:Sweroside was identified for the first time as the active component of JSP capable of treating recurrent pregnancy loss (RPL) by activating the cAMP signaling pathway. This study provides novel insights into potential clinical therapies for RPL.

BACKGROUND:Miscarriage has the characteristics of recurrent attacks and complex etiology, so it is gradually attracted the wide attention of scholars in the fields of reproduction. Potential association between gut microbiome (GM) and pregnancy disorders has been investigated. Jianwei Shoutai pills (JWP), as a representative formula, have been proven to have protective effect in both clinical and experimental research in miscarriage. However, the specific mechanism of JWP in miscarriage through GM remains unclear. PURPOSE:To investigate the underlying mechanism of JWP against miscarriage through the gut-uterus axis. METHODS:The effects of JWP on an RU486-induced rat model of miscarriage were evaluated by embryo resorption rate, vaginal bleeding rate, and appearance of the uterus and embryo. We used 16S rRNA sequencing to measure the extent of the effect of JWP on GM of rats with miscarriage. Bile acid (BA) content of the feces of rats treated with JWP was evaluated by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS). The activation of bile acid-associated receptor, Farnesoid X receptor (FXR), was evaluated by immunofluorescence. The expression level of NLRP3 inflammasome-associated protein was detected by Western blot or Elisa. Fecal microbiota transplantation (FMT) was used to confirm that GM was essential for the therapeutic effect of JWP in miscarriage. RESULTS:JWP significantly ameliorated miscarriage symptoms and embryo resorption rate caused by RU486-induced miscarriage as well as restored the abnormal activation of NLRP3-inflammasome at the maternal-fetal interface. Furthermore, JWP can significantly regulated GM dysbiosis and closely associated with BA metabolism by KEGG pathway prediction analysis. Several BA content were significantly restored by HPLC-MS. The expression of NLRP3 inflammasome-associated protein at maternal-fetal interface was reversed by JWP. Combined with FMT, JWP could regulate activation of NLRP3 at the maternal-fetal interface by BAs produced by GM. CONCLUSION:JWP restored abnormal activation of the NLRP3-inflammasome in an RU486-induced miscarriage rat model, and corrected the BA disorder by regulating imbalance of the GM.

目的 探索阴道菌群近10年来的研究现状并预测其发展趋势.方法 在Web of Science数据库中检索近10年阴道菌群相关的文献,运用可视化软件VOSviewer进行共词分析、文献耦合、合著分析等.结果 阴道菌群领域发文量呈整体上升趋势,目前的主要热点研究分为阴道菌群的多样性、传染病学、细胞生物和基因学、阴道菌群与生殖的关联四大方面.结论 文献可视化研究展现了阴道菌群的研究现状和发展趋势,为相关研究人员提供了借鉴.

Spontaneous abortion (SA) is the most common adverse pregnancy outcome in the first trimester. The causal drivers of SA have become a substantial challenge to reveal and overcome.

采用文献检索的方法收集中国知网数据库、万方数据库和维普数据库中涉及子宫内膜异位症中医证候的临床研究或有关子宫内膜异位症中医证候的流行病学调查研究,分析纳入文献与病例来源为广东地区文献的子宫内膜异位症的中医证型分布情况.共筛选得到44篇符合纳入与排除标准的文献,其中病例来源为广东地区的文献有16篇.纳入文献的子宫内膜异位症的实证以气滞血瘀、寒凝血瘀为主,虚实夹杂证中以肾虚、气虚为病理基础居多.病例来源为广东地区文献的广东地区子宫内膜异位症患者的病机多虚实夹杂,其他地区患者的病因以外邪侵扰为主.分析结果提示广东地区患者更多见肾虚血瘀、脾虚湿瘀互结等虚实夹杂证,其中医药治疗除运用活血化瘀法消瘀除癥外,还应注重调补脾、肝、肾并兼顾化痰祛湿.

The early diagnosis and treatment of ectopic pregnancy (EP) remains a major challenge. Despite a known link between vaginal microbiota and female reproductive health, few studies have focused on the association between vaginal microbiota and pregnancy location. This nested case-control study aimed to characterize the vaginal microbiota in tubal pregnancy (TP) among symptomatic women in early pregnancy. Women with symptomatic early pregnancy of unknown location (PUL) were included in this study. 16S rDNA gene sequencing was performed to assess vaginal microbial diversity and relative abundance. Machine learning and multivariate logistic regression were also used to evaluate the association between Gardnerella and TP. The results indicate that the vaginal microbiome in TP was more diverse (Shannon, p < 0.05) and was different in composition to that of women with intrauterine pregnancy (IUP) (weighted Unifrac, R = 0.08, p = 0.01). The genus Gardnerella was significantly enriched in TP. The XGBoost analysis was able to classify Gardnerella-induced TP more reliably (AUC = 0.621). Moreover, after adjusting potential confounders, our results indicate a robust association between Gardnerella and TP (as a continuous variable, adjusted OR: 12.0, 95% CI: 2.1–67.4, p < 0.01; as a categorical variable (≥0.85%), and adjusted OR: 4.2, 95% CI: 2.0–8.8, p < 0.01). In conclusion, we found that higher virginal Gardnerella levels were associated with TP in women with symptomatic early pregnancy.

Introduction Studies have suggested that the vaginal microbiome and gut microbiome are involved in pregnancy-related diseases, but little exploration of the link with early miscarriage or threatened miscarriage (TM) has been done. Whether the characteristics of the vaginal microbiome and gut microbiome in early pregnancy are related to TM and early pregnancy outcomes remains unclear.Methods and analysis The Microbiome Characteristics in Early Threatened Miscarriage Study (MCETMS) is a prospective investigation that will recruit 326 pregnant women with early TM. Pregnant women will be enrolled at 4–8 weeks of gestation, and their vaginal secretions, faecal samples, clinical data and sociodemographic characteristics will be collected prospectively. Pregnant women with TM will be followed up to 12 weeks of gestation to determine the early pregnancy outcomes (ongoing pregnancy or pregnancy loss). DNA will be extracted from the collected samples and will be analysed by 16S rRNA gene sequencing.Ethics and dissemination The MCETMS study protocol has been approved by the Ethics Committee of the First Affiliated Hospital of Guangzhou Traditional Chinese Medical University (ZYYECK[2020]051). Dissemination of study findings will occur through peer-reviewed journals, conferences and presentations.Trial registration number ChiCTR2000041172.

从辨治思路、用药特色等方面对岐黄学者罗颂平教授临证辨治妇人产后缺乳、产后恶露不绝、产后身痛等案例进行分析.罗教授强调产后疾病具有气血津液亏虚、元气受损、瘀血内阻等病因病机特点,治疗上应固护气血津液、补益肾气肾精,活血化瘀等攻伐之法宜中病即止.同时根据患者病证,或兼清热凉血、疏肝柔肝、健脾和中、祛风散寒除湿等.

小柴胡汤疗效显著,临床应用非常广泛,但是由于成方年代已久,药材的品种来源、品质、炮制方法、剂量单位和常用剂量都已经发生变化,这些因素都会影响小柴胡汤的疗效.因此厘清这些影响因素,在尊重原方的基础上,根据现代中医药发展的新研究、新技术,科学合理地加以运用,才能使小柴胡汤的疗效得到更好的发挥.

Background: Pregnancy of unknown location (PUL) is a kind of pregnancy that has a positive beta-human chorionic gonadotropin (β-hCG) test result but the location of pregnancy cannot be determined by ultrasound. Early determination of the location of the pregnancy is important for subsequent treatment. However, there is no study on the characteristics of vaginal microbiota in pregnant women with unknown locations and a model for judging it by vaginal microbiota combined with clinical indicators. Therefore, we designed this study to compare the characteristics of vaginal microbiota in intrauterine and ectopic pregnancy populations during pregnancy with unknown locations and to establish a prediction model for pregnancy locations in PUL populations with clinical indicators.Methods: This is a prospective, multicenter cohort study. 576 eligible participants will be included in this study. Vaginal microbiota was collected from all participants at inclusion, and color Doppler ultrasound was performed weekly. After the locations of pregnancy were determined, participants of intrauterine pregnancy were followed up to their early pregnancy outcome, and participants of ectopic pregnancy were followed up until a none-pregnancy level of β-hCG was confirmed. Discussion: The regular method of judging the location of pregnancy is by color Doppler ultrasound and β-hCG test. We hope to provide earlier clinical methods of prediction for women with unknown locations of pregnancy through this study.Trial registration: Chinese Clinical Trial Registry: ChiCTR2000035378, registration date: 9 August 2020. http://www.chictr.org.cn/index.aspx

OBJECTIVES:The aim of this study is to explore the effects of the angle of epiglottis (Aepi) on phonation and resonance in excised canine larynges. METHODS:The anatomic Aepi was measured for 14 excised canine larynges as a control. Then, the Aepis were manually adjusted to 60° and 90° in each larynx. Aerodynamic and acoustic parameters, including mean flow rate, sound pressure level, jitter, shimmer, fundamental frequency (F0), and formants (F1'-F4'), were measured with a subglottal pressure of 1.5 kPa. Simple linear regression analysis between acoustic and aerodynamic parameters and the Aepi of the control was performed, and an analysis of variance comparing the acoustic and aerodynamic parameters of the three treatments was carried out. RESULTS:The results of the study are as follows: (1) the larynges with larger anatomic Aepi had significantly lower jitter, shimmer, formant 1, and formant 2; (2) phonation threshold flow was significantly different for the three treatments; and (3) mean flow rate and sound pressure level were significantly different between the 60° and the 90° treatments of the 14 larynges. CONCLUSIONS:The Aepi was proposed for the first time in this study. The Aepi plays an important role in phonation and resonance of excised canine larynges.

目的:探讨脉冲电磁场(pulsed electromagnetic fileds,PEMF)对卵巢切除(ovariectomized,OVX)大鼠骨组织细胞核因子κB受体活化因子(receptor activator of NF-κB,RANK),活化T细胞核因子2(nuclear factor of activated T2,NFAT2)和空泡型V-ATP酶(vavcuolar H+-ATPase,V-ATP)表达的影响.方法:将48只SD大鼠随机分为假手术组(SHAM),卵巢切除组(OVX),卵巢切除+脉冲电磁场治疗组(OVX+PEMF).OVX+PEMF组大鼠在频率8Hz,磁场强度3.8mT的PEMF下每天干预40min,干预8周和16周后检测大鼠骨密度和骨组织RANK,NFAT2和V-ATP的mRNA表达水平.结果:OVX组BMD在第8周(P＜0.05)和第16周(P＜0.001)均低于SHAM组.SHAM组与OVX组比较,8周时RANK表达P＞0.05,而SHAM组NFAT2与V-ATP表达均低于OVX组(P＜0.05,P＜0.01);16周时RANK、NFAT2、V-ATP在OVX组表达升高(均P＜0.01).SHAM组与OVX+PEMF组比较,8周时两组RANK、NFAT2、V-ATP表达P＞0.05;16周时OVX+PEMF组RANK和NFAT2表达均高于SHAM组(均P＜0.01),而两组V-ATP表达P＞0.05.OVX组与OVX+PEMF组相比,8周时两组RANK和V-ATP表达均P＞0.05,OVX+PEMF组NFAT2表达低于OVX组(P＜0.05);第16周时两组RANK表达P＞0.05,NFAT2和V-ATP在OVX+PEMF组的表达均下降(P＜0.01,P＜0.05).结论:PEMF可通过下调OVX大鼠骨组织中NFAT2和V-ATPmRNA的表达从而抑制破骨细胞的骨吸收,进而延缓OVX大鼠的骨丢失.

OBJECTIVES:To evaluate the therapeutic effect on the voice recovery of patients with vocal cord polyps undergoing the microsurgery of preoperative voice therapy.METHODS:Twenty-six patients diagnosed with unilateral vocal cord polyp under stroboscope, who needed to undergo vocal cord loss resection under supportive laryngoscope, were randomly divided into control group (non-voice training) and treatment group (voice training), with each group of 13 patients. Patients in control group were just treated with surgical operation. Apart from surgical treatment, patients in treatment group received 6 hours intensive vocal therapy one week before the surgery. The therapy courses consist of the propaganda and education of voice care, postoperative vocal instruction and the patients' self-training under the guidance of voice therapists. The acoustic parameters (irregularity, breathiness, grade, jitter and shimmer) of the same patient were collected 24 to 48 hours before the surgery and 14 days after the surgery with Ling WAVES. The results were analyzed with SPSS 19.0.RESULTS:The differences of all the five preoperative voice parameters between control group and treatment group are not significant; but postoperative breathiness and jitter in treatment group were significantly lower than that in control group, while the differences of irregularity, overall severity and shimmer were not significant between control group and treatment group. In control group, breathiness and jitter were significantly improved after surgery, while the differences of irregularity, breathiness and shimmer were not significant between preoperation and postoperation. In treatment group, all the five voice parameters were significantly improved after surgery. According to the laryngostroboscopic examination, the vocal fold polyps were excised completely in both groups.CONCLUSIONS:Preoperative voice therapy contributes to the recovery of voice quality of the patients with vocal cord polyps. Combined intervention of surgery and voice therapy is an effective method to treat the patients with vocal cord polyps.

目的 探讨下咽肉瘤样癌的临床及病理学特点,为下咽肉瘤样癌的诊治提供参考依据,提高对肉瘤样癌的诊断、治疗及其预后的认识.方法 分析2010年1月-2014年9月我院治疗的5例下咽肉瘤样癌患者的临床资料,包括诊疗过程、病理特征等.结果 5例患者均经过不同的手术方式,其中咽后壁扩大切除1例,梨状窝扩大切除2例,全后、全下咽、全食管切除2例;肉瘤样癌肉瘤样成分与癌成分共存,且之间有一定的移行,CK、vimentin均表达阳性,P63阳性4例.5例患者均定期随访.结论 下咽肉瘤样癌有其特殊的生物学行为及病理学特点,是一种不同于其他类型的恶性肿瘤,具有自身病理特征,预后情况各不相同,外科手术仍是首选治疗方法,术后辅助放化疗.

目的:分析下咽鳞状细胞癌患者外周血T淋巴细胞亚群和NK细胞活性情况,旨在为相关研究工作提供参考资料.方法:择取2011年6月-2016年5月本院收治的95例下咽鳞状细胞癌病患为病例组,另取此期间内来本院接受健康检查的72例志愿者为正常组.使用流式细胞仪对病患开展相关检查,分析病例组与正常组的淋巴细胞亚群、NK活性情况以及不同临床分期的下咽癌病患外周血T淋巴细胞亚群以及NK细胞活性之间的关系.结果:与正常组相比,病例组的NK细胞、总B淋巴细胞、总T淋巴细胞、辅助/抑制T细胞、辅助T细胞偏低(P<0.05),活化T细胞以及抑制T细胞偏高(P<0.05).Ⅰ～Ⅱ期病患外周血总T淋巴细胞比Ⅲ～Ⅳ期者稍低(P>0.05).Ⅰ～Ⅱ期病患辅助T淋巴细胞比Ⅲ～Ⅳ期者略高(P>0.05).Ⅰ～Ⅱ期病患抑制T淋巴细胞值比Ⅲ～Ⅳ期者低(P<0.01).Ⅰ～Ⅱ期病患辅助/抑制T淋巴细胞值比Ⅲ～Ⅳ期者高(P<0.01).Ⅰ～Ⅱ期病患外周血总B淋巴细胞值比Ⅲ～Ⅳ期者高(P<0.05).Ⅰ～Ⅱ期病患的活化T细胞和Ⅲ～Ⅳ期者相近(P>0.05).Ⅰ～Ⅱ期病患外周血NK细胞数比Ⅲ～Ⅳ期者略高(P>0.05).结论:下咽鳞状细胞癌病患的免疫功能异常,且随着疾病的进展,细胞免疫和体液免疫均有所降低,证实免疫功能紊乱在疾病进展中发挥了一定作用.经流式细胞设备对外周静脉血淋巴细胞亚群以及NK细胞活性情况检测,可实现动态化检测癌症病患某阶段细胞免疫功能变化详情,此法方便简单,在指导治疗方案制定以及监测疾病预后方面,均体现出了一定效果,值得进一步推广.

OBJECTIVE To discuss the therapeutic effect of one stage surgical treatment in the multiple primary hypopharyngeal and cervical thoracic esophageal carcinoma.METHODS The thoracoscopy group: dissecting the esophagus and mediastinal lymph node assisted with thoracoscope, and then opened abdominal cavity to make gastric tube. Head and neck group: doing the cervical lymph node dissection, total laryngectomy, total hypopharyngectomy and total esophagectomy, and then anastomosis of the pharynx with gastric tube. All cases were received conventional radiotherapy and chemotherapy after operation.RESULTS All the cases in this group were successfully underwent the one stage operation. The postoperative complications were pulmonary infection in 3 cases, pleural effusion in 2 cases and tracheal tear in one case. No anastomotic fistula or postoperative deaths occurred. The 3 and 5 year survival rates were 63.6% and 50.0% respectively.CONCLUSION It should take necessary examinations of cervical thoracic esophagus to prevent missing the multiple primary carcinoma of the hypopharyngeal carcinoma. The total laryngectomy, total hypopharyngectomy and total esophagectomy, and anastomosis of the pharynx with gastric tube for multiple primary hypopharyngeal and cervical thoracic esophageal carcinoma is a feasible and active treatment method.