OBJECTIVE:Traditional Chinese medicine (TCM) has been widely used in assisted reproduction, but the outcomes have been inconsistent. This study evaluated the impact of sequential TCM treatment on pregnancy outcomes among patients undergoing intrauterine insemination (IUI). METHODS:This retrospective cohort study included female patients who underwent IUI with their husband's sperm at the Reproductive Center of Affiliated Hospital of Shaanxi University of Chinese Medicine between November 2019 and June 2022. Patients were divided into sequential TCM (TCM was administered for at least 14 consecutive days during the treatment cycle) and non-sequential TCM (TCM was administered for fewer than 14 days or not administered) groups according to the duration of TCM administration. The primary outcomes were clinical pregnancy rate and live birth rate. RESULTS:A total of 396 cycles were analyzed, with 160 cycles undergoing sequential TCM treatment. The sequential TCM group exhibited a higher clinical pregnancy rate (26.3% vs 14.0%, P = 0.002) and live birth rate (20.0% vs 10.2%, P = 0.006) compared to the non-sequential TCM group. After adjusting for endometrial pattern and dominant follicle diameter, the odds ratios for pregnancy and live birth in the sequential TCM group were 2.289 (95% confidence interval [1.335, 3.923], P = 0.003) and 2.241 (95% confidence interval [1.226, 4.096], P = 0.009), respectively. CONCLUSION:In this retrospective cohort, sequential TCM treatment was associated with higher clinical pregnancy and live birth rates in patients undergoing IUI treatment. Please cite this article as: Li N, Yan XL, Wang LJ, Zhang H, Chen M, Bai J, Ji N, Zhang YD, Pang Y, Wang HJ. Impact of sequential traditional Chinese medicine intervention on pregnancy outcomes of intrauterine insemination: A retrospective cohort study. J Integr Med. 2026; 24(3):387-393.

Introduction: This study aimed to evaluate the knowledge, attitude, and practice of patients with polycystic ovary syndrome (PCOS) regarding Traditional Chinese Medicine (TCM) treatment for PCOS. Methods: This cross-sectional study was conducted among patients with PCOS at the Gynecology Outpatient Department and Reproductive Medicine Center of our hospital between January and May 2024. A self-reported questionnaire was used to assess demographic information, knowledge, attitude, and practice scores toward TCM treatment of PCOS. A threshold of >= 70.0 % of the maximum possible score was set for adequate knowledge, positive attitude, and proactive practice Results: A total of 519 patients completed the questionnaire, 90.4 % aged 18-35. The mean scores for knowledge, attitude, and practice were 7.13 +/- 5.41 (range 0-25), 30.74 +/- 4.04 (range 8-40), and 16.95 +/- 3.63 (range 5-25), respectively. The results of Spearman correlation analysis showed that knowledge score was correlated to the attitude (r = 0.272, P < 0.001) and practice (r = 0.421, P < 0.001) scores. The attitude score was correlated to the practice score (r = 0.410, P < 0.001). The Structural Equation Modeling showed that knowledge directly influenced attitude ((3 = 0.336, P < 0.001). Attitude directly influenced practice ((3 = 0.432, P < 0.001). Conclusions: The patients exhibited inadequate knowledge, positive attitude, and proactive practice regarding TCM for PCOS. We recommend improving awareness and acceptance of TCM among patients with PCOS through targeted education, enhanced doctor-patient communication, and promotion of effective treatment models to enhance their quality of life.

OBJECTIVE:To analyze the factors influencing the recurrence of endometrial polyps after hysteroscopic polypectomy. METHODS:A retrospective analysis was conducted on the clinical data of 925 patients who underwent hysteroscopic polypectomy for endometrial polyps at the Affiliated Hospital of Shaanxi University of Chinese Medicine from January 2017 to December 2023. All patients were followed up for 6 months, and the factors influencing the recurrence of endometrial polyps after hysteroscopic polypectomy were analyzed. RESULTS:The recurrence rate of endometrial polyps after hysteroscopic polypectomy was 7.78% (72/925). Significant differences were observed between the recurrence and non-recurrence groups in terms of body mass index (BMI), menopausal status, levels of luteinizing hormone (LH), estradiol (E2), follicle-stimulating hormone (FSH), endometrial thickness, and polyp diameter (p < 0.05). Multivariate logistic regression analysis showed that high BMI, elevated levels of LH, E2, and FSH, increased endometrial thickness, and larger polyp diameter were independent risk factors for the recurrence of endometrial polyps after hysteroscopic polypectomy (odds ratio >1, p < 0.001). CONCLUSION:High BMI, elevated levels of LH, E2, and FSH, increased endometrial thickness, and larger polyp diameter increase the risk of recurrence of endometrial polyps after hysteroscopic polypectomy.

Women undergoing in vitro fertilization-embryo transfer (IVF-ET) can suffer from anxiety and depression at various levels during the process. This study aimed to assess the anxiety and depression statuses (primary outcome) and influencing factors (secondary outcome) among patients undergoing IVF-ET. A 2019-2020 survey at Northwest Women's and Children's Hospital studied IVF-ET patients, evaluating anxiety and depression with GAD-7 and PHQ-9 alongside demographic data, using logistic regression for influencing factors. Among the 2465 women who undergoing IVF-ET, 27.18% had depression, and 18.46% had anxiety. Bachelors' degree (OR = 0.659, 95%CI: 0.503-0.864), male factor infertility (OR = 0.745, 95%CI: 0.558-0.995), and assessment on the day of starting gonadotropin stimulation (OR = 0.781, 95%CI: 0.626-0.974) were negatively independently associated with depression, while comorbidities (OR = 1.541, 95%CI: 1.281-1.854) and an extended ART strategy (OR = 1.394, 95%CI: 1.162-1.672) were independently associated with depression. High school/technical school education (OR = 0.669, 95%CI: 0.490-0.915) and bachelor's degree (OR = 0.640, 95%CI: 0.472-0.868) were negatively independently associated with anxiety, while an extended ART strategy (OR = 1.476, 95%CI: 1.197-1.820) was independently associated with anxiety. In conclusion, the prevalence of depression and anxiety was high in women undergoing IVF-ET. The study identified factors independently associated with depression and anxiety that could be used to guide the psychological management of women undergoing IVF-ET.

Monocrotaline (MCT), a major pyrrolizidine alkaloid, is well-known for its high liver toxicity. Dysregulation of autophagy induced apoptosis can lead to various liver diseases, including those induced by chemical compounds. Therefore, we aim to explore whether autophagy might serve as a potential strategy for addressing liver apoptosis caused by MCT. In primary rat hepatocytes (PRHs), MCT significantly increased the number of autophagosomes and the expression levels of LC3II, Becline-1, and Atg5, while it decreased the expression of p62 in a concentration-dependent manner at doses of 100, 200, 300, and 400 μM. Western blot assays revealed MCT inhibited the phosphorylation levels of the PI3K/AKT/mTOR pathway. To elucidate the role of autophagy in mediating MCT-induced apoptosis, we further pretreated PRHs with the autophagy agonist Rapamycin and the inhibitors Bafilomycin A1 and Chloroquine, respectively, and assessed the apoptosis of PRHs induced by MCT. The results displayed that Rapamycin increased the apoptosis rate and the expression of cleaved caspase-3, whereas Bafilomycin A1 and Chloroquine reduced the apoptosis and the expression of cleaved caspase-3 in PRHs. This study confirms that autophagy enhances PRHs apoptosis induced by MCT. In summary, this study demonstrates that MCT-induced autophagy via inhibition of the PI3K/AKT/mTOR pathway can lead to apoptosis in PRHs.

就卵巢动脉血流状态的评价及中医干预措施的研究进展进行综述,指出卵巢功能的评估是生殖医学的热点问题之一,卵巢动脉血流动力学变化是反映卵巢功能状态的重要指标,中医药及针灸在改善卵巢动脉血流状态方面临床疗效显著.然而关于卵巢动脉血流状态评估临床意义的研究多为育龄期女性的一般临床观察,缺乏队列研究、双盲对照研究及大样本数据分析,同时也缺乏按照年龄的分层研究,比如青春期或围绝经期女性卵巢动脉血流状态评价的意义尚无可靠证据支撑,以及卵巢动脉血流状态能否预测妊娠结局呈现出两种对立观点,亟待进一步研究,并为中西医结合改善卵巢动脉血流动力学状态,提高临床妊娠率的研究提供借鉴.

高危人乳头瘤病毒(HR-HPV)持续感染与宫颈癌的发病呈显著相关性.本文从扶正角度出发,提出宫颈HR-HPV持续感染的防治思路——补气固腠理,重建机体全身及感染局部的免疫屏障.补气既指调补机体一身正气,调节全身免疫功能以卫外祛邪,又指充养机体卫气,使机体腠理固密增强宫颈局部免疫功能.从而阻断HR-HPV因宫颈上皮破损侵入人体的路径,同时协助机体清除病毒持续感染.针对补气固腠理重建免疫屏障防治宫颈HR-HPV持续感染进行深入研究,对防治宫颈HR-HPV持续感染及阻断预防宫颈癌具有重要意义.

中医学认为气滞、体虚、外邪、医源性因素是卵巢早衰的主要病因,临床常以活血化瘀为治疗大法,以行气化瘀法、补血活血法、祛邪活血法、缩宫逐瘀法、补肾疏肝法为具体治疗方法,治疗效果亦较明确,并附验案1则.

目的 利用生物信息学方法确定反复着床失败(RIF)的潜在治疗靶点、生物过程及相关通路,预测作用于关键基因的治疗中药.方法 从GEO数据库下载RIF子宫内膜组织微阵列数据集,用R软件鉴定差异表达基因(DEGs).进行富集分析,构建蛋白质-蛋白质相互作用(PPI)网络,了解DEGs的功能和富集途径,并鉴定关键基因.最后利用Coremine Medical分析得出作用于RIF关键基因的中药.结果 共筛选出差异基因250个,这些DEGs参与调节有机环状化合物生物合成、氮化合物代谢过程的正调控、细胞代谢过程的正调控、细胞活化、生物黏附、白细胞活化等生物学过程,与趋化因子信号通路、Apelin信号通路、神经活性配体-受体相互作用等存在关联.筛选关键基因PTGS2、AGT、VCAM1、C3、FGB、RBP4、IGFBP1、PLA2G10、MUC1、GJA1、ACTA2、LPAR3、ABCG1、HABP2、CYP26A1、FETUB、GPX3、PTGS1、PLA2G2A、NR4A2,作用于关键基因的中药有人参、肉苁蓉、黄芪、山药、沙苑子、菟丝子、丹参、三七等.结论 通过筛选RIF关键基因,预测潜在的治疗中药,为临床治疗提供了重要的策略和方向.

Objective:To observe the effect of PI3K/AKT/mTOR pathway regulation by kidney tonic and blood activation method on autophagic injury in cultured rat ovarian granulosa cells in vitro.Methods:Primary cultured rat ovarian granulosa cells were divided into 6 groups: blank control group, model group, Chinese medicine low-dose group, Chinese medicine medium-dose group, Chinese medicine high-dose group and Gonal-F group.The E 2 and P content and the expression of PI3K,AKT,mTOR,Beclin 1,LC3 and p62 proteins in each group of OGCs.were detected by WB method and immunofluorescence method, respectively.Results:E 2 content were detected by was significantly decreased in the model group and increased in all dose groups of Chinese medicine（all P＜0.05）,and the E 2 content in the high dose group of Chinese medicine was comparable to that in the Gonal-F group.There was no effect of each group and on the content of P（P＞0.05）.The expression of p-PI3K,p-AKT,p-mTOR levels and p62 were up-regulated in each dose group of Chinese medicine and Gonal-F group, and the expression of Beclin 1 and LC3Ⅱ/LC3Ⅰ were down-regulated, and the effect of high-dose group of Chinese medicine was better than that of western medicine Gonal-F group（all P＜0.05）.Conclusion:The results suggest that the kidney tonic and blood activating Chinese herbal medicine compound Xinjia Guishen Wan may repair autophagic damage in ovarian granulosa cells by activating the PI3K/AKT/mTOR pathway, down-regulating the expression of downstream autophagic effector molecules Beclin 1 and LC3 and reducing the depletion of p62.

[目的]基于知识图谱对复发性流产(recurrent spontaneous abortion,RSA)中医药研究现状进行分析,展示RSA中医药研究的研究热点和前沿.[方法]在知网、维普、万方数据库搜索,从建库到2022年2月与RSA中医药相关的研究.采用COOC 10.07、VOSviewer软件绘制发文量、机构、作者及关键词的知识图谱,分析其特点及演化趋势.[结果]共检索到相关文献990篇,发文量整体呈增长趋势,形成了以冯晓玲、卫爱武、谈勇、雷磊等为学术带头人的研究团队,研究机构主要为高校及其附属医院,作者合作与机构合作未能形成紧密网络,合作有待加强.关键词分析显示,RSA中医药研究主要集中在辨证论治、病因病机、治疗方法.研究热点及前沿侧重于免疫因素、血栓前状态(pre-thrombolic state,PTS)及不明原因导致的RSA研究,并致力于机制性研究来阐明中医药治疗RSA的有效性.[结论]通过知识图谱直观展现了RSA中医药研究的研究方向、研究热点、演化趋势,以及各研究机构间缺乏深度、广度合作的问题,为进一步的临床及相关实验研究提供方向和思路.

目的 观察体外受精-胚胎移植(IVF-ET)高龄不孕女性扳机日的中医证型分布规律,探析与妊娠结局关系.方法 采用流行病学调查方法,对2019年7月-2020年5月西北妇女儿童医院生殖医学中心行IVF-ET长/超长方案的高龄女性患者230例在人绒毛膜促性腺激素(HCG)扳机日开展问卷调查,分析年龄、体质量指数对妊娠结局的影响情况,并观察中医证候及妊娠结局相关因素,研究中医证型分布特征及与妊娠结局关系.结果 Logistic回归分析表明,年龄是妊娠结局的危险因素(OR=0.671,95％CI 0.54～0.83,P<0.001);患者高频证候聚类分析显示,证型分布为肾阴亏虚证91例(39.57％)、肝郁气滞证64例(27.83％)、血瘀证43例(18.69％)、肾阳虚兼痰湿证32例(13.91％).不孕病程与中医证型分布差异无统计学意义(P>0.05),不孕因素与中医证型分布差异存在统计学意义(P<0.05),不同中医证型的妊娠结局差异有统计学意义(P<0.05).结论 接受IVF-ET的高龄女性在HCG扳机日的中医证型以肾阴亏虚证最为常见.IVF-ET高龄患者在HCG扳机日的中医证型与不孕因素、妊娠结局具有一定相关性,临床上应基于患者不同证型预防性辨证施治,以提高临床妊娠率.

Objective: To evaluate the effectiveness and safety of Bushen Huoxue prescription in the treatment of recurrent spontaneous abortion (RSA) due to prethrombotic state (PTS). Methods: Databases such as CNKI, WanFang, VIP, CBM, PubMed, Embase, and Cochrane Library were searched for randomized controlled trials on Bushen Huoxue prescription in treating RSA due to PTS from inception to March 2021; meta-analysis was performed by RevMan Version 5.3.0 following quality evaluation. Results: Seven trials were included, with 496 patients; the meta-analysis indicated that Bushen Huoxue prescription has advantages on the improvement of total clinical effective rate [RR = 1.22, 95% CI (1.10, 1.35), Z = 3.80 (P = 0.0001)], embryo survival rate at pregnancy of 12 weeks [RR = 1.25, 95% CI (1.10, 1.41), Z = 3.53 (P = 0.0004)], D-dimer levels [SMD = -1.59, 95% CI (-2.20, -0.97), Z = 5.07 (P < 0.00001)], and fibrinogen levels [MD = -1.00, 95% CI (-1.29, -0.70), Z = 6.61 (P < 0.00001)], but the statistical heterogeneity was significant; in terms of incidence of adverse reactions, there was no statistical difference between Bushen Huoxue prescription and western medicine. Conclusion: Compared with western medicine alone, Bushen Huoxue prescription alone or in combination with western medicine showed significant advantages in improving the overall clinical efficiency, embryonic survival rate at 12 weeks of pregnancy, and reducing D-dimer values as well as fibrinogen levels, without any significant difference in the incidence of adverse effects; however, the number of included studies is small and there are drawbacks, such as small sample size and low quality; therefore, high-quality clinical studies with large sample size and rigorous trial designs are needed in the future to provide a reliable basis for the effectiveness and safety of TCM in reducing the incidence of RSA due to prethrombotic state.

Background/Aim: Intestinal stem cells (ISCs) are responsible for intestinal proliferation, differentiation, and neoplasia, and also play a crucial role in inflammation. Thus, it is important to investigate the effect of TNF-alpha on the activities of NF-kappa B, PI3K/Akt, and Wnt/beta-catenin signaling pathways. Materials and Methods: The Lgr5(+) intestinal cells were isolated using fluorescence-activated cell sorting from NCM460 spheroid cells, and the potential molecular mechanisms were investigated via short hairpin RNA (shRNA) transfection or the use of an inhibitor. Results: The Lgr5(+) cells were termed ISCs because of the higher expression of stem cell genes, including Sox2, Nanog, Oct4, Lgr5, and CD133. The Lgr5(+) ISCs had a higher proliferation capacity, invasive ability, and drug resistance to 5-fluorouracil, as well as higher expression levels of anti-apoptotic proteins but lower expression levels of pro-apoptotic proteins, compared with Lgr5(-) cells. The PI3K/Akt and Wnt/beta-catenin pathways were triggered by the TNF-alpha-induced activation of NF-kappa B signaling. Notably, when p65 expression was knocked-down via shRNA transfection in Lgr5(+) ISCs, the TNF-alpha-induced activation of the NF-kappa B, PI3K/Akt, and Wnt/beta-catenin pathways were reversed. The same effect was observed with regards to beta-catenin shRNA transfection. Moreover, the Akt inhibitor MK2206 inhibited the TNF-alpha-induced activation of the PI3K/Akt pathway, as well as the NF-kappa B and Wnt/beta-catenin pathways. Conclusion: PI3K/Akt and Wnt/beta-catenin signaling cross-regulate NF-kappa B signaling in TNF-alpha-induced human Lgr5(+) ISCs.

以既病防变的宏观治病思路深入剖析,探讨其与自噬可能存在微观联系.认为自噬作为一种自我保护性的细胞死亡,对维持细胞及机体内环境稳态具有重要作用.近年来发现自噬水平的高低影响着宫颈癌前病变的发生发展,具有双向调节作用.中医既病防变理论包含了早期治疗及防止传变两层含义,抓住宫颈癌前病变这一黄金期进行调控的思路,与中医"既病防变"理论不谋而合,从中医微观辨证角度探讨,自噬机制与人之"正气"相类,自噬维持的稳态即"阴平阳秘"状态,既病防变理论原则下需要早期扶正制邪及平衡阴阳,防止疾病传变,当下中医药对细胞自噬的调节作用已有一定的实验论证,但证据不够充分,其中的调控机制仍亟待研究.

Zygotic epigenetic reprogramming is the major initial event in embryo development to acquire a totipotent potential. However, the patterns of epigenetic modifications in bovine zygote were not well clarified, especially in the first cell cycle of bovine somatic cell nuclear transfer (SCNT) embryos. This study was conducted to examine the patterns of DNA methylation (5-methylcytosine [5mc] and 5-hydroxymethylcytosine [5hmc]) and histone H3 lysine 9 methylation (H3K9m2 and H3K9m3) in the first cell cycle of bovine in vitro fertilization (IVF) and SCNT embryos. In bovine zygotic development, the 5mc in the paternal pronucleus (pPN) undergoes partial demethylation from PN1 to PN3, and remethylation from PN4 to PN5, while 5hmc exhibits absolutely different patterns. The 5mc in SCNT embryos underwent much more dramatic demethylation and much earlier de novo methylation compared with their IVF counterparts, while 5hmc stayed stable from PN1 to PN4, and significantly increased at PN5, which made significantly higher level of 5mc and 5hmc at the end of the first cell cycle in SCNT embryos. Different H3K9m2 and H3K9m3 patterns were also observed between IVF and SCNT embryos. H3K9m2 and H3K9m3 asymmetrically distributed in parental genomes in IVF zygote, highly present in the maternal pronucleus, whereas faintly stained in the pPN. H3K9m2 and H3K9m3 in the somatic cell genome were gradually demethylated from PN1-PN4, and significantly increased at the end of the first cell cycle. TET3 dioxygenase was highly present in the first cell cycle of embryos compared with TET1 and TET2. Our results showed that SCNT embryos underwent aberrant epigenetic reprogramming in the first cell cycle; much more dramatic demethylation and significant higher remethylation were observed compared with IVF counterparts.

运用中医学理论,结合现代医学,从中医分期辨证的角度出发,对宫颈癌前病变期、围手术期、放化疗期3个阶段进行概述.根据宫颈癌形成、发展的不同时期,治疗上第一阶段应侧重祛邪为主,佐以补虚;第二阶段应补虚与祛邪并重,同时注重术后并发症的预防与治疗;第三阶段着重扶助正气,兼顾他症.倡导中医药使用不同的治法进行分期论治,提高人们对中医分期辨证论治的认知度,运用中西医的优势互补,为临床治疗开拓新的思路.

宫颈癌患者术后、放化疗后多出现乏力、虚烦少寐、潮热盗汗、形体羸瘦等症状,贺丰杰教授认为气阴两虚为其核心病机,临床治疗以益气养阴为大法,以生脉散为基础方加减治疗,临床收效甚验.

众多医家认为肾虚是导致排卵障碍性不孕的主要病机,临床常以补肾为主.然而,随着女性社会角色的转变,有学者认为肝与女性生殖密切相关,肝乃生殖之枢.中医认为,肝之疏泄失职是排卵障碍性不孕的核心关键.肝失疏泄可致气机失调,影响月经周期的消退生长,同时破坏女性生殖轴各个环节的协调与平衡,导致排卵障碍引起不孕.治疗当以疏肝解郁、调理气机为主,辅以理脾化痰,并应注重补肾益精.附验案加以佐证.

Autophagy is a self-protection mechanism of the body, and also an important physiological process for cells to maintain internal environment stability. Studies have shown that the degree of autophagy damage is positively correlated with the expression of oncogenes, and the expression of oncogenes is closely related to cervical HPV infection, so the control of autophagy ability can interfere with cervical HPV virus infection. Traditional Chinese medicine believes that dampness-heat evil down, can damage and Chong Ren cell. The author believes that autophagy damage and the theory of dampness-heat injection in cervical HPV infection have similar pathogenic mechanism, and explores the prevention and treatment of autophagy and cervical HPV infection based on the theory of traditional Chinese medicine dampness-heat injection, in attempt to provide a new treatment for clinical prevention and treatment.