OBJECTIVETo explore the best therapy for infertility caused by polycystic ovary syndrome (PCOS).

METHODSOne hundred and twenty patients were randomized into three groups, a clomi-phene group (group A), an acupuncture-moxibustion + Chinese medicine group (group B) and a clomiphene + acupuncture-moxibustion+ Chinese medicine group (group C), 40 cases in each one. In the group A, since the 5th day of menstruation, clomiphene was prescribed for oral administration. In the group B, on the 5th day of menstruation, warm needling therapy was applied at Zhongji (CV 3), Guanyuan (CV 4), Guilai (ST 29), etc. Additionally, the Chinese herbal medication for tonifying the kidney and activating blood circulation was provided. In the group C, the therapy as the group B was combined on the basis of the treatment as the group A. The treatment lasted continuously for 3 menstrual cycles. The endometrial thickness, endometrial type and cervical mucus score on human chorionic gon adotropin (HCG) day, and ovulatory cycle rate, clinical pregnancy rate and abortion rate after treatment were observed in the patients of the three groups.

RESULTS1) HCG day cervical mucus score, endometrial thickness and endometrial morphology (A type rate): the results in the group C were better than those in the group A (all P<0.01); the results in the group B were better than those in the group A (all P<0.05). The difference in the endometrial thickness was not significant in comparison between the group C and the group B (P>0.05). The cervical mucus score and endometrial morphology (A type rate) in the group C were better than those in the group B (both P<0.05). 2) The ovulatory cycle rates in the group A and group (C were higher than that in the group B (both P<0.05), the pregnancy rate in the group C was higher than that in the other groups (both P<0.05), and the early abortion rate in the group C was lower than that in the group A and group B (both P<0.01). 3) Follicle diameter from 18 mm to 20 mm and endometrial thickness: the differences were not significant between the normal pregnancy patients and the early abortion patients (both P>0.05). The endometrial morphology A type rate in the normal pregnancy patients was higher than that in the early abortion patients (P<0.05).

CONCLUSIONThe combined therapy of acupuncture, herbal medicine and clomiphene improves the pregnancy rate and reduces early abortion rate by effectively improving HCG day cervical mucus, endometrial thickness and morphology. The efficacy is apparently superior to the simple medication with clomiphene and the combined application of acupuncture and herbal medicine.

Acupuncture Therapy ; Administration, Oral ; Adult ; Chorionic Gonadotropin ; metabolism ; Clomiphene ; administration & dosage ; Combined Modality Therapy ; Female ; Fertility Agents, Female ; administration & dosage ; Humans ; Infertility, Female ; drug therapy ; etiology ; metabolism ; therapy ; Moxibustion ; Polycystic Ovary Syndrome ; Pregnancy ; Pregnancy Rate ; Young Adult

Objective To study the temporo-spatial changing laws of calcitonin gene-related peptide(CGRP)in the rat model of sciatic nerve ligation.Methods Totally 48 Sprague-Dawley rats were randomly divided into sham-operation group(n=6)and experimental groups which survived for 1,3,5,7,14,21,28 d respectively after sciatic nerve ligation(n=6 at each time point).The distribution and quantity of CGRP in sciatic nerve,dorsal root ganglion(DRG)and spinal cord were detected by immunohistochemistry and image analysis methods.Results A large amount of CGRP piled up in the sciatic nerve at 1 d after the ligation,significantly higher in proximal segment than that in distal segment,gradually dropping till disappear basically at 14 d in proximal segment and at 7 d in distal segment.The expression of CGRP in DRG at 7 d began to drop after the ligation,at 21 d to the minimal value and at 28 d lower than normal.The CGRP-immunoreactivety in ipsilateral spinal dorsal horn at 14 d decreased after operation,but the immuno-positive areas of CGRP were of no changes.There are no changes in the CGRP-positive spinal ventral motoneurons of all groups.Conclusion The changes of CGRP presented a temporo-spatial pattern following peripheral nerve legation,maybe resulting from the deficiency of neurothrophins from target organs.

Objective:To analyze the digital substraction angiography (DSA) features of inferior petrosal sinus (IPS) in patients with carotid cavernous fistulas (CCF), and explore its guiding value in endovascular treatment of CCF.Methods:The surgical process and whole brain DSA images of 76 CCF patients accepted endovascular treatment in our hospital from January 2013 to December 2019 were retrospectively analyzed. These patients were divided into direct CCF group ( n=52) and indirect CCF group ( n=24) according to the Barrow typing. The development of IPS in the affected side of the 2 groups was compared, and the location of IPS entry into the internal jugular vein (IJV) in patients from direct CCF group and indirect CCF group during the whole process of IPS development was compared, and the efficacy of endovascular treatment of CCF by IPS was analyzed. Results:Indirect CCF group had significantly higher proportion of patients with poor visualization (45.8%, 11/24) as compared with direct CCF group (17.3%, 9/52, P<0.05). Except one patient with IPS not connecting to IJV, the proportion of intracranial IPS-IJV junction showed no significant difference between the two groups ( P>0.05). IPS embolization was the first choice for all the 24 indirect CCF patients: 13 patients with IPS whole-process development had a relatively smooth superselecative cathelerization (reperfusion rate=100%), and the time of microcatheter placement was relatively short (32 min on average); in the 11 patients with poor IPS development, 5 were successfully opened by loach guidewire guidance and microguide wire looping technique (reperfusion rate=45%), and microcatheter placement was relatively long (69 min on average). Conclusions:Indirect CCF has a high rate of IPS occlusion. Lateral and 3D images show that IPS is parallel to the petrous bone segment of internal carotid artery. Mastering the course of IPS and the location of its terminal into IJV has very important value for guiding the microcatheter to enter the cavernous sinus through the poorly visualized IPS.

Objective·To investigate the effect of F-box only protein 38(FBXO38)on the ocular melanoma proliferation and the potential regulatory pathway.Methods·Human skin cutaneous melanoma A375 and human uveal melanoma OMM2.3 cell lines with FBXO38 knockdown and overexpression were constructed by FBXO38 short hairpin RNA(shRNA)and FBXO38 overexpression plasmids respectively.Knockdown and overexpression efficiency of FBXO38 at transcription and protein levels were verified by using quantitative real-time PCR(qRT-PCR)and Western blotting.The effects of FBXO38 on melanoma cell proliferation were detected through clonal formation assay,BrdU immunofluorescence staining and CCK8 cell proliferation assay.By using The Cancer Genome Atlas(TCGA)database,differentially expressed genes were analyzed in the high and low expression groups of FBXO38.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment was performed to reveal the signaling pathways associated with FBXO38.CCK8 cell proliferation assay was used to detect the inhibition rates of the signaling pathway inhibitors on cells with different FBXO38 expression levels.qRT-PCR and Western blotting were used to detect whether the signaling pathway was activated after knocking down FBXO38.Results·qRT-PCR and Western blotting verified that mRNA and protein expression levels of FBXO38 in FBXO38 knockdown A375 and OMM2.3 cell lines decreased compared with the control group,while the expression levels of FBXO38 in the overexpression cell lines increased compared with wild type group(P＜0.05).Clonal formation assay,BrdU immunofluorescence staining and CCK8 cell proliferation assay showed that FBXO38 knockdown significantly enhanced the proliferation of A375 and OMM2.3 cells(P＜0.05),while overexpression of FBXO38 inhibited melanoma cell proliferation(P＜0.05).Enrichment analysis showed that in skin cutaneous melanoma and uveal melanoma,FBXO38 expression influenced the phosphoinositide 3-kinase/protein kinase B(PI3K-Akt)pathway activation.Compared with those in the control group,the inhibition rates of P13K inhibitor LY294002 and mTOR1 inhibitor Everolimus in the FBXO38 knockdown group significantly improved(P＜0.05),while their inhibition rates of the overexpression group significantly decreased compared with those of control cells(P＜0.05).Western blotting results showed that after knocking down FBXO38,expression levels of PTEN,P21 and P53 proteins decreased,while expression level of MDM2 protein increased.The qRT-PCR results showed a significant decrease in P53 transcription level(P＜0.05)and a significant increase in MDM2 transcription level in FBXO38 knockdown cells(P＜0.05).Conclusion·FBXO38 plays a role in regulating the proliferation of ocular melanoma,and this regulatory effect is related to the PI3K-Akt signaling pathway.