OBJECTIVETo observe the effects of "menstrual cycle-based acupuncture therapy" on ovarian function and pregnancy results of in vitro fertilization-embryo transfer (IVF-ET) in patients with decline in ovarian reserve (DOR).

METHODSA total of 63 patients of DOR who received treatment of IVF/intracytoplasmic sperm injection (ICSI) were randomly divided into an observation group (30 cases) and a control group (33 cases). The patients in the observation group were treated with "menstrual cycle-based acupuncture therapy". The syndrome differentiation and treatment were given based on different phases of menstruation. Shiqizhui (EX-B 8) and Mingmen (GV 4) were selected during menstrual phase, Shenshu (BL 23), Geshu (BL 17), Sanyinjiao (SP 6) and Taixi (KI 3) were selected after menstruation, Qihai (CV 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zusanli (ST 36) were selected during ovulatory period, Qihai (CV 6), Guanyuan (CV 4), Yanglingquan (GB 34), Taichong (LR 3) were selected before menstruation. The acupuncture was given twice a week until second menstrual cycle of oocyte retrieval. The total times of acupuncture was (15 ± 2). After acupuncture, patients were treated with IVF-ET. The patients in the control group were treated with IVF-ET but no acupuncture. The indices of ovarian reserve function, including basic follicle-stimulating hormone (FSH), estradiol (E2), antral follicle count (AFC), number of retrieved oocytes, number of fertilization and number of high quality embryo, were compared and analyzed before and after acupuncture in the observation group. The differences of outcomes of IVF-ET, including the cycle cancellation rate, implantation rate, the clinical pregnancy rate, were compared between the two groups.

RESULTSCompared before acupuncture, the E2, AFC, number of retrieved oocytes, number of high quality embrgo and number of fertilization were all increased after acupuncture in the observation group (all P< 0. 05). Compared with the control group, levels of the E2, the number of retrieved oocytes, number of fertilization and number of high quality embryo were all increased in the observation group (all P < 0.05). Also, the implantation rate, the clinical pregnancy rate were improved (both P < 0.01) and cycle cancellation rate was reduced (P< 0.01).

CONCLUSIONThe "menstrual cycle-based acupuncture therapy" can effectively improve the ovarian reserve function in DOR patients, leading to an improved clinical pregnancy rate of IVF-ET.

Acupuncture Therapy ; Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; physiopathology ; therapy ; Menstrual Cycle ; Middle Aged ; Ovarian Reserve ; Ovary ; physiopathology ; Pregnancy ; Young Adult

Objective To explore lipoxinA4 (LXA4) expression in maternal serum of pregnant women and the protective effect and mechanism of LXA4 on trophoblastic cells from oxidative injury. Methods Trophoblastic cells were randomized into six groups: Control group; Lipopolysaccharides (LPS) group, cells were stimulated by 10 μg/ml LPS for 24 h; Intervention group, cells stimulated by LPS were treated with 100 nmol/L LXA4 for 24 h; LXA4 group, cells were treated with 100 nmol/L LXA4 for 24 h; Antagonistic group, cells stimulated by LPS were treated with 100 nmol/L LXA4 plus 100 μmol/L N-tert-butoxycarbonyl-2-pyrrolidine (BOC-2) for 24 h; BOC-2 group, trophoblastic cells stimulated by LPS were treated with 100 μmol/L BOC-2 for 24 h. The serum concentration of LXA4 in normal group and preeclampsia group was detected by ELISA. The intracellular formation of reactive oxygen species (ROS) was detected by 2,7-dichlorofluorescein diacetate (DCFH-DA) as a fluorescent probe. SOD mRNA was analyzed by RT-PCR. SOD and Nrf2 protein expressions were analyzed by Western blot. The levels of SOD in trophoblastic cells were detected by using detection kit. Results (1) The serum concentration of LXA4 was significantly lower in preeclampsia group (165.53±18.89) pg/L than in the control [(545.67±30.91) pg/L, P<0.01]. (2) Compared with control group, the levels of ROS in LPS group were significantly higher, DCF density of trophoblastic cells increased from 53.00±3.08 to 77.00±5.83 (P<0.01). The expression of nuclear Nrf2 protein, SOD mRNA and protein in LPS group were obviously decreased (P<0.01). The levels of SOD in LPS group were also significantly lower (P<0.01). (3) Compared with LPS group, the levels of ROS in intervention group were significantly lower, DCF density of trophoblastic cells decreased from 77.00±5.83 to 62.00±3.39 (P<0.01). The expression of nuclear Nrf2 protein, SOD mRNA in intervention group were obviously increased (P<0.01), so did the SOD protein expression (P<0.05). The levels of SOD were significantly increased from (4.77±0.34) U/ml to (8.93±0.53) U/ml (P<0.01). (4) The levels of SOD in antagonistic group were lower than in intervention group, but still higher than LPS group. [(6.23±0.41) U/ml vs (8.93±0.53) U/ml (P<0.01) or (4.77±0.34) U/ml (P<0.01)]. No significant difference was found in the levels of SOD between BOC-2 and LPS group (P>0.05). Conclusions LXA4 can significantly reduce the oxidative stress of placental trophoblastic cells stimulated by LPS. LXA4 can bind to lipoxin receptors and activate Nrf2-ARE signaling pathway playing a protective effect. So LXA4 in pregnant women can affect the oxidative stress of placenta.

AIM: To explore the serum levels of visfatin (VF) and tumor necrosis factor-alpha (TNF-α) in the patients with pre-eclampsia (PE) and their correlation with insulin resistance (IR).METHODS: The severe PE pa-tients (n =30), mild PE patients (n =30) and normal pregnant women (n =40) were selected according to the classifica-tion standard of PE.The serum levels of VF and TNF-αwere measured by ELISA.Fasting plasma glucose (FPG) and fasting insulin (FIns) were detected by glucose oxidase method and radioimmunoassay, respectively.Triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol ( HDL-C) and low-density lipoprotein cholesterol ( LDL-C) were measured by an automatic biochemical analyzer.According to calculating the mean arterial pressure (MAP), body mass index (BMI) and homeostatic model assessment for insulin resistance index (HOMA-IR), the correlation between IR and the levels of serum VF as well as TNF-αwere analyzed.RESULTS: The levels of VF and TNF-αin severe PE group and mild PE group were significantly lower than those in normal pregnancy group (P <0.05).In addition, the levels of VF and TNF-αin severe PE group were lower than those in mild PE group (P <0.05).Linear correlation analysis showed that serum VF was positively correlated with TNF-αand HDL-C (P <0.05), and negatively with MAP and FIns (P <0.05). The serum TNF-αwas positively correlated with HDL-C (P <0.05), and negatively with BMI, TG, MAP and FIns (P <0.05).Multiple stepwise regression analysis showed that FBG, FIns and HOMA-IR were relative independent factors of se-
rum VF and TNF-α(P <0.05).CONCLUSION: Serum levels of VF and TNF-αare closely related to IR.

It analyzed the definition, mechanism, characteristics of Mirror Visual Feedback and summarized the application of mirror visual feedback in recovering upper limb function after stroke patients at home and abroad, so as to provide evidences for the further research in China.

AIM:To investigate the expression of visfatin in the placenta of patients with preeclampsia and its significance.METHODS:The pregnant women (n=100) were divided into normal pregnancy group , mild preeclampsia group and severe preeclampsia group according to the severity of the disease .The pathological changes of the placenta were observed by hematoxylin-eosin staining .The expression of visfatin at mRNA and protein levels in the placenta was detected by real-time PCR and immunohistochemistry respectively .RESULTS:Compared with normal pregnancy group , the patho-logical changes of the placenta in preeclampsia groups was significant , showing that the structure and the form were disor-dered and incompleted in both cytotrophoblasts and syncytiotrophoblasts .The proliferation of cytotrophoblasts and the num-bers of the placental villi with syncytial knots were observed .The vascular numbers of villi were decreased and congested . The results of immunohistochemistry and real-time PCR showed that the visfatin protein was observed in the cytoplasm of cy-totrophoblasts and syncytiotrophoblasts among 3 groups.The expression of visfatin at mRNA and protein levels was in-creased with the severity of the preeclampsia .CONCLUSION:The injury and dysfunction of vascular endothelial cells in the villi exist in the patients with preeclampsia .High expression of visfatin at mRNA and protein levels in placenta of the patients with preeclampsia indicates that visfatin is closely related to preeclampsia .

ObjectiveTo investigate the effects of 5(S),6(R),7-trihydroxyheptanoic acid methyl ester (BML-111) on pregnant mice with fetal growth restriction(FGR) induced by antenatal dexamethasone and its probable mechanism. MethodsThe mice were mated overnight,with day 1 of pregnancy designated as the day on which spermatozoa were presented in a vaginal smear.The pregnant mice were then randomly divided into control group,dexamethasone group and BML-111 group.From 9 to 14 days of pregnancy,pregnant ICR mice of control,dexamethasone and BML-111 group were treated separately with saline,dexamethasone(5 mg/kg) and dexamethasone at 8:00 am,and two hours later they were treated separately again with 1 mg/kg saline,saline and BML-111.On the day 18 of gestation,they were sacrificed after blood were collected from their eyeballs.The serum lipoxin A4 was measured with enzyme-linked immunosorbent assay. Fetuses were delivered by cesarean section; the placenta and uterus were immediately removed and frozen.Gene expressions of 11β-hydroxysteroid dehydrogenase 2 ( 11β-HSD2 ),interleukin-1β (IL-1β) in placenta and lipoxin A4 receptor-formyl peptide receptor 3 (FPR3)in uterine were detected by reverse transcriptionpolymerase chain reaction and compared with analysis of variance.The 11β-HSD2 protein in mice placenta was detected by immunohistochemistry. ResultsThe mean fetal weight of dexamethasone group was (0.823±0.054) g,lower than that of the control group and BML-111 group [(1.103±0.218) g and (0.992 ± 0.207) g] (t =- 4.108 and - 2.890,P ＜ 0.05 respectively).Protein expression of 11β-HSD2 in dexamethasone group (0.030±0.019) was weaker than that in control group (0.058±0.015,t=-3.107,P＜0.05) or in BML-111 group (0.049±0.026,t=-2.211,P＜0.05).The expression of 11β-HSD2 mRNA in dexamethasone group (0.457±0.062) was lower than that in control group (0.943±0.057,t=-9.418,P＜0.05) or in BML-111 group (0.698±0.071,t=-4.617,P＜0.05).Expression of IL-1β mRNA in dexamethasone group (0.543±0.103)was less than that in control group (0.710± 0.085,t=-3.736,P＜0.05) but more than that in BML-111 group (0.229 ±0.031,t=7.025,P＜0.05). The expression of FPR3 mRNA in dexamethasone group (0.323 ± 0.019) was less than that in control group (0.857 ± 0.057,t =-14.630,P＜0.05) or in BML-111 group (0.499 ±0.050,t=-4.822,P＜0.05).The serum concentration of lipoxin A4 in dexamethasone group was lower than that in control group [(64.463±22.144) pg/ml vs (101.610±24.916) pg/ml,t=3.152,P＜0.05].ConclusionsBML-111 regulate the expression of 11β-HSD2 and then protect against FGR resulted from too much prenatal application of dexamethasone.

Objective To investigate the expression and clinical significance of lipoxin A4,leukotrienc C4,lipoxygenase-5 in peripheral blood of pregnant women with different types of severe preeclampsia.Methods Forty-five singleton pregnant women who accepted antenatal care and delivered in First Affiliated Hospital of Wenzhou Medical College were enrolled in this study from December 2010 to June 2011.All objects were divided into normal pregnancy group (n=20),early onset severe preeclampsia group (n=10) and late onset severe preeclampsia group (n=15).Enzymelinked immunosorbent assay was used to detect lipoxin A4 and leukotriene C4 levels in peripheral blood.The level of lipoxygenase-5 mRNA in white blood cells was detected by real time fluorescence quantitative reverse transcription-polymerase chain reaction.The differences of lipoxin A4,leukotriene C4 and lipoxygenase-5 mRNA among groups were compared by analysis of variance and LSD-t test;and correlations among their expressions were analyzed by linear regression.Results Lipoxin A4 level in early and late onset severe preeclampsia group was (355.3±116.0) pg/ml and (389.7±117.5) pg/ml,which were both significantly lower than that in normal pregnancy group [(555.0±139.8) pg/ml] (t=-4.03 and-3.77,P＜0.05 respectively).The leukotriene C4 level in early and lateonset severe preeclampsia and normal pregnaney group was (591.3±185.5) pg/ml,(510.3±197.1) pg/ml and (496.9 ± 158.8) pg/ml,no statistical difference were found (F=0.889,P＞0.05) ; neither did the expression of lipoxygenase 5 mRNA,which was 4.2± 1.9 in normal pregnancy group,4.8 ± 2.0 in early onset severe preeclampsia group and 4.4 ± 1.2 in late onset severe preeclampsia group (F=0.311,P＞0.05).There was no correlation among the levels of lipoxin A4,leukotriene C4 and lipoxygenase-5 mRNA in each group (P ＞ 0.05).Conclusions Early and remarkable decreasing of lipoxin A4 level might contribute to the development of early onset severe preeclampsia.

Objective:To explore the clinical effect of mycophenolate mofetil combined with glucocorticosteroid on the children with anaphylatic purpura nephritis.Methods:70 cases of children treated and diagnosed as anaphylatic purpura nephritis in our hospital from March,2012 to September,2015 were enrolled in this study.They were randomly divided into the observation group and the control group.Conventional therapy was applied to both groups,the observation group was treated by mycophenolate mofetil combined with prednisone,the control group was given cyclophosphamide combined with prednisone.The total effective rate,disappearence time of clinical symptoms,biochemical indicators,immune function as well as the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of observation group was 94.29％,which was 85.17％ in the control group,no statistical difference was found between two groups(P＞0.05).After therapy,the disappearence time of albuminuria,hematuria in observation group showed no significant difference compared with those of the control group,the level of 24 h urine protein quantitation and CD19+ of both groups were significantly decreased,and the level of CD19+ of observation group was significantly lower than that of the control group (P ＜0.05),the level of albumin,total protein and CD3+,CD3+CD4+ of both groups were significantly increased,and the level of CD3+,CD3+CD4+of observation group were significantly higher than those of the control group (P＜0.05).The incidence of adverse reactions in observation group was significantly lower than that of the control group (P ＜0.05).Conclusion:Mycophenolate mofetil combined with glucocorticosteroid was more effective and safe on the children with anaphylatic purpura nephritis than that of cyclophosphamide combined with prednisone.

Objective:To study the difference in anti-hepatic fiborsis components between pre-and post-processed Trionyx Sinensis Carapace to guide the clinical application of Trionyx Sinensis Carapace. Methods:SDS-PAGE gel electrophoresis was used to compare the constituents in pre-and post-processed Trionyx Sinensis Carapace, and the inhibitory effect on the proliferation of HSC-T6 was deter-mined by MTT. Results:The processed Trionyx Sinensis Carapace had much more components than the crude Trionyx Sinensis Cara-pace,and the relative molecular mass in the first-level band decreased resulting in the generation of micromolecular polypeptides. Both pre-and post-processed Trionyx Sinensis Carapace had anti-hepatic fibrosis, while the vinegar-processed Trionyx Sinensis was more ef-fective. Conclusion:The difference in the active components in pre- and post-processed Trionyx Sinensis Carapace is obvious, which provides foundation for the clinical application and further researches.

Objective To evaluate the potential risk of schistosomiasis transmission in the area along the Yangtze River in Yangzhou City,so as to provide evidences for establishing a post?transmission surveillance system for schistosomiasis in marsh?land regions. Methods The water infectivity,floating boatmen and fishermen infection,reservoir host infection and wild feces contamination were investigated in five districts/counties along the Yangtze River in Yangzhou City,including Guangling,Hanji?ang,Jiangdu,Yizheng and Development Zone,and the transmission factors and risky characteristics were assessed after inter?ruption of schistosomiasis transmission in marshland regions. Results A total of 15 key water regions were identified in the area along the Yangtze River in Yangzhou City in 2015. A total of 1 500 sentinel mice were placed,after breeding,their overall sur?vival rate was 99.33%;1 490 were dissected,with no schistosome infection. Of the 5 576 floating boatmen and fishermen exam?ined,no schistosome infection was observed,and among the 3 566 domestic animals(including 171 cattle,1 895 sheep and 1 500 pigs),no infections were detected. During the period between January and March,2016,there were 3 200 mouse traps placed on 8 marshlands,and 62 wild mice were captured from 6 marshlands,with a capture rate of 1.94%,and no schistosome?infected wild mice were seen. In addition,there were 35 pieces of fresh wild feces captured from 7 marshlands,including 11 pieces of bovine feces(31.43%),17 pieces of sheep feces(48.57%),2 pieces of dog feces(5.71%)and 5 pieces of other feces (14.29%),and no infections were detected. Conclusions There is a low risk of schistosomiasis transmission in the area along the Yangtze River in Yangzhou City. However,the contamination of feces from bovine and sheep that are freely pastured on marshlands is a big threat to schistosomiasis control.