Objective To study the effect of Shaoyaozhitong Mixture on stageⅢ-Ⅳendometriosis, and explore its mechanism. Methods Ninty-five cases of stageⅢ-Ⅳ endometriosis were randomly divided into three groups. The traditional Chinese medicine (TCM) group (31 cases) was treated with Shaoyaozhitong Mixture, the GnRHa group (31 cases) was treated with Triptorelin Acetate for Injection, while the expectant group (33 cases) received no medications. The changes of CA125, TNF-α and VEGF levels, visual pain score and SF-36 score, total effective rate, pregnancy and recurrence were compared. Results There were significant increases in CA125, TNF-α and VEGF levels, visual analogue pain score and SF-36 score in all the three groups after treatment (P<0.05). The decline of CA125, TNF-αand VEGF levels and visual analogue pain score in TCM group and GnRHa group was significantly faster and greater than that of the expectant group (P<0.05). The total effective rates of TCM group was 83.9%(26/31), GnRHa group was 87.1%(27/31), and expectant group was 60.6%(20/33), TCM group and GnRHa group were superior to the expectant group, respectively (P<0.05). The pregnancy rate was higher and recurrence rate was lower in TCM group and GnRHa group than that of expectant group, but there was no statistical difference (P>0.05). Conclusion Shaoyaozhitong Mixture is effective in treating endometriosis by inhibiting the growth of ectopic endometrium.

Objective:To explore the effect of progesterone treatment during early pregnancy on natural pregnancy outcome in patients with endometriosis .Methods :A total of 120 postoperative endometriosis patients with single natural intrauterine preg-nancy from January 2008 to January 2013 were enrolled and randomly divided into Group A and Group B ,with 60 cases in each group .Meanwhile ,100 cases of normal single intrauterine pregnancy in the same period were enrolled as control group (Group C) .Serum progesterone levels were detected regularly in the three groups .Those who had lower progesterone levels (lower than 15 ng/mL) in Group A were treated with progesterone and the dose of progesterone was adjusted according to serum pro-gesterone level .Pregnancy outcomes of patients in the three groups were compared .Results:At 5~5+6 gestational weeks ,the progesterone levels of Group A and Group B were significantly lower than that of Group C [(14 .3 ± 5 .2)ng/mL、(15 .1 ± 4 .9) ng/mL vs .(19 .3 ± 3 .8)ng/mL] ,P<0 .05 .After progesterone treatment ,the serum progesterone level was significantly in-creased in Group A .At 6~6+6 gestational weeks ,no statistically significant difference in serum progesterone level was found between Group A and Group C (P>0 .05);serum progesterone level in Group B was signficantly lower than that in Group C (P<0 .05) .At 10~10+6 gestational weeks ,no statistically significant difference in serum progesterone level was found among the three groups (P> 0 .05) .The incidence of early embryonic diapause in Group B (11 .7% )was significantly higher than those in Group A (3 .3% ) and Group C (5 .0% ) ,P<0 .05 .No statistically significant differences in the incidences of abortion , stillbirth ,premature delivery and fetal malformation were found among the three groups .Conclusions :Detection of serum pro-gesterone level and replenishing of progesterone timely in the early natural pregnancy women with endometriosis can reduce em-bryonic diapauses .The optimal time to replenish progesterone may be at 5~10 gestational weeks .

Objective To study the mechanism of Yangjing Zhongyu Decoction in regulating the initiation of primordial follicles in model rats with diminished ovarian reserve(DOR)based on lncRNA.Methods Three-day-old female rats were selected and their ovaries were cultured in vitro.The blank group,model group,DHEA group and Yangjing Zhongyu Decoction high-,medium-and low-dosage groups were set.The DOR model was induced by triptolide,corresponding drug containing serum was given to culture respectively.HE staining was used to observe germ cells and follicles,Western blot was used for determining the expressions of AMH,BMP15,PTEN,MST,TGF-β1,p-Smad1 protein,RT-PCR was used to detected AMH,BMP15,PTEN,MST,LTCONS-00011173,TGF-β1,Smad1 mRNA expression.Results Compared with the blank group,the number of primordial and growing follicles in the model group rats decreased(P<0.05),the expression of AMH,BMP15,TGF-β1,p-Smad1 protein in ovarian tissue decreased(P<0.05),expressions of PTEN and MST proteins increased(P<0.05),AMH,BMP15,TGF-β1,Smad1 mRNA expression decreased(P<0.05),while the expressions of PTEN,MST,and LTCONS-00011173 mRNA increased(P<0.05).Compared with the model group,the DHEA group and Yangjing Zhongyu Decoction high-and medium-dosage groups showed an increase in the number of primordial and growing follicles(P<0.05),the expressions of AMH,BMP15,TGF-β1 and p-Smad1 protein in ovarian tissue increased(P<0.05),PTEN and MST protein expressions decreased(P<0.05),AMH,BMP15,TGF-β1,Smad1 mRNA expressions increased(P<0.05),while PTEN,MST,and LTCONS-00011173 mRNA expressions decreased(P<0.05).Conclusion Yangjing Zhongyu Decoction may mediate TGF-β1/Smad1 signaling pathway through LTCONS-00011173,regulating primordial follicle initiation in DOR model rats.

OBJECTIVETo explore the effect difference between acupuncture combined with Chinese medicine of artificial cycle therapy on the basis of western medication and simple western medication for polycystic ovarian syndrome (PCOS) of phlegm damp type with insulin resistance, and to explore its mechanism.

METHODSSixty patients were randomly assigned into an observation group and a control group, 30 cases in each group. Patients of the control group began to take letrozole and metformin orally on the third menstrual day. Patients of the observation group were treated with acupuncture combined with Chinese medicine of artificial cycle therapy on the basis of the treatment of the control group. The main acupoints were Guanyuan (CV 4), Qihai (CV 6) and bilateral Zigong (EX-CA 1), Luanchao (Extra), Fenglong (ST 40), Yinlingquan (SP 9), Zusanli (ST 36), Sanyinjiao (SP 6). Dahe (KI 12) was matched in the follicular phase, and warm acupuncture was applied at Guanyuan (CV 4) and Qihai (CV 6); Zhongji (CV 3) and Xuehai (SP 10) were matched in the ovulatory phase, and electroacupuncture were used at Qihai (CV 6) and Zhongji (CV 3), Xuehai (SP 10) and Yinlingquan (SP 9), 2 Hz and continuous wave; The acupoints in the luteal phase were the above main acupoints, at the same time, moxibustion was used at Guanyuan (CV 4) and Qihai (CV 6), the treatment was given once every other day, 30 min a time. There was no treatment in the menstrual phase. Chinese medicine was applied for tonifying kidney and nourishing blood, strengthening spleen and eliminating phlegm. The patients of the two groups were treated for continuous three menstrual cycles. The indexes before and after treatment were detected, including serum microRNA-29 (miR-29) expression, TCM symptom score, insulin (INS), blood-sugar content and homeostasis model assessment-insulin resistance (HOMA-IR) index, the endocrine hormone values of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), LH/FSH ratio, prolactin (PRL). The pregnancy rates of the two groups were compared.

RESULTSAfter treatment the expressions of miR-29 and TCM symptom scores of the two groups were lower than those before treatment (<0.01,<0.05), with better results in the observation group (<0.01,<0.05). The levels of LH LH/FSH and T of the observation group were lower than those before treatment (<0.01,<0.05), and the T value in the control group decreased after treatment (<0.05). The changes of LH and LH/FSH in the observation group were better than those in the control group (both<0.05). After treatment, The INS, blood-sugar content and HOMA-IR were lower than those before treatment in the two groups (<0.05,<0.01), with better results for INS and HOMA-IR improvements in the observation group (both<0.05). The pregnancy rate in the observation group was 56.7% (17/30), which was significantly higher than 30.0% (9/30) in the control group (<0.05).

CONCLUSIONAcupuncture combined with Chinese medicine of artificial cycle therapy can improve the endocrine levels and insulin resistance of PCOS with phlegm damp type. At the same time, the pregnancy rate is improved. By the view of molecular biology, there may be a pathway trough changing serum miR-29 expression.