Objective:To analyze the vaginal microecological status of vaginitis population and non-vaginitis population of gynecological female outpatients.Methods:A total of 30 265 women who visited the gynecological outpatient clinic of Beijing Obstetrics and Gynecology Hospital from December 2018 to December 2020 completed vaginal microecological examination. After removing the follow-up patients, 23 181 women were divided into group with symptoms and signs of vaginitis (6 697 cases) and group without symptoms and signs of vaginitis (16 484 cases), according to whether the women with symptoms and signs of vaginitis or not. And the vaginal microecological status of the two groups was compared and analyzed.Results:(1) The total detection rate of vaginitis in the initial women was 34.87% (8 083/23 181), of which 46.10% (3 087/6 697) in group with symptoms and signs of vaginitis and 30.31% (4 996/16 484) in group without symptoms and signs of vaginitis, nearly 1/3 of the gynecological outpatients without signs and symptoms of vaginitis had vaginitis. (2) Among the types of simple vaginitis, vulvovaginal candidiasis (VVC) was the most frequent in group with symptoms and signs of vaginitis (16.01%, 1 072/6 697), followed by aerobic vaginitis (AV; 12.83%, 859/6 697), with significant differences compared with group without symptoms and signs of vaginitis (all P<0.001). There were no statistical differences between the two groups of bacterial vaginosis (BV) and trichomonal vaginitis (TV), indicating that BV and TV were more likely to be neglected (all P>0.05). (3) The proportion of various combinations of vaginitis among 2 632 cases of mixed vaginitis were, in descending order: BV+AV, VVC+AV, BV+AV+VVC, AV+TV, AV+TV+BV, BV+VVC. (4) Microecological analysis of 15 098 cases diagnosed with non-vaginitis had normal flora (including those with normal flora and those with normal flora but decreased function) in 14 013 cases (92.81%, 14 013/15 098), abnormal flora in 429 cases (2.84%, 429/15 098) and the BV intermediate in 656 cases (4.34%, 656/15 098); this indicated that the vast majority of the microecological tests were normal in the vaginal microbiota of those without vaginitis. Conclusions:Microecological examination could diagnose multiple pathogenic infections at once, and is especially important as a guide for the definitive diagnosis of mixed vaginitis and vaginitis with atypical clinical symptoms. Vaginal infections such as BV and TV that are easily overlooked should be concerned.

ObjectiveTo investigate the effect and mechanism of Yiguan Decoction （YGJD） on the efficacy of M1 bone marrow-derived macrophages （M1-BMDMs） in the treatment of rats with liver cirrhosis induced by 2-AAF/CCl₄. MethodsBMDMs were isolated and induced into M1-BMDMs by lipopolysaccharide. A total of 50 male Wistar rats were randomly divided into normal group with 5 rats and model group with 45 rats. The rats for modeling were given subcutaneous injection of 50% CCl₄ twice a week. Since week 7， the rats for modeling were randomly divided into model group （M group）， YGJD group， M1-BMDM group， M1-BMDM+YGJD group， and sorafenib （SORA） group， and they were given subcutaneous injection of 30% CCl₄ to maintain the progression of liver cirrhosis and intragastric administration of 2-AAF. CCR2 inhibitors were added to the drinking water， and each group was given the corresponding intervention. Related samples were collected at week 9. The rats were observed in terms of serum liver function parameters， liver pathology， hydroxyproline （Hyp） content in liver tissue， hepatic stellate cell activation， hepatic fibrosis and inflammation factors， and the expression levels of molecules associated with the Wnt signaling pathway. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the M group， the M1-BMDM+YGJD group had significant reductions in the serum levels of alanine aminotransferase， aspartate aminotransferase， and total bilirubin （TBil） （all P<0.05） and a significant increase in the content of albumin （Alb） （P<0.05）， and compared with the M1-BMDM group， the M1-BMDM+YGJD group had a significant reduction in the serum level of TBil （P<0.05） and a significant increase in the serum level of Alb （P<0.05）. Compared with the M1-BMDM group， the M1-BMDM+YGJD group had significant reductions in the expression levels of CD68 and TNF-α （P<0.05）. Compared with the M1-BMDM group， the M1-BMDM+YGJD group had significant reductions in Hyp content and Sirius red positive area （P<0.05）. As for the non-canonical Wnt signaling pathway molecules， compared with the M1-BMDM group， the M1-BMDM+YGJD group had significantly lower mRNA and protein expression levels of Wnt5a （P<0.05） and mRNA expression level of Fzd2 （P<0.05）， as well as significant reductions in the mRNA expression levels of Wnt4， Wnt5b， and Fzd3 （P<0.05）， while there were no significant changes in the mRNA expression levels of the canonical Wnt signaling pathway molecules β-catenin， LRP5， LRP6， Fzd5， and TCF. ConclusionYGJD can enhance the therapeutic effect of M1-BMDMs on rats with liver cirrhosis induced by 2-AAF/CCl₄， possibly by inhibiting the non-canonical Wnt5a/Fzd2 signaling pathway， which provides new ideas for the synergistic effect of traditional Chinese medicine on M1-BMDMs in the treatment of liver cirrhosis.

ObjectiveTo investigate the effect of transplantation of bone marrow mesenchymal stem cells （BMSCs） co-cultured with bone marrow-derived M2 macrophages （M2-BMDMs）， named as BMSC^M2， on a rat model of liver cirrhosis induced by carbon tetrachloride （CCl₄）/2-acetaminofluorene （2-AAF）. MethodsRat BMDMs were isolated and polarized into M2 phenotype， and rat BMSCs were isolated and co-cultured with M2-BMDMs at the third generation to obtain BMSC^M2. The rats were given subcutaneous injection of CCl₄ for 6 weeks to establish a model of liver cirrhosis， and then they were randomly divided into model group （M group）， BMSC group， and BMSC^M2 group， with 6 rats in each group. A normal group （N group） with 6 rats was also established. Since week 7， the model rats were given 2-AAF by gavage in addition to the subcutaneous injection of CCl₄. Samples were collected at the end of week 10 to observe liver function， liver histopathology， and hydroxyproline （Hyp） content in liver tissue， as well as changes in the markers for hepatic stellate cells， hepatic progenitor cells， cholangiocytes， and hepatocytes. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the N group， the M group had significant increases in the activities of serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST） （P<0.01）； compared with the M group， the BMSC and BMSC^M2 groups had significant reductions in ALT and AST （P<0.01）， and the BMSC^M2 group had significantly better activities than the BMSC group （P<0.05）. Compared with the N group， the M group had significant increases in Hyp content and the mRNA and protein expression levels of alpha-smooth muscle actin （α-SMA） in the liver （P<0.01）； compared with the M group， the BMSC and BMSC^M2 groups had significant reductions in Hyp content and the expression of α-SMA （P<0.05）， and the BMSC^M2 group had a significantly lower level of α-SMA than the BMSC group （P<0.01）. Compared with the N group， the M group had significant increases in the mRNA expression levels of the hepatic progenitor cell markers EpCam and Sox9 and the cholangiocyte markers CK7 and CK19 （P<0.01） and significant reductions in the expression levels of the hepatocyte markers HNF-4α and Alb （P<0.01）； compared with the M group， the BMSC and BMSC^M2 groups had significant reductions in the mRNA expression levels of EpCam， Sox9， CK7， and CK19 （P<0.05） and significant increases in the mRNA expression levels of HNF-4α and Alb （P<0.05）， and compared with the BMSC group， the BMSC^M2 group had significant reductions in the mRNA expression levels of EpCam and CK19 （P<0.05） and significant increase in the expression level of HNF-4α （P<0.05）. ConclusionM2-BMDMs can enhance the therapeutic effect of BMSCs on CCl₄/2-AAF-induced liver cirrhosis in rats， which provides new ideas for further improving the therapeutic effect of BMSCs on liver cirrhosis.