1.Selection, installation, and acceptance test of MRI simulator
Xinyuan CHEN ; Wei HAN ; Yixin SONG ; Kuo MEN ; Chuanmeng NIU ; Lijing ZUO ; Wenting REN ; Jianrong DAI
Chinese Journal of Radiation Oncology 2017;26(5):603-606
Magnetic resonance imaging (MRI) simulator (MRI-Sim) can provide superior images for radiotherapy.Due to the complexity of MRI technology and the safety problem caused by strong magnetic field, the acquisition and implementation of MRI simulation is more complicated than CT simulation.In order to ensure the introduction of MRI-Sim, this paper reviews the selection, installation, and acceptance test of MRI-Sim, including the selection of host and auxiliary equipment, installation site preparation, and safety precautions,as well as MRI-Sim acceptance test and commissioning.
2.Clinical Efficacy and Transcriptomics Study of Shuihuo Zhongyu Decoction in the Treatment of Patients with Intrauterine Adhesion of Kidney Deficiency and Blood Stasis Syndrome
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(9):970-978
OBJECTIVE To observe the clinical efficacy of Shuihuo Zhongyu Decoction combined with estrogen and progesterone sequential treatment for patients with intrauterine adhesion(IUA)of kidney deficiency and blood stasis syndrome,and to explore its possible mechanism of action by transcriptomics.METHODS A total of 70 hospitalized patients with IUA of kidney deficiency and blood stasis syndrome who met the inclusion criteria were retrospectively selected,with 35 cases in the observation group and 35 cases in the control group.The control group underwent hysteroscopic transcervical resection of adhesion(TCRA)and then received estrogen and progesterone sequential treatment.The observation group was treated with Shuihuo Zhongyu Decoction on the basis of the treatment of the control group.The treatment course of both groups was 3 months.The TCM syndrome scores,therapeutic efficacy,AFS scores,endometrial thickness(ED),endometrial receptivity[endometrial volume(EV),endometrial flow index(FI),vascularization index(VI),vascularization flow index(VFI)],pregnancy outcomes and intrauterine re-adhesion were evaluated in the 2 groups before and after treatment.10 cases of endometrial tissues in each group were selected for transcriptomic sequencing,and differentially expressed genes were verified by qPCR.RESULTS After treatment,the TCM syndrome scores,AFS scores and CD138 positive rate in the 2 groups were significantly decreased(P<0.05),and the observation group was better than the control group(P<0.05);after treatment,ED,EV,FI,VI and VFI in the observation group were significantly increased(P<0.01),which were better than those in the control group(P<0.05,P<0.01);the therapeutic efficacy,pregnancy rate and incidence of intrauterine re-adhesion in the observation group were better than those in the control group(P<0.05,P<0.01).Transcriptomics results showed that a total of 365 differentially ex-pressed genes(DEGs)were found in the observation group compared with the control group,of which 132 were upregulated,including sulfotransferase family 2B member 1(SULT2B1),apolipoprotein A1(APOA1),etc.;233 were downregulated,including lactoferrin(LTF),C-X-C chemokine ligand 1(CXCL1),etc.;GO function and KEGG pathway enrichment analysis showed that SHT may in-teract with metal ions,glycosaminoglycans,protein serine/threonine kinases,endopeptidases,etc.in the membrane components,plasma membrane,extracellular part,extracellular matrix,etc.,and play a role by regulating biological processes such as cell adhe-sion,extracellular tissue structure,and antigen receptor regulation.The signaling pathways involved include chemokine signaling path-way,chemokine and cytokine receptor interactions,IL-17 signaling pathway,nuclear factor-κ-light chain enhanced of activated B cells(NF-κB),etc.CONCLUSION Shuihuo Zhongyu Decoction can effectively improve the clinical symptoms of IUA patients with kidney deficiency and blood stasis syndrome,reduce AFS scores,increase endometrial thickness,improve endometrial receptivity,im-prove pregnancy outcomes,and decrease the incidence of intrauterine re-adhesion.Its mechanism may be related to upregulating SULT2B1 and APOA1,downregulating the expression of genes such as LTF and CXCL1,and regulating signal pathways such as che-mokines,IL-17,and NF-κB.
3.Effect and Mechanisms of Kaiyu Zhongyutang on Insulin Resistance, Glucose and Lipid Metabolism, Psychological State, and Embryo Outcome in Infertile Patients with PCOS Due to Liver Depression and Kidney Deficiency
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(24):130-137
ObjectiveTo explore the effects and mechanisms of Kaiyu Zhongyutang on insulin resistance, glucose and lipid metabolism, psychological state, and embryo outcome in the infertile patients with polycystic ovary syndrome (PCOS) due to liver depression and kidney deficiency. MethodThe 126 infertile patients with PCOS due to liver depression and kidney deficiency who underwent in vitro fertilization-embryo transfer (IVF-ET) in the Department of Reproduction of the affiliated hospital of Nanjing university of Chinese medicine were randomly assigned into the observation (Kaiyu Zhongyutang + metformin) and control (metformin) groups. The two groups were compared in terms of traditional Chinese medicine (TCM) syndrome scores, body mass index (BMI), glucose and lipid metabolism, homeostasis model assessment-insulin resistance (HOMA-IR), interleukin (IL)-6, IL-8, C-reactive protein (CRP), self-rating depression scale (SDS) score, self-rating anxiety scale (SAS) score, and clinical and laboratory scores of IVF after treatment. Result① After treatment, the observation group showed decreased scores of primary and secondary TCM syndromes and total TCM syndrome score (P < 0.05), and the control group presented decreased scores of irritability and depression and total TCM syndrome score (P<0.05). Compared with the control group, the observation group demonstrated reduced primary and secondary syndrome scores and total score after treatment (P<0.05). ② After treatment, both groups showed decreased BMI, lowered levels of fasting insulin (FINS), fasting plasma glucose (FPG), cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and HOMA-IR (P<0.05), and elevated high-density lipoprotein (HDL) level (P<0.05). Moreover, the observation group had lower BMI, FINS, FPG, TC, TG, LDL, and HOMA-IR and higher HDL than the control group (P<0.05). ③ The treatment in both groups lowered the levels of IL-6, IL-8, and CRP and decreased SDS and SAS scores (P<0.05). Moreover, the declines in the observation group were more obvious than those in the control group (P<0.05). ④ Correlation analysis before treatment, IL-6, IL-8, and CRP had positive correlations with BMI, HOMA-IR, TC, TG, LDL, SDS, and SAS (P<0.05) and a negative correlation with HDL (P<0.05). ⑤ The observation group showed reduced gonadotropin (Gn) using days and total Gn dose and higher two-pronuclear (2PN) fertilized oocytes, 2PN cleavage rate, normal fertilization rate, D3 transferable embryo number, D3 high-quality embryo number, high-quality embryo rate, and blastocyst formation rate than the control group (P<0.05). ConclusionKaiyu Zhongyutang can treat PCOS patients by improving the emotional and reproductive functions and alleviating insulin resistance and glucose and lipid metabolism disorders. Moreover, it can reduce the Gn dose and Gn using days in the IVF process, improve the quality and maturity of eggs, increase the egg fertilization rate, enhance the potential of embryo development, and increase the rate of blastocyst formation by inhibiting inflammation.