Objective:To explore the mechanism of Yiqi Huoxue Prescription in regulating ferroptosis in endometriosis through MIR-143-3P targeting.Methods:The adherent purification method was used to culture in vitro the isolated endometrial tissue from patients with endometriosis, both in situ and ectopic. The CCK-8 assay was used to detect cell viability. ELISA was used to detect the levels of Fe 2+, MDA, and reduced GSH, and qPCR was used to detect the mRNA expressions of GPX4 and MIR-143-3P. Female SD rats were randomly divided into five groups: sham-operation group, model group, and Yiqi Huoxue Prescription low -, medium -, high - dosage groups, with 8 rats in each group. An endometriosis rat model was established through surgery. Yiqi Huoxue Prescription low-, medium-, and high- dosage groups were administered the solution at dosages of 6.25, 12.5, and 25 g/kg respectively. The sham-operation group and the model group were given the same volume of normal saline. Administration was done twice a day for four consecutive weeks. The volume and weight of ectopic endometrial lesions in rats were measured. HE staining was used to observe pathological changes in the lesions. Levels of Fe 2+, MDA, and GSH were determined. PCR was used to detect GPX4 and MIR-143-3P mRNA levels, and Western blot analysis was used to assess the protein expressions of solute carrier family 7 member 11 (SLC7A11) and GPX4. Results:Compared with the eutopic endometrial cells, the viability of ectopic endometrial cells was enhanced, and the levels of Fe 2+, MDA, and MIR-143-3P mRNA decreased ( P<0.01), while the levels of GSH and GPX4 mRNA increased ( P<0.01). Compared with the model group, the volume and weight of ectopic lesions were reduced in Yiqi Huoxue Prescription high-dosage group ( P<0.01), levels of MIR-143-3P, Fe 2+, and MDA in ectopic lesions were elevated ( P<0.05 or P<0.01), and GSH and GPX4 mRNA levels, as well as the expression levels of SLC7A11 and GPX4 in ectopic lesions, decreased ( P<0.05 or P<0.01). Conclusion:MIR-143-3P is involved in the regulation of ferroptosis in ectopic endometrial cells, and high-dosage Yiqi Huoxue Prescription may promote ferroptosis in ectopic endometrial cells by up-regulating the expression of MIR-143-3P, thereby reducing the ectopic endometrial lesions in endometriosis rats.

Objective:To evaluate the effect of Qishi Tongguan Prescription on pregnancy outcomes after interventional recanalisation in patients with tubal infertility (TFI).Methods:This was a retrospective study based on real-world and propensity score matching. Totally 260 patients with TFI from January 2020 to October 2021 in Shuguang Hospital of Shanghai University of Traditional Chinese Medicine and Maternal and Child Health Hospital of Pudong New Area were selected as observation subjects, and were divided into 123 cases in the TCM combination group and 137 cases in the control group based on whether they were treated with Qishi Tongguan Prescription in combination with interventional revascularization. Propensity score matching (PSM) was used as a covariate to obtain a new sample of inter group covariate equilibrium, and confounding factors that may affect the pregnancy outcome of TFI patients undergoing interventional recanalization surgery were used as covariates. The intrauterine pregnancy rate, ectopic pregnancy rate, biochemical pregnancy rate, early abortion rate and adverse reactions of the two groups of patients within 12 months of follow-up were compared, and the influence of TFI intervention and recanalization combined with Qishi Tongguan Prescription on intrauterine pregnancy rate was evaluated.Results:Age, years of infertility, type of infertility, history of miscarriage, history of ectopic pregnancy, history of biochemical pregnancy, history of uterine surgery, history of pelvic laparotomy, and degree of tubal patency had an effect on whether intrauterine pregnancy was achieved after interventional reversal in patients with TFI ( P<0.05), with age [ OR (95% CI) was 0.843 (0.769, 0.926)], history of pelvic laparotomy [ OR (95% CI) was 0.477 (0.248, 0.920)] and the degree of tubal obstruction [ OR (95% CI) was 0.152 (0.046, 0.500)] were independent factors ( P<0.01 or P<0.05). 81 patients were seen in each of the 2 groups after PSM, of whom the intrauterine pregnancy rates in the combined herbal group at 9 and 12 months after recanalisation were 48.1% (39/81) and 58.0% (47/81) respectively, compared with 32.1% (26/81) and 35.8% (29/81) in the control group, with statistical significance between the 2 groups ( χ2 values of 4.34 and 8.03, respectively, P<0.01); there was no statistical significance in the ectopic pregnancy rate, biochemical pregnancy rate and early abortion rate between the 2 groups ( P>0.05). There were no significant adverse reactions during the treatment. Conclusion:Qishi Tongguan Prescription combined with interventional recanalization can effectively improve the intrauterine pregnancy rate and shorten the waiting time for pregnancy in patients with TFI with higher safety.