Adverse pregnancy outcome (APO) refers to any pregnancy outcome other than a normal live birth, mainly including preeclampsia, fetal growth restriction, recurrent pregnancy loss, etc., which seriously threaten the health of both the mother and the fetus. Most APOs originate from abnormal uterine endometrial microenvironment before pregnancy. Once a woman confirms pregnancy, intervening in the uterine endometrium at this stage is often too late. The uterine endometrium, as a key site for embryo implantation and development, its abnormal microenvironment can lead to APO. Therefore, in-depth exploration of the relationship between the pre-pregnancy uterine endometrial microenvironment and APO is helpful for clarifying the mechanism of APO occurrence and providing key ideas and methods for early prevention and treatment. This article reviews the latest research on the mechanism of action between uterine endometrial microenvironment and APO, systematically summarizing the research progress and main conclusions in this field from several aspects such as immune imbalance, inflammatory response, abnormal energy metabolism, and senescence of uterine endometrial stromal cells.

Adverse pregnancy outcome (APO) refers to any pregnancy outcome other than a normal live birth, mainly including preeclampsia, fetal growth restriction, recurrent pregnancy loss, etc., which seriously threaten the health of both the mother and the fetus. Most APOs originate from abnormal uterine endometrial microenvironment before pregnancy. Once a woman confirms pregnancy, intervening in the uterine endometrium at this stage is often too late. The uterine endometrium, as a key site for embryo implantation and development, its abnormal microenvironment can lead to APO. Therefore, in-depth exploration of the relationship between the pre-pregnancy uterine endometrial microenvironment and APO is helpful for clarifying the mechanism of APO occurrence and providing key ideas and methods for early prevention and treatment. This article reviews the latest research on the mechanism of action between uterine endometrial microenvironment and APO, systematically summarizing the research progress and main conclusions in this field from several aspects such as immune imbalance, inflammatory response, abnormal energy metabolism, and senescence of uterine endometrial stromal cells.

Objective:To observe the effect of Wenyang Huazhuo recipe (WYHZ) on pregnancy outcomes in patients with unexplained recurrent spontaneous abortion (URSA).Methods:A retrospective cohort study was used and 240 cases of pregnancy URSA patients with spleen kidney yang deficiency syndrome at the Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and Department of Gynaecology and Obstetrics, General Hospital of Tianjin Medial University from November 2018 to March 2022 were recruited. The patients were assigned to WYHZ group (120 cases) and control group (120 cases) based on whether accepting oral WYHZ from 3 months before pregnancy to 8-12 weeks after pregnancy regularly. Pregnancy outcomes, perinatal period outcomes and obstetric complications were compared between the two groups. Multivariate logistic regression were used to analyze the effect of WYHZ on pregnancy outcome.Results:The live birth rate and the clinical pregnancy rate in WYHZ group [86.67% (104/120), 90.00% (108/120)] were higher than those in control group [71.67% (86/120), P=0.004; 75.00% (90/120), P=0.002]. The early abortion rate in WYHZ group [10.08% (12/119)] was lower than that in control group [25.86% (30/116), P=0.002], the differences were statistically significant. There were no significant differences in perinatal outcome and incidence rate of obstetric complications between the two groups (all P>0.05). Multivariate logistic regression analysis showed that the application of WYHZ significantly improved the live birth rate ( OR=8.818, 95% CI: 3.556-21.871, P<0.001) and sustained pregnancy rate ( OR=11.261, 95% CI: 4.262-29.751, P<0.001) in URSA patients. Conclusion:WYHZ using before and during pregnancy can significantly improve the live birth rate and the clinical pregnancy rate of URSA patients with syndrome of yang deficiency of spleen and kidney, and improve their pregnancy outcomes.

Diminished ovarian reserve (DOR) is a common reproductive endocrine disease in women, which is an important factor leading to the decline of female fertility. The number and quality of oocytes in DOR women gradually decrease with age, which leads to the decline of fertility in women. Mitochondrial dysfunction is an important cause of oocyte quality decline. In recent years, studies have found that mitophagy, as an important mechanism of self-repair and metabolic balance in cells, is closely related to oocyte development. This article focuses on the regulation of mitochondrial DNA copy number and mutation, ATP content, mitochondrial reactive oxygen species content, mitochondrial membrane potential changes on mitophagy, and the effects on oocyte development and the regulation of drugs on oocyte mitophagy.

Objective:To observe the effect of Wenyang Huazhuo recipe (WYHZ) on pregnancy outcomes in patients with unexplained recurrent spontaneous abortion (URSA).Methods:A retrospective cohort study was used and 240 cases of pregnancy URSA patients with spleen kidney yang deficiency syndrome at the Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and Department of Gynaecology and Obstetrics, General Hospital of Tianjin Medial University from November 2018 to March 2022 were recruited. The patients were assigned to WYHZ group (120 cases) and control group (120 cases) based on whether accepting oral WYHZ from 3 months before pregnancy to 8-12 weeks after pregnancy regularly. Pregnancy outcomes, perinatal period outcomes and obstetric complications were compared between the two groups. Multivariate logistic regression were used to analyze the effect of WYHZ on pregnancy outcome.Results:The live birth rate and the clinical pregnancy rate in WYHZ group [86.67% (104/120), 90.00% (108/120)] were higher than those in control group [71.67% (86/120), P=0.004; 75.00% (90/120), P=0.002]. The early abortion rate in WYHZ group [10.08% (12/119)] was lower than that in control group [25.86% (30/116), P=0.002], the differences were statistically significant. There were no significant differences in perinatal outcome and incidence rate of obstetric complications between the two groups (all P>0.05). Multivariate logistic regression analysis showed that the application of WYHZ significantly improved the live birth rate ( OR=8.818, 95% CI: 3.556-21.871, P<0.001) and sustained pregnancy rate ( OR=11.261, 95% CI: 4.262-29.751, P<0.001) in URSA patients. Conclusion:WYHZ using before and during pregnancy can significantly improve the live birth rate and the clinical pregnancy rate of URSA patients with syndrome of yang deficiency of spleen and kidney, and improve their pregnancy outcomes.

Diminished ovarian reserve (DOR) is a common reproductive endocrine disease in women, which is an important factor leading to the decline of female fertility. The number and quality of oocytes in DOR women gradually decrease with age, which leads to the decline of fertility in women. Mitochondrial dysfunction is an important cause of oocyte quality decline. In recent years, studies have found that mitophagy, as an important mechanism of self-repair and metabolic balance in cells, is closely related to oocyte development. This article focuses on the regulation of mitochondrial DNA copy number and mutation, ATP content, mitochondrial reactive oxygen species content, mitochondrial membrane potential changes on mitophagy, and the effects on oocyte development and the regulation of drugs on oocyte mitophagy.

It is believed that the key pathogenesis of endometriosis combined with infertility is spleen and kidney yang deficiency and binding of dampness and stasis， for which the method of warming yang and removing turbidity is advocated， and self-made Wenyang Huazhuo Formula （温阳化浊方） is recommended with flexibility by stages in accordance with the rules of the changes of yin and yang in the menstrual cycle and the storing and drainage of uterus. Specifically， during the menstruation， it is suggested to warm channels and invigorate blood， drain dampness and remove dampness； during the late menstruation， the method of warming yang and replenishing yin， regulating and supplementing the chong mai （冲脉） and ren mai （任脉）； for inter-menstruation period， it is advised to warm yang and replenish qi， rectify qi and harmonize blood； in terms of premenstrual period， the method of warming and supplementing spleen and kidney， warming uterus and assisting in fertility can be used. Accordingly， Formulas at the menstruation stage， follicular stage， ovulation stage， and luteal stage to warm yang and remove turbidity are recommended in their modifications， respectively.

Objective: To observe any curative effect on dysphagia of freehand respiratory training applied to hemiplegic stroke survivors. Methods: Forty-eight hospitalized, hemiplegic stroke survivors were randomly divided into an observation group and a control group, each of 24. Both groups received routine stroke rehabilitation, including motor function training, exercise training, physical therapy and swallowing training. The observation group was additionally provided with barehanded breathing function training, mainly consisting of cough glottis exercise, lip constriction aspiration exercise, chest movement exercise, abdominal muscle contraction and relaxation exercise, as well as abdominal aspiration training. The intervention lasted for 6 weeks for both groups. Before and after the intervention the maximum breathing time, first and second forced volume (FEV₁), forced vital capacity (FVC), maximum inspiratory pressure (PImax), standardized swallowing assessment (SSA), Kubota drinking water test (KDWT) and functional dysphagia scale (FDS) scoring were quantified for both groups. Results: There was no significant difference between the two groups′ averages on any of the measurements before the intervention. Afterward, however, the average maximal breathing time, FEV₁, FVC, and PImax of the observation group were all significantly higher than before the intervention and significantly higher than those of the control group. After treatment, the observation group′s average KDWT efficiency was not, however, significantly better than that of the control group. Moreover, after the treatment the average SSA and FDS of the observation group were significantly lower than those of the control group, as well as significantly better than before the treatment. Conclusion Barehanded breathing function training can supplement routine rehabilitation to significantly improve the breathing of stroke survivors.

AIM:To investigate the influence of Jiedu hugan granule on the inflammatory factor and tight junction protein of small intestine in rats with immunological liver injury.METHODS:Fifty SD rats were randomly divided into control group,model group,low,middle and high experimental group of Jiedu hugan granule (2.7,5.4,and 10.8 g/kg).All the groups excepted the control group received intraperitoneal injections of 0.5 mL pig serum for each to establish immunological liver injury model.The experimental group was irrigated ltime/d,continuous dosing for 14 d.The liver tissue and small intestinal tissue pathological changes were observed by HE staining,the serum alanine aminotransferase (ALT),aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were detected,and the expression of liver tissue TNF-α and small intestine tissue occludin-5 were detected by immunohistochemical method.RESULTS:The model group liver tissue showed accumulation of fat cells,liver cells enlargement,disorganized liver and associated with inflammatory cells infiltration;the experimental group liver cell morphological ruled,hepatic cords in alignment and inflammatory cells infiltration significantly decrease.The model group small intestinal mucosa villi showed atrophy,fall off of epithelial cell,edema,large number of inflammatory cells infiltration;the experimental group showed closelyknitted small intestinal mucosa villi,relieve edema,and no obvious infiltration of inflammatory cells.The levels of ALT,AST,LDH and TNF-α in experimental group were statistically lower than the model group,and the levels were statistically reduce with the dose of jiedu hugan granule increased.The levels of occludin-5 in experimental group were statistically highter than those of the model group,and the levels of occludin-5 were statistically increase with the dose of Jiedu hugan granule increased,the differences were statistically significant (P ＜ 0.05).CONCLUSION:Jiedu hugan granule can improve the organizational structure of liver and small intestine,protect the damage of liver,reduce inflammation,and maintain small intestine mucosal barrier function.