OBJECTIVE: To observe the effects of electroacupuncture (EA) with different frequencies on spermatogenic function, testicular morphology and oxidative stress in oligoasthenospermia (OAT) rats, and to explore the mechanism and the optimal parameters of EA for OAT. METHODS: Sixty SPF-grade male SD rats were randomly divided into a solvent control group, a model group, a 2 Hz EA group, a 100 Hz EA group and a 2 Hz/100 Hz EA group, with 12 rats in each group. Except for the solvent control group, the other 4 groups were administered ornidazole suspension (800 mg·kg^-1·d^-1) by gavage for 28 d to establish the OAT model. Starting from the 1st of modeling, EA was applied at "Guanyuan" (CV4), "Qihai" (CV6) and bilateral "Sanyinjiao" (SP6) and "Zusanli" (ST36) in the 3 EA groups, continuous wave of 2 Hz, continuous wave of 100 Hz, and disperse-dense wave of 2 Hz/100 Hz were used in the 2 Hz EA group, the 100 Hz EA group, and the 2 Hz/100 Hz EA group, respectively, with current intensity of 1-3 mA, 30 min a time, once every other day, for 28 consecutive days. After intervention, the testicular index was calculated, epididymal sperm quality was assessed, and the fertility ability was observed; morphology of testicular tissue was observed by HE staining, and the Johnson score was calculated; the positive expression of reactive oxygen species (ROS) in testicular tissue was detected by immunofluorescence; the activity of superoxide dismutase (SOD) and catalase (CAT), as well as the level of malondialdehyde (MDA) in testicular tissue were measured by ELISA; the protein expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in testicular tissue was detected by Western blot. RESULTS: Compared with the solvent control group, in the model group, the testicular index, sperm concentration, sperm motility and the number of offspring were decreased (P<0.01), the seminiferous tubules atrophied and the Johnson score decreased (P<0.01); the activity of SOD and CAT, as well as the protein expression of Nrf2 and HO-1 in testicular tissue were decreased (P<0.01); the sperm deformity rate, the positive expression of ROS and the MDA level in testicular tissue were increased (P<0.01). Compared with the model group, in the 2 Hz EA group, the 100 Hz EA group and the 2 Hz/100 Hz EA group, the testicular index, sperm concentration, sperm motility and the number of offspring were increased (P<0.05, P<0.01), the pathological morphology of testicular tissue improved and the Johnson scores increased (P<0.01); the activity of SOD and CAT, as well as the protein expression of Nrf2 and HO-1 in testicular tissue were increased (P<0.05, P<0.01); the sperm deformity rate, the positive expression of ROS and the MDA level in testicular tissue were decreased (P<0.05, P<0.01). Compared with the 2 Hz EA group, in the 2 Hz/100 Hz EA group, the testicular index, sperm concentration, sperm motility, as well as the CAT activity and HO-1 protein expression in testicular tissue were increased (P<0.01, P<0.05); the positive expression of ROS was decreased (P<0.01). Compared with the 100 Hz EA group, in the 2 Hz/100 Hz EA group, the testicular index was increased (P<0.01), the positive expression of ROS in testicular tissue was decreased (P<0.01). CONCLUSION EA with 2 Hz continuous wave, 100 Hz continuous wave, and 2 Hz/100 Hz disperse-dense wave can all improve the spermatogenic arrest and reduce the level of oxidative stress in testicular tissue in OAT rats, the mechanism may be related to up-regulating the protein expression of Nrf2 and HO-1 and improving oxidative stress. EA with disperse-dense wave of 2 Hz/100 Hz shows the optimal effect.
Male ; Animals ; Electroacupuncture ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Spermatogenesis ; Oligospermia/genetics* ; Humans ; Testis/metabolism* ; Superoxide Dismutase/metabolism* ; Asthenozoospermia/genetics* ; Acupuncture Points ; Malondialdehyde/metabolism*

Objective:To explore whether the duration of oral estrogen treatment before progesterone application affects neonatal outcome in single frozen-thawed embryo transfer (FET) with artificial cycles.Methods:It was a retrospective cohort study. Patients who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), receiving single frozen blastocyst transfer with artificial cycle and delivering a single live birth in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University between January 2015 and December 2019 were included. All FET cycles were divided into four groups according to the estrogen treatment duration before progesterone application, ≤12 d ( n=306), 13-15 d ( n=620), 16-18 d ( n=471), and ≥19 d ( n=275). Primary outcome was the incidence of small for gestational age (SGA). Secondary outcomes were the incidence of preterm birth, low birth weight, macrosomia and large for gestational age (LGA). Results:A total of 1 672 single blastocyst transfer cycles were included. The incidence of SGA among the four groups was 7.8% (24/306), 4.8% (30/620), 5.7% (27/471), and 7.6% (21/275), respectively, with no statistically significant difference ( P=0.204). The results of multiple logistic regression analysis showed that the duration of estrogen used before progesterone application did not affect the incidence of SGA in singleton offspring (with ≤12 d as the reference, 13-15 d: a OR=1.37, 95% CI: 0.70-2.70, P=0.361; 16-18 d: a OR=0.74, 95% CI: 0.40-1.36, P=0.336; ≥19 d: a OR=0.81, 95% CI: 0.44-1.49, P=0.501). There were no significant differences in neonatal preterm birth rate ( P=0.204), low birth weight ( P=0.582), incidences of macrosomia ( P=0.201) and LGA infants ( P=0.335) among the four groups. Conclusion:In artificial FET cycle, the duration of oral estrogen treatment before progesterone application does not affect the outcome of singleton offspring after single blastocyst transfer.

Objective:To explore whether the duration of oral estrogen treatment before progesterone application affects neonatal outcome in single frozen-thawed embryo transfer (FET) with artificial cycles.Methods:It was a retrospective cohort study. Patients who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), receiving single frozen blastocyst transfer with artificial cycle and delivering a single live birth in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University between January 2015 and December 2019 were included. All FET cycles were divided into four groups according to the estrogen treatment duration before progesterone application, ≤12 d ( n=306), 13-15 d ( n=620), 16-18 d ( n=471), and ≥19 d ( n=275). Primary outcome was the incidence of small for gestational age (SGA). Secondary outcomes were the incidence of preterm birth, low birth weight, macrosomia and large for gestational age (LGA). Results:A total of 1 672 single blastocyst transfer cycles were included. The incidence of SGA among the four groups was 7.8% (24/306), 4.8% (30/620), 5.7% (27/471), and 7.6% (21/275), respectively, with no statistically significant difference ( P=0.204). The results of multiple logistic regression analysis showed that the duration of estrogen used before progesterone application did not affect the incidence of SGA in singleton offspring (with ≤12 d as the reference, 13-15 d: a OR=1.37, 95% CI: 0.70-2.70, P=0.361; 16-18 d: a OR=0.74, 95% CI: 0.40-1.36, P=0.336; ≥19 d: a OR=0.81, 95% CI: 0.44-1.49, P=0.501). There were no significant differences in neonatal preterm birth rate ( P=0.204), low birth weight ( P=0.582), incidences of macrosomia ( P=0.201) and LGA infants ( P=0.335) among the four groups. Conclusion:In artificial FET cycle, the duration of oral estrogen treatment before progesterone application does not affect the outcome of singleton offspring after single blastocyst transfer.

Objective:To investigate whether there are differences in clinical pregnancy and perinatal outcomes among different protocols for artificial insemination by donor (AID) in female patients aged ≤35 years.Methods:This retrospective cohort study analyzed clinical data of patients who underwent AID at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 1, 2016 to January 31, 2021. Based on ovulation induction therapy, patients were divided into 4 groups: natural cycle (NC) group, letrozole (LE)/clomiphene (CC) group, gonadotropin (Gn) group and LE/CC combined with Gn (LE/CC+Gn) group. The clinical outcomes, incidence of complications, and offspring health were compared among these groups, and logistic regression analysis was employed to investigate the effects of different protocols on the clinical and perinatal outcomes of AID cycles.Results:In NC group, LE/CC group, Gn group and LE/CC+Gn group, the cycle cancellation rate [0.5% (11/2 147), 1.1% (12/1 045), 1.6% (9/549), 3.2% (9/315), P<0.001], the clinical pregnancy rate [31.5% (673/2 136), 35.8% (370/1 033), 42.8% (231/540), 38.2% (117/306), P<0.001], the multiple pregnancy rate [0.7% (5/673), 3.2% (12/370), 3.5% (8/231), 6.8% (8/117), P<0.001], the abortion rate [12.8% (86/673), 9.2% (34/370), 5.2% (12/231), 8.5% (10/117), P=0.008] and the live birth rate [27.2% (581/2 136), 31.4% (324/1 033), 40.0% (216/540), 34.3% (105/306), P<0.001] were statistically significant, while the differences among the four groups in the ectopic pregnancy rate, the preterm birth rate, and the overdue birth rate were not statistically significant (all P>0.05). After adjusting for confounding factors, the differences were not statistically significant in all indicators compared with the NC group (all P>0.05), except for the miscarriage rate in the LE/CC+Gn group, which was significantly higher than that in the NC group (a OR=2.141, 95% CI: 1.12-4.09; P=0.021). For patients who have been using the same treatment protocol, the cumulative pregnancy rate and the cumulative live birth rate in the NC group and the LE/CC group increased with the increase of assisted reproductive cycles, and the difference was statistically significant (all P<0.001). Regardless of whether confounding factors were adjusted, there were no statistically significant differences in neonatal mortality rate, low birth weight rate, normal birth weight rate, macrosomia rate, and male-to-female ratio among the groups (all P>0.05). Conclusion:In AID cycles with female patients aged ≤35 years, stimulated cycles had similar pregnancy outcomes to natural cycles and did not increase the risk of adverse neonatal outcomes or multiple pregnancies. Choosing the LE/CC stimulation protocol can improve the cumulative pregnancy rate of patients with abnormal ovarian follicle development or ovulation function.

Objective:To investigate whether there are differences in clinical pregnancy and perinatal outcomes among different protocols for artificial insemination by donor (AID) in female patients aged ≤35 years.Methods:This retrospective cohort study analyzed clinical data of patients who underwent AID at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 1, 2016 to January 31, 2021. Based on ovulation induction therapy, patients were divided into 4 groups: natural cycle (NC) group, letrozole (LE)/clomiphene (CC) group, gonadotropin (Gn) group and LE/CC combined with Gn (LE/CC+Gn) group. The clinical outcomes, incidence of complications, and offspring health were compared among these groups, and logistic regression analysis was employed to investigate the effects of different protocols on the clinical and perinatal outcomes of AID cycles.Results:In NC group, LE/CC group, Gn group and LE/CC+Gn group, the cycle cancellation rate [0.5% (11/2 147), 1.1% (12/1 045), 1.6% (9/549), 3.2% (9/315), P<0.001], the clinical pregnancy rate [31.5% (673/2 136), 35.8% (370/1 033), 42.8% (231/540), 38.2% (117/306), P<0.001], the multiple pregnancy rate [0.7% (5/673), 3.2% (12/370), 3.5% (8/231), 6.8% (8/117), P<0.001], the abortion rate [12.8% (86/673), 9.2% (34/370), 5.2% (12/231), 8.5% (10/117), P=0.008] and the live birth rate [27.2% (581/2 136), 31.4% (324/1 033), 40.0% (216/540), 34.3% (105/306), P<0.001] were statistically significant, while the differences among the four groups in the ectopic pregnancy rate, the preterm birth rate, and the overdue birth rate were not statistically significant (all P>0.05). After adjusting for confounding factors, the differences were not statistically significant in all indicators compared with the NC group (all P>0.05), except for the miscarriage rate in the LE/CC+Gn group, which was significantly higher than that in the NC group (a OR=2.141, 95% CI: 1.12-4.09; P=0.021). For patients who have been using the same treatment protocol, the cumulative pregnancy rate and the cumulative live birth rate in the NC group and the LE/CC group increased with the increase of assisted reproductive cycles, and the difference was statistically significant (all P<0.001). Regardless of whether confounding factors were adjusted, there were no statistically significant differences in neonatal mortality rate, low birth weight rate, normal birth weight rate, macrosomia rate, and male-to-female ratio among the groups (all P>0.05). Conclusion:In AID cycles with female patients aged ≤35 years, stimulated cycles had similar pregnancy outcomes to natural cycles and did not increase the risk of adverse neonatal outcomes or multiple pregnancies. Choosing the LE/CC stimulation protocol can improve the cumulative pregnancy rate of patients with abnormal ovarian follicle development or ovulation function.

Objective:To preliminarily explore the priority order of transfer of frozen low-quality blastocyst and high-quality cleavage embryos in the recovery frozen-thawed embryo transfer (FET) cycle of frozen embryos.Methods:In this retrospective study, 3677 in vitro fertilization-embryo transfer (IVF-ET) cycles were reviewed in Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from November 2015 to May 2018. According to the stage of embryo development, quality and number of embryos transferred, the embryos were divided into five groups: single-non-high-quality blastocyst group (group A), single-high-quality blastocyst group (group B), day 3 (D3) double-high-quality embryo group (group C), D3 high-quality plus non-high-quality embryo group (group D) and D3 double-non-high-quality embryo group (group E). According to the age of the patients, they were divided into three subgroups, <35 years old, 35-37 years old and >37 years old. The main observation indicator was live birth rate, and the secondary observation indicators were clinical pregnancy rate, implantation rate, and multiple birth rate. Results:The implantation rates of double D3 embryos transfer groups (groups C-E) were significantly lower than those of single blastocyst groups (groups A and B)(all P<0.05), while the multiple pregnancy rates were significantly higher than those of single blastocyst groups (all P<0.01). There was no significant difference in clinical pregnancy rate between group C and group A ( P>0.05). Live birth rate increased significantly when patients were younger than 35 years old ( P=0.003), but there was no significant difference when patients were older than 35 years old. There was no significant difference in clinical pregnancy rate and live birth rate between group D and group A when patients were younger than 38 years old. When the patient was over 37 years old, the clinical pregnancy rate of group D was lower significantly ( P=0.018), but there was no significant difference in the live birth rate ( P>0.05). The clinical pregnancy rate and the live birth rate of group E were lower than those of group A. The difference was significant when the age of the patients was less than 35 years and more than 37 years (all P<0.01). There was no significant difference when the age of the patients was 35-37 years ( P>0.05). Age and the type of embryos transferred were independent factors affecting live birth. After adjusting the effect of age on live birth, compared with group A, the effects of group B ( OR=1.311, 95% CI=1.083-1.586, P=0.005), group C ( OR=1.322, 95% CI=1.092-1.601, P=0.004), group E ( OR=0.616, 95% CI=0.468-0.809, P=0.001) on the live birth rate were significantly different, while the effects of group D ( OR=1.139, 95% CI=0.914-1.420, P=0.247) on the live birth rate was not significantly different from those of group A. Conclusion:Considering multiple pregnancies and live births, the optimal transplantation sequence of frozen embryo transfer cycle may be single-high-quality blastocyst, single-non-high-quality blastocyst, D3 double-high-quality embryo, D3 high-quality plus non-high-quality embryo and D3 double-non-high-quality embryo.

Objective:To preliminarily explore the priority order of transfer of frozen low-quality blastocyst and high-quality cleavage embryos in the recovery frozen-thawed embryo transfer (FET) cycle of frozen embryos.Methods:In this retrospective study, 3677 in vitro fertilization-embryo transfer (IVF-ET) cycles were reviewed in Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from November 2015 to May 2018. According to the stage of embryo development, quality and number of embryos transferred, the embryos were divided into five groups: single-non-high-quality blastocyst group (group A), single-high-quality blastocyst group (group B), day 3 (D3) double-high-quality embryo group (group C), D3 high-quality plus non-high-quality embryo group (group D) and D3 double-non-high-quality embryo group (group E). According to the age of the patients, they were divided into three subgroups, <35 years old, 35-37 years old and >37 years old. The main observation indicator was live birth rate, and the secondary observation indicators were clinical pregnancy rate, implantation rate, and multiple birth rate. Results:The implantation rates of double D3 embryos transfer groups (groups C-E) were significantly lower than those of single blastocyst groups (groups A and B)(all P<0.05), while the multiple pregnancy rates were significantly higher than those of single blastocyst groups (all P<0.01). There was no significant difference in clinical pregnancy rate between group C and group A ( P>0.05). Live birth rate increased significantly when patients were younger than 35 years old ( P=0.003), but there was no significant difference when patients were older than 35 years old. There was no significant difference in clinical pregnancy rate and live birth rate between group D and group A when patients were younger than 38 years old. When the patient was over 37 years old, the clinical pregnancy rate of group D was lower significantly ( P=0.018), but there was no significant difference in the live birth rate ( P>0.05). The clinical pregnancy rate and the live birth rate of group E were lower than those of group A. The difference was significant when the age of the patients was less than 35 years and more than 37 years (all P<0.01). There was no significant difference when the age of the patients was 35-37 years ( P>0.05). Age and the type of embryos transferred were independent factors affecting live birth. After adjusting the effect of age on live birth, compared with group A, the effects of group B ( OR=1.311, 95% CI=1.083-1.586, P=0.005), group C ( OR=1.322, 95% CI=1.092-1.601, P=0.004), group E ( OR=0.616, 95% CI=0.468-0.809, P=0.001) on the live birth rate were significantly different, while the effects of group D ( OR=1.139, 95% CI=0.914-1.420, P=0.247) on the live birth rate was not significantly different from those of group A. Conclusion:Considering multiple pregnancies and live births, the optimal transplantation sequence of frozen embryo transfer cycle may be single-high-quality blastocyst, single-non-high-quality blastocyst, D3 double-high-quality embryo, D3 high-quality plus non-high-quality embryo and D3 double-non-high-quality embryo.

Anti-Inflammatory Agents ; therapeutic use ; Antioxidants ; therapeutic use ; Diabetes Mellitus, Type 2 ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Herbal Medicine ; methods ; Humans ; Hypoglycemic Agents ; therapeutic use

Endophthalmitis ; diagnosis ; etiology ; Humans ; Klebsiella pneumoniae ; pathogenicity ; Male ; Middle Aged ; Substance Abuse, Intravenous ; complications

RNA interference (RNAi) is a process triggered by the introduction of small double strand RNA (dsRNA),which leads to a specific degradation of messenger RNA and therefore regulate the expression of target gene.Being one of post transcriptional gene silencing (PTGS),RNAi is found to extensively exist in the body.Some researches of ophthalmology showed that RNAi can be used to prevent and treat multiple eye diseases,including ocular neovascularization,anti-fibrosis,intraocular tumors,autoimmune uveoretinitis,etc.RNAi plays role in switching on and off the target gene.Because RNAi can inhibit gene expression specifically and efficiently,it has gained increasing attention in recent years.The basic concept,acting mechanics and character of RNAi and its application in ophthalmology were summarized.