1.Exploring the Effect of Astragaloside Ⅳ on the Immune Function of Systemic Lupus Erythematosus Mouse Model Based on NF-κB/NLRP3 Inflammasome
Yi QING ; Xu-Hui ZOU ; Fan WANG ; Jie-Lian LI ; Yun-Chun ZHAO
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(9):2433-2441
		                        		
		                        			
		                        			Objective To investigate the therapeutic effect and mechanism of astragaloside Ⅳ on systemic lupus erythematosus(SLE)mice.Methods A total of 40 female spontaneous MRL/lpr SLE model mice were randomly divided into five groups:model group,Prednisone group,astragaloside Ⅳ group,astragaloside Ⅳ+CHPG[nuclear factor KappaB(NF-κB)pathway activator]group and astragaloside Ⅳ+Nigerian[NOD-like receptor family pyrin domain containing protein 3(NLRP3)activator]group,with eight mice in each group.Eight female MRL/MpJ mice were used as normal group.During the administration,the body mass was weighted.After administration,the spleen,thymus and kidney were weighted,and the organ index was calculated.The 24-hour urinary protein level in urine samples,the biochemical indexes of creatinine(SCr),blood urea nitrogen(BUN),autoantibodies[antinuclear antibody(ANA),anti-double-stranded DNA(dsDNA)antibody,anti-snRNP/Sm antibody]and inflammatory mediators[interleukin(IL)-1β,IL-18]in blood samples were detected.The pathological damage of renal tissue was observed by hematoxylin-eosin(HE)staining,and the fibrosis of renal tissue was observed by Masson staining.The expressions of NF-κB/NLRP3 inflammasome pathway-related proteins in kidney and spleen tissues were detected by Western Blot.Results Compared with the model group,the body mass of mice in prednisone group and astragaloside Ⅳ group increased,the spleen index,thymus index and kidney index were decreased,the serum levels of ANA antibody,anti-dsDNA antibody and anti-snRNP/Sm antibody were decreased,the levels of SCr,BUN and 24-hour urine protein were decreased,the levels of IL-1 βand IL-18 wrere decreased,the ratios of p-p65/p65,p-IKBα/IKBα,cleaved caspase-1/pro caspase-1 and the relative expression of NLRP3 protein in kidney and spleen tissues were decreased(all P<0.05),and the pathological damage and fibrosis of renal tissue in SLE mice were alleviated,there being no significant difference between the two administration groups(P>0.05).NF-κB activator and NLRP3 inflammasome activator eliminated the improvement of astragaloside Ⅳ on the above indexes in SLE mice to a certain extent.Conclusion Astragaloside Ⅳ can improve the immune function of SLE mice,reduce renal injury and inflammatory response,and its mechanism may be related to its inhibition of the activation of NF-κB/NLRP3 inflammasome pathway.
		                        		
		                        		
		                        		
		                        	
2.Luteolin ameliorates ulcerative colitis in mice via reducing the depletion of NCR+ILC3 through Notch signaling pathway
Xueqian XIE ; Pengcheng LI ; Meng ZHAO ; Bo XU ; Guixing ZHANG ; Qing WANG ; Chen NI ; Xia LUO ; Lian ZHOU
Chinese Journal of Natural Medicines (English Ed.) 2024;22(11):991-1002
		                        		
		                        			
		                        			The disorder of group 3 innate lymphoid cells(ILC3)subgroup,such as the predominance of NCR-ILC3 but the deple-tion of NCR+ILC3,is unfavorable to damaged intestinal barrier repair,which leads to the prolongations and obstinacy of ulcerative colitis(UC).Our previous studies had shown that luteolin promoted NCRILC3 differentitating into NCR+ILC3 to improving the de-pletion of NCR+ILC3 in UC mice,while the mechanism is unclear.This article aimed to explore the underlying mechanism of luteolin enhancing the proportion NCR+ILC3.UC mice model was established with 2%DSS and Notch signaling was blocked,then luteolin was used to intervene.The results showed that the effect of luteolin on ameliorating disease symptoms in UC mice,including inhibit-ing the weight loss,reducing the pathological damage of colon mucosa,etc.,was diminished with blocking Notch signaling pathway.In addition,luteolin increased the proportion of NCR+ILC3,NCR+MNK3 and IL-22+ILC3,decreased intestinal permeability,pro-moted mucin secretion,and promoted ZO-1 and Occludin expression,the above effect of luteolin was neutralized by Notch inhibitor LY-411575.Luteolin activated the abnormally blocked Notch signaling pathway in UC mice.And molecular docking predicted the af-finity of luteolin for RBPJ to be-7.5 kcal·mol-1 in mouse,respectively;the affinity of luteolin for Notchl and RBPJ was respectively scored to be-6.4 kcal·mol-1 and-7.7 kcal·mol-1 homo sapiens.These results proved that luteolin is positive for enhancing the propor-tion of NCR+ILC3 via Notch signaling,and it provides a basis for targeting NCR+ILC3 for restoring intestinal barrier function to alle-viating ulcerative colitis.
		                        		
		                        		
		                        		
		                        	
3.Design of punching and positioning device for training Da Vinci surgical robots
Yi-Shu LIU ; Meng-Lu XU ; Qing-Lian KONG ; Li-Ping CAI
Chinese Medical Equipment Journal 2024;45(7):35-39
		                        		
		                        			
		                        			Objective To design a punching and positioning device for training Da Vinci surgical robots to improve the efficiency and accuracy of operation training.Methods The punching and positioning device mainly consisted of an abdominal girth,a connecting plate,a punching plate,a positioning disk and a punching cartridge.The abdominal girth had a long-strip shape and was made of stretch nylon elastic band;the connecting plate had a rectangular shape with its length direction perpendicular to the abdominal girth;the punching plate also had a rectangular shape and was made of hard silicone;the positioning plate was made of hard silicone and privided with a plated through hole;the punching cartridge were equipped with anti-fog components composed of heating wires and support strips,which had scale bars inside.Ten physicians were randomly divided into a control group and an experimental group,with 5 ones in each group.The two groups carried out positioning and punching respectively,with the traditional method for the control group and the device designed for the experimental group,which were compared in terms of the time consumption,ratio for lens fogging and number of collisions with the robotic arm.Results The experimental group had the time consumption and ratio for lens fogging lower significantly when compared with the control group(P<0.05),while had no obvious difference in number of collisions with the robotic arm(P>0.05),and the requirements of the training specifications were met.Conclusion The punching and positioning device has high efficiency and accuracy,and thus is worthy promoting for the operation training of surgical robots.[Chinese Medical Equipment Journal,2024,45(7):35-39]
		                        		
		                        		
		                        		
		                        	
4.Paeoniflorin ameliorates chronic colitis via the DR3 signaling pathway in group 3 innate lymphoid cells
Huang SHAOWEI ; Xie XUEQIAN ; Xu BO ; Pan ZENGFENG ; Liang JUNJIE ; Zhang MEILING ; Pan SIMIN ; Wang XIAOJING ; Zhao MENG ; Wang QING ; Chen JINYAN ; Li YANYANG ; Zhou LIAN ; Luo XIA
Journal of Pharmaceutical Analysis 2024;14(6):889-901
		                        		
		                        			
		                        			Inhibiting the death receptor 3(DR3)signaling pathway in group 3 innate lymphoid cells(ILC3s)pre-sents a promising approach for promoting mucosal repair in individuals with ulcerative colitis(UC).Paeoniflorin,a prominent component of Paeonia lactiflora Pall.,has demonstrated the ability to restore barrier function in UC mice,but the precise mechanism remains unclear.In this study,we aimed to delve into whether paeoniflorin may promote intestinal mucosal repair in chronic colitis by inhibiting DR3 signaling in ILC3s.C57BL/6 mice were subjected to random allocation into 7 distinct groups,namely the control group,the 2%dextran sodium sulfate(DSS)group,the paeoniflorin groups(25,50,and 100 mg/kg),the anti-tumor necrosis factor-like ligand 1A(anti-TL1A)antibody group,and the IgG group.We detected the expression of DR3 signaling pathway proteins and the proportion of ILC3s in the mouse colon using Western blot and flow cytometry,respectively.Meanwhile,DR3-overexpressing MNK-3 cells and 2% DSS-induced Rag1-/-mice were used for verification.The results showed that paeoniflorin alleviated DSS-induced chronic colitis and repaired the intestinal mucosal barrier.Simultaneously,paeoniflorin inhibited the DR3 signaling pathway in ILC3s and regulated the content of cytokines(interleukin-17A,granulocyte-macrophage colony stimulating factor,and interleukin-22).Alternatively,paeoniflorin directly inhibited the DR3 signaling pathway in ILC3s to repair mucosal damage indepen-dently of the adaptive immune system.We additionally confirmed that paeoniflorin-conditioned me-dium(CM)restored the expression of tight junctions in Caco-2 cells via coculture.In conclusion,paeoniflorin ameliorates chronic colitis by enhancing the intestinal barrier in an ILC3-dependent manner,and its mechanism is associated with the inhibition of the DR3 signaling pathway.
		                        		
		                        		
		                        		
		                        	
5.The expression mechanism of programmed cell death 1 ligand 1 and its role in immunomodulatory ability of mesenchymal stem cells
Zhuo CHEN ; Meng-Wei YAO ; Xiang AO ; Qing-Jia GONG ; Yi YANG ; Jin-Xia LIU ; Qi-Zhou LIAN ; Xiang XU ; Ling-Jing ZUO
Chinese Journal of Traumatology 2024;27(1):1-10
		                        		
		                        			
		                        			Programmed cell death 1 ligand 1 (PD-L1) is an important immunosuppressive molecule, which inhibits the function of T cells and other immune cells by binding to the receptor programmed cell death-1. The PD-L1 expression disorder plays an important role in the occurrence, development, and treatment of sepsis or other inflammatory diseases, and has become an important target for the treatment of these diseases. Mesenchymal stem cells (MSCs) are a kind of pluripotent stem cells with multiple differentiation potential. In recent years, MSCs have been found to have a strong immunosuppressive ability and are used to treat various inflammatory insults caused by hyperimmune diseases. Moreover, PD-L1 is deeply involved in the immunosuppressive events of MSCs and plays an important role in the treatment of various diseases. In this review, we will summarize the main regulatory mechanism of PD-L1 expression, and discuss various biological functions of PD-L1 in the immune regulation of MSCs.
		                        		
		                        		
		                        		
		                        	
6.Recompensation of complications in patients with hepatitis B virus-related decompensated cirrhosis treated with entecavir antiviral therapy.
Ting ZHANG ; You DENG ; Hai Yan KANG ; Hui Ling XIANG ; Yue Min NAN ; Jin Hua HU ; Qing Hua MENG ; Ji Lian FANG ; Jie XU ; Xiao Ming WANG ; Hong ZHAO ; Calvin Q PAN ; Ji Dong JIA ; Xiao Yuan XU ; Wen XIE
Chinese Journal of Hepatology 2023;31(7):692-697
		                        		
		                        			
		                        			Objective: To analyze the occurrence of recompensation conditions in patients with chronic hepatitis B virus-related decompensated cirrhosis after entecavir antiviral therapy. Methods: Patients with hepatitis B virus-related decompensated cirrhosis with ascites as the initial manifestation were prospectively enrolled. Patients who received entecavir treatment for 120 weeks and were followed up every 24 weeks (including clinical endpoint events, hematological and imaging indicators, and others) were calculated for recompensation rates according to the Baveno VII criteria. Measurement data were compared using the Student t-test or Mann-Whitney U test between groups. Categorical data were compared by the χ (2) test or Fisher's exact probability method between groups. Results: 283 of the 320 enrolled cases completed the 120-week follow-up, and 92.2% (261/283) achieved a virological response (HBV DNA 20 IU/ml). Child-Pugh and MELD scores were significantly improved after treatment (8.33 ± 1.90 vs. 5.77 ± 1.37, t = 12.70, P < 0.001; 13.37 ± 4.44 vs. 10.45 ± 4.58, t = 5.963, P < 0.001). During the 120-week follow-up period, 14 cases died, two received liver transplants, 19 developed hepatocellular cancer, 11 developed gastroesophageal variceal bleeding, and four developed hepatic encephalopathy. 60.4% (171/283) (no decompensation events occurred for 12 months) and 56.2% (159/283) (no decompensation events occurred for 12 months and improved liver function) of the patients had achieved clinical recompensation within 120 weeks. Patients with baseline MELD scores > 15 after active antiviral therapy achieved higher recompensation than patients with baseline MELD scores ≤15 [50/74 (67.6%) vs. 109/209 (52.2%), χ (2) = 5.275, P = 0.029]. Conclusion: Antiviral therapy can significantly improve the prognosis of patients with hepatitis B virus-related decompensated cirrhosis. The majority of patients (56.2%) had achieved recompensation. Patients with severe disease did not have a lower probability of recompensation at baseline than other patients.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hepatitis B virus/genetics*
		                        			;
		                        		
		                        			Hepatitis B, Chronic/drug therapy*
		                        			;
		                        		
		                        			Antiviral Agents/adverse effects*
		                        			;
		                        		
		                        			Esophageal and Gastric Varices/complications*
		                        			;
		                        		
		                        			Liver Cirrhosis/complications*
		                        			;
		                        		
		                        			Treatment Outcome
		                        			;
		                        		
		                        			Gastrointestinal Hemorrhage/complications*
		                        			;
		                        		
		                        			Hepatitis B/drug therapy*
		                        			
		                        		
		                        	
7.The In Vivo Intervention and Relative Mechanism of Genistein on the Inflammation and Thrombophilia in Lymphoma-Bearing Mice.
Zhi-Yue CHEN ; Qing-Qing SHI ; Xin SUN ; Jun NI ; Wei WU ; Lian-Jun SHEN ; Mei SUN ; Kai-Lin XU ; Jian GU ; Hao GU
Journal of Experimental Hematology 2023;31(1):125-129
		                        		
		                        			OBJECTIVE:
		                        			To investigate the in vivo intervention and relative mechanism of Genistein (GEN) on tumor-associated inflammatory and tumor thrombophilia in lymphoma-bearing mice.
		                        		
		                        			METHODS:
		                        			Forty female Balb/c mice aged 5-6 weeks were injected with murine-derived Pro B-cell lymphoma cell line 38B9 to establish a lymphoma mouse model, which was randomly divided into control group, tumor-bearing group, GEN drug intervention group and cyclophosphamide (CTX)drug intervention group. Histopathologic was used to evaluate the tumorigenesis. Tumor formation was observed, and tumor tissues were collected of HE and immunohistochemical staining. ELISA and flow cytometry were used to detect the expression of inflammatory factors and the changes of thrombus indices in plasma after intervention of GEN and Cyclophosphamide (CTX) respectively. Immunohistochemistry method was used to detect the expression of CD19 in tomor tissues of tummor bearing mice.
		                        		
		                        			RESULTS:
		                        			After 14 days of tumor bearing, the mice were tumorigenic. The lymphoma cells were diffusely distributed in the tumor tissue and the expression of CD19 in the tumor tissue was positive. The inflammatory factors such as IL-6, NETs and CLEC-2, and thrombotic indices such as TF, FIB and D-D in lymphoma-bearing mice were significantly higher than those before tumor-injection and lower than those after drug-intervention (all P<0.05). The levels of CLEC-2 and D-D in GEN group were significantly lower than those in CTX group (P<0.05).
		                        		
		                        			CONCLUSION
		                        			Tumor-associated inflammation and thrombophilia exist in lymphoma-bearing mice. GEN shows better anti-inflammatory and anti-thrombotic effects compared with CTX by interfering with tumor inflammatory factors.
		                        		
		                        		
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Genistein
		                        			;
		                        		
		                        			Lymphoma
		                        			;
		                        		
		                        			Cyclophosphamide
		                        			;
		                        		
		                        			Thrombophilia
		                        			;
		                        		
		                        			Inflammation
		                        			;
		                        		
		                        			Lectins, C-Type
		                        			
		                        		
		                        	
8.Regulatory Mechanism of Mangiferin Combined with Bortezomib on Malignant Biological Behavior of Burkitt Lymphoma and Its Effect on Expression of CXC Chemokine Receptors.
Zhi-Min YAN ; Yan-Quan LIU ; Qing-Lin XU ; Jie LIN ; Xin LIU ; Qiu-Ping ZHU ; Xin-Ji CHEN ; Ting-Bo LIU ; Xiao-Lan LIAN
Journal of Experimental Hematology 2023;31(5):1394-1402
		                        		
		                        			OBJECTIVE:
		                        			To analyze the effects of mangiferin combined with bortezomib on the proliferation, invasion, apoptosis and autophagy of human Burkitt lymphoma Raji cells, as well as the expression of CXC chemokine receptors (CXCRs) family, and explore the molecular mechanism between them to provide scientific basis for basic research and clinical work of Burkitt lymphoma.
		                        		
		                        			METHODS:
		                        			Raji cells were intervened with different concentrations of mangiferin and bortezomib alone or in combination, then cell proliferation was detected by CCK-8 assay, cell invasion ability was detected by Transwell chamber method, cell apoptosis was detected by Annexin V/PI double-staining flow cytometry, apoptosis, autophagy and Akt/mTOR pathway protein expression were detected by Western blot, and the expression changes of CXCR family was detected by real-time quantitative PCR (RT-qPCR).
		                        		
		                        			RESULTS:
		                        			Different concentrations of mangiferin intervened Raji cells for different time could inhibit cell viability in a concentration- and time-dependent manner (r =-0.682, r =-0.836). When Raji cells were intervened by combination of mangiferin and bortezomib, compared with single drug group, the proliferation and invasion abilities were significantly decreased, while the apoptosis level was significantly increased (P <0.01). Mangiferin combined with bortezomib could significantly up-regulate the expression of pro-apoptotic protein Bax and down-regulate the expression of anti-apoptotic protein Bcl-2 after intervention in Raji cells. Caspase-3 was also hydrolyzed and activated, and then induced the apoptosis of Raji cells. Mangiferin combined with bortezomib could up-regulate the expression of LC3Ⅱ protein in Raji cells, and the ratio of LC3Ⅱ/LC3Ⅰ in cells was significantly up-regulated compared with single drug or control group (P <0.01). Mangiferin combined with bortezomib could significantly inhibit the phosphorylation levels of Akt and mTOR, inhibit the proliferation and invasion of Raji cells by inhibiting Akt/mTOR pathway, and induce cell autophagy and apoptosis. Mangiferin and bortezomib could down-regulate the expressions of CXCR4 and CXCR7 mRNA after single-agent intervention in Raji cells, and the down-regulations of CXCR4 and CXCR7 mRNA expression were more significant when the two drugs were combined (P <0.01). Mangiferin alone or combined with bortezomib had no significant effect on CXCR5 mRNA expression in Raji cells (P >0.05), while the combination of the two drugs could down-regulate the expression of CXCR3 (P <0.05).
		                        		
		                        			CONCLUSION
		                        			Mangiferin combined with bortezomib can synergistically inhibit the proliferation and invasion of Raji cells, and induce autophagy and apoptosis. The mechanism may be related to the inhibition of Akt/mTOR signaling pathway, down-regulation of anti-apoptotic protein Bcl-2 and up-regulation of pro-apoptotic protein Bax, and the inhibition of the expression of CXCR family.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Antineoplastic Agents/therapeutic use*
		                        			;
		                        		
		                        			Apoptosis/drug effects*
		                        			;
		                        		
		                        			Apoptosis Regulatory Proteins/immunology*
		                        			;
		                        		
		                        			Autophagy/immunology*
		                        			;
		                        		
		                        			bcl-2-Associated X Protein/immunology*
		                        			;
		                        		
		                        			Bortezomib/therapeutic use*
		                        			;
		                        		
		                        			Burkitt Lymphoma/immunology*
		                        			;
		                        		
		                        			Cell Line, Tumor
		                        			;
		                        		
		                        			Cell Proliferation/drug effects*
		                        			;
		                        		
		                        			Drug Therapy, Combination
		                        			;
		                        		
		                        			Proto-Oncogene Proteins c-akt
		                        			;
		                        		
		                        			Proto-Oncogene Proteins c-bcl-2
		                        			;
		                        		
		                        			Receptors, CXCR/immunology*
		                        			;
		                        		
		                        			RNA, Messenger
		                        			;
		                        		
		                        			TOR Serine-Threonine Kinases
		                        			;
		                        		
		                        			Xanthones/therapeutic use*
		                        			
		                        		
		                        	
9.Mechanism of Zhenwu Decoction in improving renal inflammatory injury in mice with DN of spleen-kidney Yang deficiency syndrome by regulating ROCK/IKK/NF-κB pathway.
Yu-Qiu JIN ; Guang-Shun CHEN ; Min BAI ; Zhe ZHAO ; Yan-Xu CHEN ; Meng-Yuan TIAN ; Jia-Lian CHEN ; Qing-Sheng WANG ; Zhen-Hua LIU
China Journal of Chinese Materia Medica 2023;48(18):5041-5048
		                        		
		                        			
		                        			To investigate the intervention effect and mechanism of Zhenwu Decoction on diabetic nephropathy(DN) mice of spleen-kidney Yang deficiency syndrome based on the Rho-associated coiled-coil kinase(ROCK)/IκB kinase(IKK)/nuclear factor-κB(NF-κB) pathway. Ninety-five 7-week-old db/db male mice and 25 7-week-old db/m male mice were fed adaptively for one week. The DN model of spleen-kidney Yang deficiency syndrome was induced by Dahuang Decoction combined with hydrocortisone by gavage, and then the model was evaluated. After modeling, they were randomly divided into a model group, high-dose, medium-dose, and low-dose Zhenwu Decoction groups(33.8, 16.9, and 8.45 g·kg~(-1)·d~(-1)), and an irbesartan group(25 mg·kg~(-1)·d~(-1)), with at least 15 animals in each group. The intervention lasted for eight weeks. After the intervention, body weight and food intake were measured. Serum crea-tinine(Scr), blood urea nitrogen(BUN), fasting blood glucose(FBG), urinary albumin(uALb), and urine creatinine(Ucr) were determined. The uALb/Ucr ratio(ACR) and 24 h urinary protein(UTP) were calculated. Renal pathological morphology was evaluated by HE staining and Masson staining. The levels of key molecular proteins in the ROCK/IKK/NF-κB pathway were detected by Western blot. Enzyme-linked immunosorbent assay(ELISA) was used to detect interleukin-1β(IL-1β), interleukin-6(IL-6), interleukin-8(IL-8), interleukin-10(IL-10), and tumor necrosis factor-α(TNF-α). Compared with the blank group, the model group showed increased content of BUN, uALb, and SCr, increased values of 24 h UTP and ACR, decreased content of Ucr(P<0.05), enlarged glomeruli, thickened basement membrane, mesangial matrix proliferation, inflammatory cell infiltration, and collagen fiber deposition. The protein expression of ROCK1, ROCK2, IKK, NF-κB, phosphorylated IKK(p-IKK), phosphorylated NF-κB(p-NF-κB), and phosphorylated inhibitor of NF-κB(p-IκB) increased(P<0.05), while the protein expression of inhibitor of NF-κB(IκB) decreased(P<0.05). The levels of inflammatory factors IL-1β, IL-6, IL-8, and TNF-α increased(P<0.05), while the level of IL-10 decreased(P<0.05). Compared with the model group, the groups with drug treatment showed decreased levels of BUN, uALb, SCr, 24 h UTP, and ACR, increased level of Ucr(P<0.05), and improved renal pathological status to varying degrees. The high-and medium-dose Zhenwu Decoction groups and the irbesartan group showed reduced protein expression of ROCK1, ROCK2, IKK, NF-κB, p-IKK, p-NF-κB, and p-IκB in the kidneys(P<0.05), increased protein expression of IκB(P<0.05), decreased levels of serum inflammatory factors IL-1β, IL-6, IL-8, and TNF-α(P<0.05), and increased level of IL-10(P<0.05). Zhenwu Decoction can significantly improve renal function and renal pathological damage in DN mice of spleen-kidney Yang deficiency syndrome, and its specific mechanism may be related to the inhibition of inflammatory response by down-regulating the expression of key molecules in the ROCK/IKK/NF-κB pathway in the kidney.
		                        		
		                        		
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			NF-kappa B/metabolism*
		                        			;
		                        		
		                        			Interleukin-8
		                        			;
		                        		
		                        			Interleukin-10
		                        			;
		                        		
		                        			Tumor Necrosis Factor-alpha/metabolism*
		                        			;
		                        		
		                        			Interleukin-6
		                        			;
		                        		
		                        			I-kappa B Kinase
		                        			;
		                        		
		                        			Spleen
		                        			;
		                        		
		                        			Irbesartan
		                        			;
		                        		
		                        			Uridine Triphosphate
		                        			;
		                        		
		                        			Yang Deficiency/drug therapy*
		                        			;
		                        		
		                        			Kidney/pathology*
		                        			
		                        		
		                        	
10.Effects of Zishen Yutai Pills on in vitro Fertilization-Embryo Transfer Outcomes in Patients with Diminished Ovarian Reserve: A Prospective, Open-Labeled, Randomized and Controlled Study.
Xiu-Fang LI ; Zhong-Qing WANG ; Hai-Yan XU ; Hong LIU ; Yan SHENG ; Jin XU ; Yuan-Mei LI ; Fang LIAN
Chinese journal of integrative medicine 2023;29(4):291-298
		                        		
		                        			OBJECTIVE:
		                        			To explore the effects of Zishen Yutai Pills (ZYPs) on the quality of oocytes and embryos, as well as pregnancy outcomes in patients with diminished ovarian reserve (DOR) receiving in vitro fertilization-embryo transfer (IVF-ET). The possible mechanisms, involving the regulation of bone morphogenetic protein 15 (BMP15) and growth differentiation factor 9 (GDF9), were also investigated.
		                        		
		                        			METHODS:
		                        			A total of 120 patients with DOR who underwent their IVF-ET cycle were randomly allocated to 2 groups in a 1:1 ratio. The patients in the treatment group (60 cases) received ZYPs from the mid-luteal phase of the former menstrual cycle by using gonadotropin-releasing hormone (GnRH) antagonist protocol. The patients in the control group (60 cases) received the same protocol but without ZYPs. The primary outcomes were the number of oocytes retrieved and high-quality embryos. Secondary outcomes included other oocyte or embryo indices as well as pregnancy outcomes. Adverse events were assessed by comparison of the incidence of ectopic pregnancy, pregnancy complications, pregnancy loss, and preterm birth. Contents of BMP15 and GDF9 in the follicle fluids (FF) were also quantified with enzyme-linked immunosorbent assay.
		                        		
		                        			RESULTS:
		                        			Compared with the control group, the numbers of oocytes retrieved and high-quality embryos were significantly increased in the ZYPs group (both P<0.05). After treatment with ZYPs, a significant regulation of serum sex hormones was observed, including progesterone and estradiol. Both hormones were up-regulated compared with the control group (P=0.014 and 0.008), respectively. No significant differences were observed with regard to pregnancy outcomes including implantation rates, biochemical pregnancy rates, clinical pregnancy rates, live birth rates, and pregnancy loss rates (all P>0.05). The administration of ZYPs did not increase the incidence of adverse events. The expressions of BMP15 and GDF9 in the ZYPs group were significantly up-regulated compared with the control group (both P<0.05).
		                        		
		                        			CONCLUSIONS
		                        			ZYPs exhibited beneficial effects in DOR patients undergoing IVF-ET, resulting in increments of oocytes and embryos, and up-regulation of BMP15 and GDF9 expressions in the FF. However, the effects of ZYPs on pregnancy outcomes should be assessed in clinical trials with larger sample sizes (Trial reqistration No. ChiCTR2100048441).
		                        		
		                        		
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Pregnancy
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Fertilization in Vitro/methods*
		                        			;
		                        		
		                        			Ovarian Reserve
		                        			;
		                        		
		                        			Prospective Studies
		                        			;
		                        		
		                        			Premature Birth
		                        			;
		                        		
		                        			Embryo Transfer/methods*
		                        			;
		                        		
		                        			Ovulation Induction/methods*
		                        			;
		                        		
		                        			Gonadotropin-Releasing Hormone/therapeutic use*
		                        			
		                        		
		                        	
            
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