The Effect of Granulocyte Colony-Stimulating Factor on Endometrial Receptivity of Implantation Failure Mouse.

The purpose of this study was to investigate the effect of G-CSF on the endometrial receptivity of implantation failure mice. Sixty female mice were treated mifepristone to establish an implant failure model. The treatment groups received different doses of G-CSF. Endometrial tissue and serum were collected on day 5 after mating. The abundance of pinopodes on the endometrium was observed by scanning electron microscopy. The expressions of LPAR3, COX2, and HOXA10 were detected by RT-qPCR and Western blotting. Serum levels of E2, P, VEGF, LIF, TNF-α and IL-10 were measured by ELISA. The expressions of VEGF, CD34, CD57, TNF-α, and IL-10 were assessed by immunohistochemistry. Immunofluorescence analysis was performed to determine the number of CD57, Treg, and Th17 cells. G-CSF increased implantation and pregnancy rates of mifepristone-induced implantation failure mice, with the most significant effect seen at the intermediate dose. G-CSF increased the serum levels of E2 and P, the abundance of endometrial pinopodes, and the level of LIF in the endometrium. It also promoted the expression of VEGF, HOXA10, LPAR3, and COX2. Moreover, G-CSF reduced the level of CD57 cells and the ratio of Th17/Treg cells in endometrium. G-CSF reduced the inflammatory factor TNF-α, but IL-10 did not change significantly. G-CSF can enhance embryo implantation rate and pregnancy rate and improve endometrial receptivity by attenuating degeneration of pinopodes, upregulating estrogen and progesterone, facilitating angiogenesis, maintaining immune cell homeostasis, and reducing the production of inflammatory cytokines in implantation failure mouse.

Efficacy and safety of recombinant human granulocyte colony-stimulating factor in patients with poor ovarian response: protocol for a multicentre, randomised, controlled trial.

INTRODUCTION: Approximately 17.5% of couples of reproductive age have experienced infertility. Women with a poor ovarian response (POR) must undergo in vitro fertilisation (IVF) and embryo transfer to achieve pregnancy. However, studies have reported a poor response to gonadotropin stimulation in women undergoing IVF-ET. Results from animal experiments suggest that granulocyte colony-stimulating factor (G-CSF) has a curative effect by protecting ovarian function, reducing follicle loss and delaying premature ovarian failure in rats caused by chemotherapy. Clinical studies on the therapeutic effect of G-CSF are deficient; therefore, this study will investigate its ability to improve ovum quality and maturity among women with POR undergoing IVF/intracytoplasmic sperm injection (ICSI). METHODS AND ANALYSIS: This clinical, multicentre, triple-blind, placebo-controlled trial will employ balanced randomisation (1:1). The planned sample size is 312 participants (156 subjects in each group). A total of 312 patients with infertility undergoing IVF/ICSI will be recruited from four public hospitals in China. The participants will be randomly divided into an experimental group (G-CSF) and a placebo group (control). All patients will be treated by using the progestin-primed ovarian stimulation superovulation protocol. The primary outcome will be D3 embryo quality. The number of ova obtained, MII ova and transferable embryos will be inclusive in the secondary outcome. ETHICS AND DISSEMINATION: To our knowledge, this is the first clinical trial to investigate the effect of G-CSF treatment timing and stimulation protocol in patients with POR in China. This study will provide new information about G-CSF efficacy among patients with POR undergoing IVF/ICSI and can help improve ovum quality and maturity. Clinical trials on this subject are deficient in China; therefore, a well-designed randomised trial is needed to determine the ability of G-CSF to improve ovum quality and maturity to facilitate conception among women with POR treated with IVF/ICSI. TRIAL REGISTRATION NUMBER: ChiCTR2200062412.

Chromosome analysis of foetal tissue from 1903 spontaneous abortion patients in 5 regions of China: a retrospective multicentre study.

BACKGROUND: Abnormal foetal tissue chromosome karyotypes are one of the important pathogenic factors for spontaneous abortion (SA). To investigate the age and abnormal foetal karyotypes of 1903 couples who experienced SA. METHODS: A retrospective multicentre study collected age and foetal tissue karyotypes CNV-seq data of 1903 SA couples from 6 hospitals in 5 regions from January 2017 to March 2022. The distribution and correlation of abnormal foetal tissue karyotypes were evaluated by using regions and age. RESULTS: In our study, 1140 couples (60.5% of the total) had abnormal foetal tissue chromosome karyotypes in all regions. We found that there were differences in the number of abnormal foetal tissue chromosome karyotypes, of which the incidence of trisomy was higher. At the same time, the populations situated in the eastern region had a more triploid (15.5%) distribution, trisomy (58.1%) in the southern region, mosaicism (14.8%) and microduplication (31.7%) in the southwestern region, microdeletion (16.7%) in the northern region. There are variances across areas, and it is more common in the north. The incidence risk of prenatal chromosomal abnormalities varied according to age group. CONCLUSION: The findings of this study suggest that the karyotypes of patients with abnormal foetal tissue chromosome abortion in different regions were different. Meanwhile, patients ≥ 35 years old had a higher risk of abnormal foetal tissue chromosome abortion.

Effect of fracture risk in inhaled corticosteroids in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.

BACKGROUND: The fracture risk of patients with chronic obstructive pulmonary disease (COPD) treated with inhaled corticosteroids is controversial. And some large-scale randomized controlled trials have not solved this problem. The purpose of our systematic review and meta-analysis including 44 RCTs is to reveal the effect of inhaled corticosteroids on the fracture risk of COPD patients. METHODS: Two reviewers independently retrieved randomized controlled trials of inhaled corticosteroids or combinations of inhaled corticosteroids in the treatment of COPD from PubMed, Embase, Medline, Cochrane Library, and Web of Science. The primary outcome was a fracture event. This study was registered at PROSPERO (CRD42022366778). RESULTS: Forty-four RCTs were performed in 87,594 patients. Inhaled therapy containing ICSs (RR, 1.19; 95%CI, 1.04-1.37; P = 0.010), especially ICS/LABA (RR, 1.30; 95%CI, 1.10-1.53; P = 0.002) and triple therapy (RR, 1.49; 95%CI, 1.03-2.17; P = 0.04) were significantly associated with the increased risk of fracture in COPD patients when compared with inhaled therapy without ICSs. Subgroup analyses showed that treatment duration ≥ 12 months (RR, 1.19; 95%CI, 1.04-1.38; P = 0.01), budesonide therapy (RR, 1.64; 95%CI., 1.07-2.51; P = 0.02), fluticasone furoate therapy (RR, 1.37; 95%CI, 1.05-1.78; P = 0.02), mean age of study participants ≥ 65 (RR, 1.27; 95%CI, 1.01-1.61; P = 0.04), and GOLD stage III(RR, 1.18; 95%CI, 1.00-1.38; P = 0.04) were significantly associated with an increased risk of fracture. In addition, budesonide ≥ 320 ug bid via MDI (RR, 1.75; 95%CI, 1.07-2.87; P = 0.03) was significantly associated with the increased risk of fracture. CONCLUSION: Inhalation therapy with ICSs, especially ICS/LABA or triple therapy, increased the risk of fracture in patients with COPD compared with inhaled therapy without ICS. Treatment duration, mean age of participants, GOLD stage, drug dosage form, and drug dose participated in this association. Moreover, different inhalation devices of the same drug also had differences in risk of fracture.

Clinical analysis of transvaginal hydrolaparoscopy in infertile patients.

OBJECTIVE: To evaluate the application of transvaginal hydrolaparoscopy for exploration of the pelvic cavity exploration in infertile women. STUDY DESIGN: A total of 510 infertile women were included in this study from May 1st, 2009 to April 30, 2012 in the clinic of the Hebei Research Institute for Family Planning. RESULTS: In 495 of 510 of the patients (97.06%), a successful operation was achieved at the first puncture. Of these 495 patients, 286 (57.78%) showed bilateral patency. Completely normal tubo-ovarian and pelvic structures were observed only in 79 patients (15.96%): 16 patients (3.23%) had bilateral tube obstruction, 18 (3.64%) had hydrosalpinx, and 8 (1.62%) had fimbrial stenosis. Pelvic abnormalities occurred in 240 patients (44.04%), including bilateral and/or unilateral tubo-ovarian adhesions in 80 patients (16.16%) and 160 (32.32%) found with adhesions in other parts of the pelvic cavity. Pelvic endometriosis was found in 82 patients (16.57%) and 19 (3.84%) had two or more lesions in the pelvic cavity. In addition, 9 cases (1.82%) of ovarian cysts, 7 (1.41%) of bilateral vesicular appendices and 43 cases (6.69%) of a unilateral vesicular appendix were observed. In addition, convoluted tubes such as bent or twisted tubes were found in 4 cases of bilateral fallopian tube occlusion patients (0.81%) and 17 cases of unilateral tubal occlusion patients (3.43%). CONCLUSIONS: Transvaginal hydrolaparoscopy is a feasible, safe, and cost-effective microinvasive technique. This technique can be considered as an alternative procedure for evaluating female infertility.

[Reproductive expectation and gender preferences of parents in poverty areas of China].

OBJECTIVE: The reproductive goals of married couples living in impoverished areas of China affect survival rates and quality of life of female children in those areas. The goal of this study was to collect information on parents' attitudes toward reproduction, gender preferences/prejudices, and to collect relevant socioeconomic and demographic data. METHODS: Random sample families were enrolled from 3 poverty counties. Sample size included parents of 1800 children from birth to 6 years old. The children were divided into 6 age groups at one-year interval. Baseline data were collected and a questionnaire (endorsed by UNICEF) was used to evaluate reproductive expectations and gender preferences of parents. RESULTS: (1) The success of the One Child Family program has lead to a decreased overall birthrate. (2) The gender ratio (boys:girls) of the 3 counties studied was 100:87-100:95-100:97. No gender imbalance was found in this study. (3) The "Boy Preference" was still expressed by both fathers (69.0%) and mothers (65.7%). Approximately 40% of fathers and 37% of mothers interviewed expressed that only a male child would be acceptable. (4) Approximately 65% of both fathers and mothers recognize that girls are more likely to care for aging parents. CONCLUSION: Government initiatives have encouraged small families, yet in this region gender ratio of newborns is still normal. More educational and social programs are needed to influence perceptions regarding gender and to eliminate the suboptimal status/poorly perceived value of girls in many societies.

[Blood leptin level of 154 Chinese children 0 - 14 years of age].

OBJECTIVE: To study blood Leptin level of 154 (78 male, 76 female) Chinese obese/non-obese children aged 0 - 14 years during 1999 - 2001. METHODS: The gender- and age-specific distribution pattern of Leptin and its relationship with anthropometric parameters (waist circumference, waist/hip ratio, lean body mass, fat mass, body fat percentage, BMI/Kaup index etc.) and blood insulin level were recorded. RESULTS: (1) The blood Leptin level in healthy non-obese kids ranged from 1.01 - 29.92 (ng/ml), the mean values and SD were 2.99 +/- 2.13 (ng/ml) [90% confidence interval was 1.36 - 14.21 (ng/ml) in boys and 1.74 - 21.17 (ng/ml) in girls]. There was no significant difference in the blood Leptin level between serum and plasma. (2) The blood Leptin level was higher in overweight/obese kids than that in non-obese kids (P < 0.001). (3) There was significant difference in the blood Leptin levels between boys and girls groups (P = 0.023), especially in non-obese group (P = 0.004). The multiple regression analysis showed that there was no correlation between gender and blood Leptin level when body fat factor was added (P = 0.138, 0.241, 0.990), but there was still a strong correlation between blood leptin level and BMI, FM and BF% (P < 0.001). (4) There was a correlation between blood Leptin level and age (P = 0.005), especially in overweight/obese group and in girls (P = 0.001). The blood Leptin level rose from early puberty, especially in girl group (P = 0.045). There was significant difference in blood Leptin level in different age groups (P < 0.001) (5) There were strong positive correlation between blood Leptin level and BMI, BM and FM%, a weak correlation with LBM, and no correlation with W/H ratio in boys and a positive relationship in girls. The Quatatic equation was better than the linear equation in description of the correlation mentioned above. (6) There was a correlation between blood Leptin from 0 to 7 yr and birth weight (P = 0.001), after 7 yr of age this correlation disappeared (P = 0.456). (7) A positive correlation was seen between blood Leptin level and blood insulin level (P < 0.001). CONCLUSION: The blood Leptin level of 0 - 14 years old children is consistent with the level of growth of adiposity tissue and the degree of adiposity rebound.