The Mechanism of Traditional Chinese Medicine Based on Semi-Targeted Metabolomics to Improve IVF Outcomes in Senile Patients.

OBJECTIVE: To identify the biological function and metabolic pathway of differential metabolites in follicular fluid of senile patients with kidney qi deficiency undergoing in vitro fertilization-embryo transfer (IVF-ET) and observe the effect of kidney-invigorating herbs on IVF outcomes in senile patients. METHODS: A total of 95 women undergoing IVF treatment were recruited and divided into three groups, including 34 cases in the treatment group (the senile patients with kidney qi deficiency after the intervention of Chinese medicine), 31 cases in the experiment group (the senile patients with kidney qi deficiency of no intervention of Chinese medicine), and 30 cases in the control group (young women with infertility due to male factor). The three groups of women were treated with long protocol ovarian hyperstimulation; the treatment group was given Qi-Zi-Yu-Si decoction on the day of HCG downregulation. Their IVF clinical outcomes were observed. The metabolites changes of kidney qi deficiency syndrome were analyzed in follicular fluid metabolomics using liquid chromatography-mass spectrometry (UPLC-MS/MS). RESULTS: The syndrome score of kidney qi deficiency syndrome in the treatment group was significantly improved after treatment (P < 0.01). Compared with the experiment group, the available embryo rate and implantation rate were increased, and the difference was statistically significant (P < 0.05). Progesterone, indoleacrylic acid, 2-propenyl 1-(1-propenylsulfinyl) propyl disulfide, N-acetyltryptophan, decanoylcarnitine, 20a-dihydroprogesterone, testosterone acetate, eicosatrienoic acid, 1H-indole-3-carboxaldehyde, choline, phosphorylcholine, and tryptophan were downregulated in the treatment group. Through pathway analysis, glycerophospholipid metabolism and steroid hormone biosynthesis were regulated in senile patients with kidney qi deficiency after Qi-Zi-Yu-Si decoction intervention. CONCLUSION: Qi-Zi-Yu-Si decoction can effectively improve the IVF outcome and clinical symptoms of senile patients. Follicular fluid metabolites were significantly changed in senile infertile women with kidney qi deficiency, and the mechanism by which kidney-invigorating herbs improve IVF treatment outcomes may be related to glycerophospholipid metabolism and steroid hormone biosynthesis. This study was registered in the Chinese Clinical Trials Registry Platform (ChiCTR1800014422).

[Correlation Between Gross Motor Function and Risk Factors in Children with Cerebral Palsy:an Epidemiology Study in Chengdu].

OBJECTIVES: To investigate the correlation between gross motor function and risk factors in children with cerebral palsy(CP). METHODS: We included the children aged 2-12 years old who were diagnosed with CP and registered in Chengdu Federation of Disabled Persons in 20 districts of Chengdu. Gross motor function was estimated by gross motor function classification system (CMFCS). Risk factors of the CP children were investigated retrospectively. Univariate and multivariate logistic regression analyses were used to analysis the correlation of the CP risk factors and GMFCS grades in the children with CP. RESULTS: A total of 333 children were identified with a male to female ratio of 1.15,an average age of (6.32±2.74) years old, and dominated in 6-<12 age group (197 cases,59.16%) and spastic CP (228 cases,68.47%).Thirty risk factors for CP were included, among which the majors were listed as premature delivery (185 cases,55.56%),low body mass (150 cases,45.05%),and neonatal hypoxic-ischemic encephalopathy (104 cases,31.23%).No risk factors of CP were found correlating with GMFCS grades by univariate logistic regression analysis. Stepwise multiple logistic regression analysis showed no risk factors of CP in the regression equation. CONCLUSIONS: The risk factors of CP can not be used to predict the severity of gross motor function of children with CP.

[The Relationship Between the Damages of Hand Functions and the Type of Cerebral Palsy in Children].

OBJECTIVE: To investigate the relationship between the damages of hand functions and the type of cerebral palsy (CP) in children with CP. METHODS: A total of 280 children aged 4-12 years old with CP in the 20 districts of Chengdu were included. The damages of hand functions were assessed with the Chinese Version of Manual Ability Classification System (MACS) and its relationship with the type of CP were analyzed. RESULTS: Among the 280 investigated children, there were 195 chidren with spastic CP, which accounted for the largest proportion (69.64%), wherein the spastic diplegia was most common (56.41%). The classification of MACS was level I-II in 65.13% children with spastic CP, whereas the classification of MACS was level IU-V in 84. 44% and 80.95% children with mixed and dyskinetic CP, respectively. With the increase of the degree of cognitive dysfunction in children with CP, the level of MACS was also increased. There was a difference between the classification of MACS and the different type of CP (P<0.05). The children with spastic CP were mostly mild hand dysfunction, while the children with mixed and dyskinetic type of CP were mostly middle and severe hand dysfunction. A positive correlation was found between the MACS and the subtype of spastic CP (r=0.541, P<0.05). In most of the children with diplegia from spastic CP, the hand dysfunction was mild, whereas the children with quadriplegia from spastic CP were mostly middle and severe hand dysfunction. CONCLUSION: There was a correlation between the MACS and the type of CP which can be used to determine the damaged condition of hand functions and develop the program of rehabilitation and the measures of classification management for the chidren with CP.