Fibrosarcoma of small bowel in a case of carcinoma ovary post cytoreductive surgery and hyperthermic intra peritoneal chemotherapy: a case report with review of literature

Fibrosarcoma is a rare, malignant tumor of mesenchymal cell origin which derives from pathologically transformed spindle shaped fibroblasts with an excessively high division rate. There is no reported case of fibrosarcoma of the small intestine as a form of recurrence in carcinoma ovary post cytoreductive surgery and hyperthermic intra peritoneal chemotherapy (CRS and HIPEC). A 35-year-old female who is a known case of recurrent carcinoma ovary previously treated with cytoreductive surgery and HIPEC presented to emergency with features suggestive of intestinal obstruction. Upon exploration dense bowel adhesion and a segmental stricture with micro perforation without any leakage of intestinal content was discovered at 200 cm from DJ flexure. A diagnosis of fibrosarcoma was made on histopathological analysis. Recurrent carcinoma ovary patient treated with secondary CRS and HIPEC presenting with fibrosarcoma in small intestine is a rare entity and hardly any report in the literature. But appropriate diagnosis and management is the key for the successful outcome which we maintained in our case and managed successfully.

A comparative study of letrozole and clomiphene citrate for ovulation induction in women with polycystic ovarian syndrome: a randomized controlled trial

Background: Effective ovulation induction is crucial in management of polycystic ovarian syndrome (PCOS) related infertility. Clomiphene citrate (CC) has long been the first line of treatment for inducing ovulation in women with PCOS. Letrozole, an aromatase inhibitor, has emerged as a promising alternative to CC for ovulation induction. The present study was aimed to compare efficacy and safety of letrozole versus CC for ovulation induction in women with PCOS.Methods: This study consists of 384 PCOS women, randomized into two groups: Letrozole (2.5 mg/day) and CC (50 mg/day), both administered from day 3 to day 7 of the menstrual cycle. The primary outcome was the ovulation rate, confirmed by serum progesterone levels >10 ng/ml. Secondary outcomes included clinical pregnancy rate, live birth rate, endometrial thickness, adverse effects, cost-effectiveness, and patient satisfaction. Participants were monitored through transvaginal ultrasound and serum progesterone measurements.Results: Ovulation was achieved in 76.0% of participants in the letrozole group compared to 55.2% in the CC group (p<0.001). Clinical pregnancy rates were significantly higher in the letrozole group (44.8%) compared to the CC group (28.1%) (p<0.001). Similarly, live birth rates were higher with letrozole (36.5% vs. 22.4%; p=0.002). Endometrial thickness was greater in the letrozole group (8.7 mm vs. 7.5 mm; p<0.001). Adverse effects, were significantly lower in the letrozole group.Conclusions: Letrozole is more effective than CC in inducing ovulation and achieving higher pregnancy and live birth rates in women with PCOS.

Frequency of depression and anxiety in infertile women with and without polycystic ovary syndrome referring to Ardabil infertility center

Background: In spite of the serious consequences that polycystic ovary syndrome (PCOS) can have on the mental health aspects of sufferers, most of the researches conducted in this field have dealt with the medical aspects of this disease, and its effects and psychological aspects have received far less attention in the literature. The aim of this study was to determine the frequency of depression and anxiety in infertile women with and without PCO referred to Ardabil infertility center.Methods: This case-control study was conducted on 99 women with polycystic ovary syndrome and 96 infertile women for other reasons who referred to the infertility center of Ardabil city in 2022. The diagnosis of polycystic ovary syndrome in this study was based on the Rotterdam criteria. Mood disorders including depression and anxiety were determined based on the Beck standard test. After collecting the data, it was analyzed using descriptive and analytical statistics by statistical package for the social sciences (SPSS) software version 26.Results: Most of the underlying diseases among them were related to bleeding with 71 cases (36.6%) and then related to hair growth with 43 cases (22.2%). Among the studied women, the rate of depression was 53 (27.3%) and 184 (94.8%) had a low level of anxiety. Among women with PCOS, 38 (38.4%) and among women without PCOS, 15 (15.8%) had depression. Statistically, there was a significant relationship between depression and PCOS.Conclusion: The rate and severity of depression in PCOS patients was significantly higher than non-PCOS infertile patients.

Inflammatory myofibroblastic tumour

Inflammatory myofibroblastic tumor (IMT) is a rarely described tumor of unknown etiology and pathogenesis. An IMT may occur in almost any part of the body, from the central nervous system to the limbs, and has nonspecific clinical manifestations. Histologically these lesions appear as an inflammatory infiltrate within a variable myofibrotic background. We here present a case of 67-year-old woman who presented with vague abdominal mass and her TAH with BSO was done in view of preoperative diagnosis of ovarian malignancy, which after histopathology came out to be IMT of pelvis.

Adult granulosa tumor of the ovary about a case

Granulosa tumors are rare tumors of the ovary (0.6 to 3%). They belong to the group of mesenchymal and sex cord tumors, and represent more than 70% of malignant tumors in this group and 5% of ovarian cancers. They present two histological forms: the juvenile form and the adult form, the most common, occurring mainly in women in the post-menopausal period. The solido-cystic appearance of these tumors is generally non-specific and the histological diagnosis can be confirmed by immunohistochemistry. Surgery remains the basis of treatment and must be extensive in elderly patients. The prognosis depends on the histological type and several parameters. We report the observation of a 53-year-old patient without known risk factors, who presented with a granulosa tumor of the left ovary diagnosed postoperatively. The epidemiological, clinical and therapeutic aspects are discussed.

Sertoli-Leydig tumor in a 17-year-old girl: a case report

Sertoli-Leydig tumors of the ovary are rare. They can affect women in all age groups but are more frequent in the first three decades. No case of Sertoli-Leydig cells tumors has been reported in the Haitian literature. We present a case of a 17-year-old teenage who was seen in the outpatient clinic of the Mirebalais teaching hospital for: amenorrhea, change in voice and hair loss. After our evaluation and the completion of certain assessments, the clinical impression of a stromal and sexual cord tumor was retained, which guided us to perform a laparotomy. We conclude that in the management of this type of case, it is important to take into account the desire to preserve the patient's subsequent fertility and if there is one point that should not be overlooked, it is the psychosocial repercussions of the pathology before and after its treatment.

Torsion of ovary and acute abdomen

Ovarian torsion refers to partial or complete rotation of ovarian vascular pedicle. This study explored the presenting symptoms and management of ovarian torsion in a newly established ESIC Medical College and Hospital, Bihta, Patna. This report presents two cases of ovarian torsion, the presenting symptoms and management. This underscores the need of prompt diagnosis and management to improve postoperative outcomes.

Cistoadenoma mucinoso gigante de ovario / Giant ovarian mucinous cystadenoma

Aunque el cistoadenoma mucinoso de ovario tiene un crecimiento benigno, puede crecer hasta tener grandes dimensiones. Se presenta el caso de una paciente de 70 años que acudió a consulta por presentar dolor abdominal recurrente y difuso. A la exploración física se palpó una gran masa que ocupaba toda la cavidad abdominal, hasta la apófisis xifoides, redondeada, renitente, de bordes definidos, no dolorosa, no movible. Presencia de edema en miembros inferiores. Durante el acto operatorio se identificó útero miomatoso y quiste gigante de ovario izquierdo, aproximadamente de 40 x 30 cm y 13,6 kg de peso. Se realizó histerectomía total abdominal y salpingooforectomía bilateral. La biopsia confirmó el diagnóstico de cistoadenoma mucinoso benigno de ovario y leiomiomatosis uterina. El posoperatorio transcurrió favorablemente. La incidencia de cistoadenoma gigante de ovario es desconocida, debido a la falta de un concepto estandarizado y las modalidades de imagen avanzadas disponibles en la actualidad(AU)

Although ovarian mucinous cystadenoma has a benign growth, it can grow to be very large. We present the case of a 70-year-old patient who came to the clinic for recurrent and diffuse abdominal pain. On physical examination, a large mass was palpated that occupied the entire abdominal cavity, up to the xiphoid appendix, rounded, retentive, with defined edges, non- painful, non-movable. Presence of edema in lower limbs. During the surgical act, a myomatous uterus and a giant left ovarian cyst measuring approximately 40 x3 0 cm and weighing 13.6 kg were identified. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The biopsy confirmed the diagnosis of benign ovarian mucinous cystadenoma and uterine leiomyomatosis. The postoperative period progressed favorably. The incidence of giant ovarian cystadenoma is relatively unknown due to the lack of a standardized concept and currently available advanced imaging modalities(AU)

Endometrioid adenofibroma of ovary-a two faced tumour: case report

Endometrioid variant of the adenofibromas accounts for only 1% of epithelial neoplasms of ovary. Though benign, specimen of endometroid adenofibroma of ovary needs to be evaluated by an experienced pathologist to rule out borderline and malignant cases. This prevents unnecessary adjuvant therapy for benign cases. We report a case of a large endometrioid adenofibroma arising at the left ovarian fossa in a post-menopausal woman who had undergone total abdominal hysterectomy with bilateral salpingo-oophorectomy 6 years back. Recurrence of endometroid adenofibroma of ovary is rare, however, long term follow-up is mandatory due to its low malignant potential. Though benign, specimen of endometroid adenofibroma of ovary needs to be evaluated by an experienced pathologist so that borderline and malignancy can be ruled out. Endometroid adenofibroma of ovary though benign needs long term follow up due to its low malignant potential.

Improvement effects of poria acid on insulin resistance in rats with polycystic ovary syndrome and its mechanism / 中国药房

OBJECTIVE To study the improvement effects of poria acid on insulin resistance in rats with polycystic ovary syndrome （PCOS） and its mechanism. METHODS One hundred and twenty-six female rats were randomly separated into blank group， PCOS group， poria acid low-dose group （8.33 mg/kg）， pachymic acid high-dose group （33.32 mg/kg）， ethinylestradiol cyproterone group （positive control group， 0.34 mg/kg）， recombinant rat high mobility group protein B1 protein （rHMGB1） group （8 μg/kg）， and poria acid high dose+rHMGB1 group （33.32 mg/kg poria acid+8 μg/kg rHMGB1）， with 18 rats in each group. Except for the blank group， the rats in all other groups were given Letrozole suspension intragastrically to construct the PCOS model. After successful modeling， administration was performed once a day for 4 weeks. After medication， the fasting blood glucose and fasting insulin levels， and insulin resistance index （HOMA-IR） were measured in rats； the levels of follicle-stimulating hormone （FSH）， luteinizing hormone （LH） and testosterone （T） in rat serum， and the levels of interleukin-1β （IL-1β） and tumor necrosis factor- α （TNF- α） in ovarian tissue were detected； ovarian coefficients of rats were calculated； the pathological changes of ovarian tissue were observed； the expressions of HMGB1， receptor for advanced glycosylation elaine_ tanghong@sina.com end product （RAGE） and phosphorylated nuclear factor κB p65 （p-NF-κB p65） proteins were determined in ovarian tissue of rats. RESULTS Compared with the blank group， the pathological injury of ovarian tissue of rats in the PCOS group was serious， the levels of fasting blood glucose and fasting insulin， HOMA-IR and ovarian coefficient were increased， the levels of serum LH and T were increased， while the levels of FSH were decreased； the levels of IL-1β and TNF-α， the expressions of HMGB1， RAGE and p-NF-κB p65 protein in ovarian tissue were increased， with statistical significance （P＜0.05）. Compared with the PCOS group， pathological damage of ovarian tissue was reduced in poria acid low-dose and high-dose groups and ethinylestradiol cyproterone group， and fasting blood glucose， fasting insulin levels， HOMA-IR and ovarian coefficient were decreased； serum LH and T levels were decreased， while FSH levels were increased； the levels of IL-1β and TNF-α and the expressions of HMGB1， RAGE and p-NF-κB p65 protein in ovarian tissue were decreased， with statistical significance （P＜0.05）. The trend of corresponding indexes in rHMGB1 group was opposite to the above （P＜0.05）. Compared with poria acid high-dose group， the changes of the above indexes were reversed significantly in poria acid high-dose+rHMGB1 group （P＜0.05）. CONCLUSIONS Poria acid may improve insulin resistance and inhibit inflammatory reaction in PCOS rats by inhibiting HMGB1/ RAGE pathway.

Research progress in etiology and pathogenesis of polycystic ovary syndrome / 吉林大学学报(医学版)

Polycystic ovary syndrome(PCOS)is a heterogeneous disorder closely associated with reproductive endocrine dysfunction in the women.The etiology and pathogenesis of PCOS remain unclear.PCOS is the result of the combination of endocrine metabolic disorders,genetics,and environmental factors.Hyperandrogenemia(HA)and insulin resistance(IR)are the fundamental pathophysiological changes in the development of PCOS,and their interactions exacerbate the clinical manifestations of the PCOS patients.The family aggregation and twin study results confirm the genetic predisposition of PCOS;the genome-wide association study(GWAS)results confirm some risk loci and candidate genes of PCOS.The unhealthy lifestyle habits and environmental endocrine disruptors also play an important role in the progression of PCOS,and the gut microbita is involved in the pathogenesis of PCOS.This article provides a comprehensively retrospective analysis on the recent studies about PCOS,and reviews both internal factors and external factors related to the etiology and pathogenesis of PCOS.

Discussion on the medication law of TCM compound patents in treating polycystic ovary syndrome / 国际中医中药杂志

Objective:To analyze the medication and compatibility law of TCM compounds with national patents for the treatment of polycystic ovary syndrome (PCOS); To provide reference for the new TCM prescriptions for the treatment of PCOS.Methods:TCM compound patents for PCOS were retrieved from the China National Intellectual Property Administration's Chinese Patent Announcement Website from the establishment of the website to April 20, 2023. SPSS 25.0, IBM SPSS Modeler 18.0, and Cytoscape 3.8.0 were used to carry out frequency statistics, association rule analysis on the data, and a TCM core complex network and systematic clustering analysis were built.Results:126 compound patents were included, involving 392 kinds of Chinese materia medica, with a total frequency of 1 709 times. The medicinal property was mainly warm, the taste was mainly sweet, and the meridian was mainly liver meridian. High frequency drugs included Angelica Sinensis (46 times), Cuscutae Semen (44 times), Cyperi Rhizoma (42 times), Rehmanniae Radix Praeparata (41 times), Salviae Miltiorrhizae Radix et Rhizoma (37 times), etc. Commonly used medicinal pairs included Poria-Atractylodis Macrocephalae Rhizoma (support 16.67%, confidence 76.19%), Angelica Sinensis-Paeoniae Radix Alba (support 15.87%, confidence 80.00%), etc. The triple drug combinations were Cyperi Rhizoma-Pinelliae Rhizoma-Poria (support 12.70%, confidence 81.25%). The core prescriptions included "Poria, Pinelliae Rhizoma, Citri Rettculatae Pericarpium, Cyperi Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, Epimedii Folium, Atractylodis Macrocephalae Rhizoma, Morindae Officinalis Radix, Gleditsiae Spina, Acori Tatarinowii Rhizoma", etc. Potential prescriptions were "Hordei Fructus Germinatus, Setariae Fructus Germinatus, Sargentodoxae Caulis, Puerariae Lobatae Radix, Leonuri Fructus" and so on.Conclusion:The treatment of PCOS with TCM compounds with national patents mainly focuses on drying dampness and strengthening the spleen, tonifying kidney yang and nourishing kidney yin, promoting blood circulation.

Mechanisms of Guizhi Fuling Pills Treating Polycystic Ovary Syndrome and Endometriosis with Homotherapy for Heteropathy Based on Network Pharmacology and Molecular Docking / 广州中医药大学学报

Objective To investigate the mechanism of Guizhi Fuling Pills in the treatment of polycystic ovary syndrome(PCOS)and endometriosis(EMT).Methods TCMSP was utilized to obtain the active ingredients and related targets of the constituent Chinese medicines of Guizhi Fuling Pills.GeneCards,PharmGKB,and TTD databases were used to screen PCOS and EMT disease targets,respectively.The Venn R diagram was drawn after obtaining the intersecting targets of drugs and diseases using the Venn R package in R software,the drug-active ingredient-potential target interactions network diagram was made in Cytoscape,the intersecting target protein-protein interactions(PPI)network diagram was drawn in the STRING platform,and Cytoscape was used to optimize the PPI network and screen the core targets.R language was applied for Gene Ontology(GO)enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis,and AutoDockTools was for molecular docking.Results A total of 85 active ingredients and 191 corresponding targets of Guizhi Fuling Pills were obtained,and 77 potential targets of Guizhi Fuling Pills for the treatment of PCOS and EMT.The core active ingredients of Guizhi Fuling Pills for PCOS and EMT were quercetin,β-sitosterol,kaempferol,hederagenin,baicalein,and the core targets were AKT1,EGFR,IL-6,TNF,and TP53.GO functional analysis yielded 2 020 biological process,34 cellular components,126 molecular functions,and KEGG enrichment analysis yielded 165 signaling pathways.Molecular docking showed that the core components in the formula docked well with the targets.Conclusion Guizhi Fuling Pills may regulate the signaling pathways of lipid and atherosclerosis,AGE-RAGE signaling pathway,fluid shear stress and atherosclerosis,and chemical carcinogenesis-receptor activation through quercetin,β-sitosterol,kaempferol,hederagenin,and baicalein,and act on AKT1,EGFR,IL-6,TNF,and TP53,thus treating PCOS and EMT with homotherapy for heteropathy.

Research progress on the role of Asprosin in germ cell development / 基础医学与临床

Asprosin is a protein-like hormone composed of 140 amino acids,which is mainly secreted by adipo-cytes.Polycystic ovary syndrome(PCOS)and asthenospermia are common causes of infertility.Asprosin promotes the production of estradiol in small granular cells induced by follicle stimulating hormone(FSH)and progesterone in small granular cells induced by insulin-like growth factor 1(IGF-1),which functions in the growth of ovarian folli-cles and ovulation of dominant follicles.Asprosin promotes the secretion of sex hormones and the production of nu-trients,increasing the number,survival time and motility of sperms by acting on the hypothalamus and testicles.Asprosin is involved in regulation of follicle growth and spermatogenesis,so this finding may potentially support the development of new strategies for the treatment of infertility.

Correlation of FSHR gene polymorphism,BMI and sex hormone six with the risk of polycystic ovary syndrome / 解放军医学杂志

Objective To investigate the association between body mass index(BMI),sex hormone and single nucleotide polymorphisms(SNPs)of follicle-stimulating hormone receptor(FSHR)gene rs2268361 and rs2349415 and its correlation with the risk of polycystic ovary syndrome(PCOS).Methods Peripheral blood was collected from 213 PCOS patients and 207 healthy controls,attending the Department of Reproductive Medicine at the First Hospital of Shanxi Medical University,and 32 follicular fluids were randomly collected from each of the PCOS and control groups from March to August 2021.Calculation of BMI of the PCOS and control groups;The levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),testosterone(T),progesterone(P)and prolactin(PRL)in peripheral blood of the two groups were detected by immunochemiluminescence method.Polymerase chain reaction(PCR)and high-resolution melting curve(HRM)were used to analyze the polymorphisms of rs2268361 and rs2349415 in FSHR of the two groups.Quantitative real-time PCR was used to detect the expression of FSHR gene mRNA in peripheral blood and ovarian granulosa cells.Results There was a strong positive correlation between LH and LH/FSH(r=0.88,P<0.05);The levels of BMI,E2,LH,LH/FSH and T in PCOS group were significantly higher than those in control group(P<0.05);FSH level was significantly lower than that of control group(P<0.001).HRM analysis showed the frequencies of CC,CT and TT genotypes at rs2349415 were 55.9%,34.3%and 9.8%in PCOS group and 68.6%,23.2%and 8.2%in control group,respectively.The frequencies of C and T alleles were 73.0%and 27.0%in PCOS group and 80.2%and 19.8%in control group,respectively.There were significant differences in genotype frequencies and allele frequencies between the two groups(P<0.05);The expression level of FSHR mRNA was higher in ovarian granulosa cells in PCOS group than in control group(P=0.004),the expression level of FSHR mRNA in rs2349415 TT genotype was higher than that in CC(P=0.002)and CT(P=0.035)genotype.Conclusion High levels of BMI, LH, E2 and T allele of rs2349415 increased the risk of PCOS.

Changes of Sex Hormone Levels in Infertile Population with Polycystic Ovary Syndrome after the Assisted Reproductive Technology Treatment / 昆明医科大学学报

Objective To investigate the changes of sex hormone levels in polycystic ovary syndrome(PCOS)in infertile population after the assisted reproductive technology treatment,and to provide an evidence for the choice of the treatment.Methods The medical data of patients admitted to the First Affiliated Hospital of Kunming Medical University from January 2016 to June 2021 were collected and divided into PCOS group(103)and non-PCOS group(589)according to whether they were diagnosed with PCOS,and the sex hormone changes of the two groups were compared.Results The patients in PCOS group were younger and had the higher BMI,more sinus follicles,higher AMH value,and lower total Gn usage.The number of LH/FSH>2 in PCOS group was higher than that in non-PCOS group(P<0.05).After the treatment,LH in both groups decreased,FSH,E2 and(P<0.05)increased;The difference of LH and E2 before and after the treatment in PCOS group was greater than that in non-PCOS group<0.05).Conclusion Compared with non-PCOS infertile patients,the changes of sex hormone indexes in PCOS infertile patients before and after the treatment were more obvious.In order to obtain the better clinical effect in patients with polycystic ovaries,it is recommended to pay attention to the changes of related sex hormone levels in the course of subsequent treatment,and choose a reasonable treatment plan.

Clinical Analysis of 311 Cases with Giant Ovarian Mass / 实用妇产科杂志

Objective:To analyze the clinicopathological features of giant ovarian masses(mean diameter≥10 cm)and analyze the clinical characteristics of patients in different age groups.Methods:The clinicopathological characteristics of 311 patients diagnosed with giant ovarian masses by surgery at Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University from January 2014 to December 2022 were retrospectively analyzed.Patients were further stratified by age and mass size to compare the differences of clinical and patho-logical features among different age groups and different mass diameter groups.Results:①The median age of thepatients were 44(24,60)years old.The first symptoms were as follows:ovarian mass discovered during physi-cal examination,abdominal pain,bloating,conscious abdominal distension,and symptoms of compression.②The surgical methods were as follows:unilateral oophorectomy(30.5％,95/311),ovarian cystectomy(28.9％,90/311),tumor staging or cytoreductive surgery(28.0％,87/311),total hysterectomy with bilateral adnexectomy(12.5％,39/311).③The pathological types were benign(49.5％,154/311),malignant(31.8％,99/311)and borderline(18.7％,58/311).④ Patients complained abdominal distension in＜20 years old group were signifi-cantly higher than the other two groups(P＜0.05).The ovarian resection rate in the＞50-year-old group was higher than that of the other two groups(P＜0.05),and the rate of unilateral ovarian resection in the＜20-year-old group was still as high as 30.1％(15/49).⑤ The size of the mass correlated with the duration of the disease.When the disease course was between 1 to 6 months,the mass diameter line＞30 cm was the most common(P＜0.05).The incidence of borderline tumors in the＞30 cm group was significantly higher than that in the other two groups,and the difference was statistically significant(P＜0.05).Conclusions:Ovarian mucinous and mucinous borderline tumors are the most common types of giant adnexal masses.The size of the mass tends to increase with the prolongation of the disease course.The incidence of borderline tumors increases with the in-crease of mass.Health education for young people should be strengthened.When abdominal pain,abdominal bloating,especially lower abdominal distension occurs,they should seek medical treatment in time to avoid adnex-ectomy due to borderline tumors.

Effects of Basal LH and Different LH/FSH Ratio Levels on Assisted Reproduc-tive Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome / 实用妇产科杂志

Objective:To investigate the effects of basal luteinizing hormone(bLH)and different luteinizing hor-mone/follicle stimulating hormone ratio(LH/FSH)on the pregnancy outcome of in vitro fertilization or intracyto-plasmic sperm injection(IVF/ICSI)in patients with polycystic ovary syndrome(PCOS).Methods:From July 2013 to January 2020,424 PCOS patients who underwent flexible gonadotropin-releasing hormone antagonist protocol for ovulation induction in first IVF/ICSI were collected retrospectively from the department of reproductive medi-cine,The First Affiliated Hospital of Nanjing Medical University.The patients were divided into normal bLH(LH≤10 U/L,316 cases)and high bLH(LH>10 U/L,108 cases)group according to different levels of bLH;At the same time,according to the different levels of LH/FSH ratio,they were divided into low ratio(LH/FSH≤1,227 cases)group,median ratio(1<LH/FSH<2,142 cases)group and high ratio(LH/FSH≥2,55 cases)group.The general condition,ovulation induction and pregnancy outcomes of the groups were analyzed and compared Binary Logistic regression was used to analyze the related factors affecting live birth.Results:①The basal FSH and AMH in high bLH group were higher than those in normal bLH group,and the difference was statistically significant(P<0.05).In terms of ovarian induction,the number of oocytes retrieved and endometrial thickness on HCG injection day in the high bLH group were smaller than those in the normal bLH group,but the total duration of antagonist used was longer and the differences were statistically significant(P<0.05).Furthermore the pregnancy outcomes of the two groups had no statistical difference(P>0.05).②Compared with patients in different LH/FSH ratio groups,the high ratio group had higher AMH and antral follicle count(AFC)than the other two groups,and the differences were statistically significant(P<0.05).In terms of ovulation induction,the high ratio group had lower numbers of retrieved eggs,transferred embryos,and endometrial thickness on HCG day compared to the other two groups,with statistically significant differences(P<0.05).There was no statistically significant difference in pregnancy outcome indicators among the three groups of patients(P>0.05).③Binary Logistic regression analy-sis showed no significant correlation between live birth rate and bLH,LH/FSH ratio(P>0.05),but the live birth rate was related to the number of embryos transferred(P<0.05).Conclusions:Elevated bLH level and LH/FSH ratio may affect the outcomes of ovulation induction in women with PCOS(such as the number of oocytes re-trieved and endometrial thickness on HCG injection day),but there is no significant correlation with live birth rate of assisted reproduction.

Effects of Bazhen Decoction combined with Baizhu Fuzi Decoction on glucose metabolism and estrogen levels in rats with polycystic ovary syndrome / 天津医药

Objective To study the regulation effects of Bazhen Decoction combined with Baizhu Fuzi Decoction on glucose metabolism and estrogen level in rats with polycystic ovary syndrome.Methods The rat model of polycystic ovary syndrome was established by subcutaneous injection of human chorionic gonadotropin(HCG)combined with insulin.Rats were randomly divided into the polycystic ovary syndrome group,the Baizhu Fuzi Tang group(6.4 g/kg),the Bazhen Tang group(9.2 g/kg),the Bazhen Tang combined with Baizhu Fuzi Tang group(11.55 g/kg)and the diethylstilbestrol group(0.5 mg/kg).A blank control group(unmodulated rats)was set up with 10 rats in each group.The uterine index of rats was determined and calculated.Fasting blood glucose(FBG),2 h postprandish blood glucose(2 h PBG)and fasting insulin(FINS)were determined and insulin sensitivity index(ISI)and insulin resistance index(IR)were calculated.Serum estradiol(E2),testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH),prolactin(PRL),anti-Mullerian tube hormone(AMH)and insulin-like growth factor 1(IGF-1),C-reactive protein(CRP),interleukin(IL)-6,tumor necrosis factor(TNF)-α,total peroxidase activity(T-AOC),superoxide dismutase(SOD)and malondialdehyde(MDA)levels in ovarian tissue were detected by enzyme-linked immunosorbent assay(ELISA).The pathological changes of ovarian tissue were detected by hematoxylin-eosin(HE)staining.Real-time quantitative polymerase chain reaction(qPCR)was used to determine mRNA levels of ARA70,CBP,SCR1 and HOXA10 in endometrium and mRNA expressions of AMPK,GLUT4 and PPARγ in ovarian tissue.Western blot assay was used to determine expression levels of AMPK,GLUT4 and PPARγ in ovarian tissue.Results Compared with the polycystic ovary syndrome group,uterine index,FINS,FBG,2 h PBG,IR levels,serum T,LH,FSH,PRL,AMH,IGF-1 levels,ovarian tissue CRP,IL-6,TNF-α,T-AOC and MDA level,endometrial ARA70,CBP,SCR1 mRNA level of rats decreased significantly in the Baizhu Fuzi decoction group,the Bazhen decoction group and the Bazhen decoction combined with Baizhu Fuzi decoction group(P＜0.05).ISI level,serum E2 level,ovarian tissue SOD level,endometrial HOXA10 mRNA level,ovarian tissue AMPK,GLUT4 and PPARγ mRNA and protein levels were significantly increased(P＜0.05).The above indexes were significantly changed in the Bazhen decoction and Bazhu Fuzi decoction group than those of the Bazhu Fuzi decoction group and the Bazhen decoction group(P＜0.05).Conclusion Bazhen Decoction combined with Baizhu Fuzi Decoction can regulate glucose metabolism,inhibit ovarian tissue oxidation and inflammatory damage,improve endometrium tolerance,regulate estrogen level,and improve the progression of polycystic ovary syndrome in rats.The mechanism may be related to the regulation of AMPK/GLUT4/PPARγ pathway.

Role and mechanism of umbilical cord mesenchymal stem cells on polycystic ovary syndrome / 中国组织工程研究

BACKGROUND:At present,many drugs used in the treatment of polycystic ovary syndrome are super-designated drugs,and the treatment of patients with polycystic ovary syndrome still faces great challenges.Studies have shown that human umbilical cord mesenchymal stem cells can repair ovarian function,but few studies have reported their therapeutic effect on polycystic ovary syndrome. OBJECTIVE:To investigate the therapeutic effect of human umbilical cord mesenchymal stem cells on polycystic ovary syndrome,and to preliminarily explore the correlation between mitochondrial autophagy and the improvement of polycystic ovary syndrome by human umbilical cord mesenchymal stem cells. METHODS:Polycystic ovary syndrome mouse model was established by subcutaneous injection of dehydroepiandrosterone for 20 days into C57BL/6J mice.Human umbilical cord mesenchymal stem cells(2×106)were injected through the caudal vein.After treatment,vaginal secretions were collected for 10 consecutive days to detect the estrus cycle of mice.At 2 weeks after treatment,the levels of sex hormones in the peripheral blood of mice,including luteinizing hormone and follicle-stimulating hormone,were detected by ELISA.Hematoxylin-eosin staining was used to evaluate ovarian histopathology.Finally,mitochondrial autophagy in ovaries was observed by transmission electron microscopy. RESULTS AND CONCLUSION:(1)After human umbilical cord mesenchymal stem cell therapy,follicles at different stages(primitive follicles,primary follicles,and secondary follicles)appeared in the ovary of polycystic ovary syndrome mice,and luteal tissue could be seen,indicating that ovulation function of mice was effectively improved.(2)Polycystic ovary syndrome mice treated with human umbilical cord mesenchymal stem cells had sex hormone levels.(3)Untreated polycystic ovary syndrome mice were found to be in the estrous stage for a long time,lacking estrous interphase and estrous phase,but after human umbilical cord mesenchymal stem cell therapy,the estrous cycle returned to a normal level.(4)After treatment with human umbilical cord mesenchymal stem cells,the mitochondrial autophagy of polycystic ovary syndrome mice was significantly reduced.(5)The results show that human umbilical cord mesenchymal stem cells can effectively improve the symptoms of endocrine disorders and promote ovulation in polycystic ovary syndrome mice,which may be related to the inhibition of mitochondrial autophagy.