Chinese medicine Yangmo decoction ameliorates intrauterine adhesion prognosis following hysteroscopic adhesiolysis. / ä¸­è¯å »è†œæ–¹æ”¹å–„å®«è ”é•œä¸‹å®«è ”ç²˜è¿žåˆ†ç¦»æœ¯åŽå®«è ”ç²˜è¿žçš„é¢„åŽ.

OBJECTIVES: Hysteroscopic adhesiolysis (HA) remains the mainstay on treatment for intrauterine adhesions (IUA). The fertility outcome of patients with moderate and severe intrauterine adhesions after HA is still far from satisfactory. Estrogen combined with progesterone is the most common treatment; however, they do not help in improving the fertility rate to the maximum because of the limitations. This retrospective, non-randomized controlled study will assess the effects of traditional Chinese medicine Yangmo decoction after HA in restoration of the endometrium and improvement of the fertility rate. METHODS: A total of 427 patients, who met the inclusion criteria, aged between 20 and 45 years and diagnosed with moderate or severe IUA underwent HA at the Third Xiangya Hospital from January to August 2021, were enrolled for this study. Participants were assigned into 2 groups: A Yangmo decoction group (n=213, patients were given Yangmo decoction consisting of Ginseng flower, Sanchi flower, Daidai flower, Snow lotus, Licorice and so on after HA), and an estrogen and progesterone group (n=214, patients were given estrogen and progesterone after HA). The following basic information was collected retrospectively for both groups, including age, parity, history of abortion, menstrual status, and times of hysteroscopic interventions. American Fertility Society (AFS) score was used by a senior surgeon and the density of opening of endometrial glands was evaluated during HA. The parameters were obtained from three-dimensional transvaginal ultrasound (3D-TVUS) preoperatively and postoperatively, to evaluate the efficacy of Yangmo decoction, estrogen, and progesterone. All patients were followed up on telephone to determine the fertility rate until 6 months from the last HA. RESULTS: Based on the basic information collected preoperatively, there were no significant differences between the groups (all P>0.05). Postoperatively, patients in the Yangmo decoction group had a better surgical success rate with a more significant AFS reduction (P<0.001), better density of opening of endometrial glands in the uterine cavity (P<0.000 1) after HA, and a better fertility rate (40.4%) in the time of 6 months after the last HA than those of the estrogen and progesterone group. CONCLUSIONS: Yangmo decoction has better therapeutic efficacy in the treatment of intrauterine adhesion after HA than the combined effect of estrogen and progesterone. Yangmo decoction helps restore the endometrium and improve the fertility rate, therefore, it can be adopted as a routine practice for IUA patients who have fertility requirements.

Value of transvaginal three-dimensional ultrasound in evaluating the curative effect of Yangmo decoction in the treatment of uterine adhesion. / ç»é˜´é“ä¸‰ç»´è¶ å£°åœ¨åˆ¤æ–­å »è†œæ–¹æ²»ç–—å®«è ”ç²˜è¿žæ•ˆæžœä¸­çš„ä»·å€¼.

OBJECTIVES: Intrauterine adhesions (IUA) is the damage of the basal layer of the endometrium caused by various reasons, resulting in adhesion of the uterine muscle walls to each other, which is manifested as clinical symptoms such as spanomenorrhea, amenorrhea, and infertility. Hysteroscopic adhesiolysis (HA) is the main treatment, for patients with moderate or severe adhesion or angular adhesion, the incidence of postoperative adhesion is high. Traditional Chinese medicine "Yangmo decoction" can promote endometrial growth. Three-dimensional transvaginal ultrasonography (3D-TVUS) can judge IUA and evaluate uterine receptivity through three-dimensional imaging. This study aims to investigate the value of 3D-TVUS in judging the efficacy of Yangmo decoction in the treatment of intrauterine adhesions. METHODS: The clinical data of patients who underwent HA at two different centers in department of Gynecology of Third Xiangya Hospital of Central South University and Changsha Jiangwan Hospital from January 2021 to August 2021 were retrospectively collected. A total of 275 eligible patients were included. According to the postoperative management measures, the selected patients were divided into two groups. Yangmo decoction group (n=138): the use of Yangmo decoction and uterine-shaped silicon stent post HA; Hormone group (n=137): the use of estrogen, progesterone and uterine-shaped silicon stent post HA. The preoperative general data, preoperative and postoperative 3D-TVUS parameters of the two groups were analyzed. RESULTS: The endometrial thickness of Yangmo decoction group was thicker than that of hormone group (P<0.001), the intercornual distance was wider (P=0.016), the endometrial echo was more homogeneous (P=0.018), the percentage of bilaterally visible tubal opening was higher (P<0.001), the endometrial morphology was better (P=0.012), and endometrial blood flow, endometrial motility and uterine motion were better in Yangmo decoction group than that in the hormone group (all P<0.001). CONCLUSIONS: The endometrial thickness, echo, blood flow, and peristalsis, the number of visible tubal opening, uterine motion, and the intercornual distance obtained by 3D-TVUS examination are important factors to evaluate the prognosis of postoperative drug treatment for IUA. 3D-TVUS is of great significance in evaluating the efficacy of Yangmo decoction in the treatment of IUA.

[Long Program Intervention of Huluan Decoction on In Vitro Fertilization and Embryo Transfer].

OBJECTIVE: To observe the curative effect and feasibility of Huluan Decoction (HD) in assisted reproductive technique (ART) for in vitro fertilization and embryo transfer (IVF-ET) patients. METHODS: Totally 120 patients were assigned to the Western medicine (WM) group (60 cases, as the control) and the WM + HD group (60 cases, as the intervention) according to random digit table. Patients in the control group received routine long-acting long program. Those in the intervention group additionally took HD, one dose per day for 12 successive days starting from the 3rd day of the menstrual cycle. The following indicators were observed in the two groups: endometrial thickness on human chorionic gonado- tropin (HCG) day, endometrial morphology, endometrial blood flow Applebaum type, spiral arteries blood flow pulsation index (PI) and resistance index (RI), gonadotropin (Gn) days, Gn dosage, the number of retrieval eggs, the rate of high quality eggs, the fertilization rate, the cleavage rate, the high quality embryo rate, the biochemical pregnancy rate, curative effect and integral of Shen deficiency syn- drome. And their effects on final pregnancy rate and liveborn birth rate were also observed. RESULTS: In the intervention group the number of retrieval eggs, the rate of high quality eggs, the fertilization rate, and the high quality embryo rate all increased (P <0. 05), endometrial thickness on HCG day significantly increased, PI and RI obviously decreased (P <0.01) , Gn days, Gn dosage, integral of Shen deficiency syndrome were reduced (P <0. 05), clinical pregnancy rate and liveborn birth rate were also elevated (P <0. 05) , as compared with the control group. Endometrial blood flow Applebaum type was superior in the intervention group to that in the control group (P <0. 05). The total effective rate was 96. 5% (55/57 cases) in the intervention group, higher than that in the control group [80. 0% (44/55 cases) ; P <0. 051. CONCLUSION: In IVF-ET treatment cycle, use of HD could obviously improve clinical symptoms of Shen deficiency patients, elevate the quality of eggs and embryos, improve the endometrial receptivity, and fi- nally elevate clinical pregnancy rate and liveborn birth rate.

[Effects of shoutai pills on expression of Th1/Th2 cytokine in maternal-fetal interface and pregnancy outcome].

OBJECTIVE: To evaluate its mechanism of inducing the maternal-fetal immune tolerance by studying the effects of Shoutai pills on the expression of Th1/Th2 cytokine and pregnancy in maternal-fetal interface of mice with recurrent spontaneous abortion (RSA). METHOD: The normal pregnancy and RSA model were respectively induced with CBA/J x BALB/c and CBA/J x DBA/2. The mice with RSA were randomly divided into model group and low, middle and high dose groups of Shoutai pills. The mice were killed in 14 days after administration and embryo resorption rate was counted and their decidual and placental tissues were co-cultured to detect the expressions of IL-4, IL-10, IFN-gamma and TNF-alpha with ELISA. RESULT: The embryo resorption rate of the model group was significantly higher than the normal pregnancy, middle and high dose groups of Shoutai pills could decreased the embryo resorption rate of the mice with RSA (P < 0.05). All the doses in 3 groups of Shoutai pills could decreased the expression of IFN-gamma and TNF-alpha (P < 0. 05) and there was no obvious difference between normal pregnancy group and all groups of Shoutai pills. Middle and high doses of Shoutai pills could increased the expression of IL-4 and IL-10 (P < 0.05) and there was no obvious differences between normal pregnancy and high dose group of Shoutai pills. CONCLUSION: The mechanism about Shoutai pills can change Th1 /Th2 cytokine towards Th2 bias, which induced the maternal-fetal immune tolerance.

[Effect of total flavones from Cuscuta chinensis on expression of Th type-1/Th type-2 cytokines, serum P and PR in abortion rats model].

OBJECTIVE: To study the effect of TFCC on expression of Th type-1/Th type-2 cytokines and PR in rats abortion model, and observe the changes of serum P and PRL. METHODS: Early abortion rat model was established by Bromocriptine at 6-8 gestation day, the model rats were treated with high and low dosage of TFCC and the progesterone as the positive control. Progesterone and prolactin levels in the serum were measured by radioimmunoassay, the protein expression of PR was inspected by immunohistochemical, RT-PCR was applied to determine the expression of Thl/Th2 mRNA on deciduas. RESULTS: In the deciduas of model group, IL-4 and IL-10 cytokine contens were clearly lower than that of normal pregnancy group. The difference was notable(P < 0.05), In the deciduas of model group, IFN-gamma and TNF-alpha cytokine contents were clearly higher than that of normal pregnancy group. The difference was notable (P < 0.05), TFCC could up-regulate the level of IL-4 and IL-10, and down-regulate the level of TNF-alpha and IFN-gamma, which could promote P secretion and up regulate PR mRNA expression on deciduas. CONCLUSION: TFCC can regulate endocrinologycal and immunological network equilibration on maternal-fetal face, finally achieve prevention abortion.

[Effect of total flavones from Cuscuta chinensis on expression of Fas/FasL, PCNA and HB-EGF in SD rats model with bromocriptine-induced abortion].

OBJECTIVE: To explore the effect of total flavones from cuscuta chinensis (TFCC) on expression of Fas, PCNA and HB-EGF in SD rats model with bromocriptine-induced abortion. METHODS: The model rats of bromocriptine during 6-8 d of pregnancy induced early abortion was established, adopting respectively herbs in high and low dosage and progesterone affect model rat and after 12 d, Immunohistochemical was applied to determine Fas, HB-EGF and PCNA in deciduas and placenta. RESULTS: Expression of PCNA on trophoblast and deciduas, HB-EGF on trophoblast, PR on deciduas in the model used Semen cuscutae flavonoid, proesterone and normal pregnacy, were significantlly higher than those of the pure model. Expression of Fas on trophoblast and deciduas in above four groups, were significantlly lower than those of the pure model. There were no expression of HB-EGF on deciduas. CONCLUSION: TFCC regulates the proliferation and apoptosis of the deciduas and cytotrophoblasts and prevents spontaneous abortions.

[Concise translation of TCM terminologies and its application].

TCM terminologies are the professional medical terms, marked by in Chinese features of simplification and cogency, as well as rich connotations, and thus conciseness should be one of the main principles when it comes to their translation. The concise translation and its application were discussed in this paper through semantic and logic analysis on TCM terms and starting with the English word-building.

[Effects of herb therapy for benefiting qi and removing blood stasis on ultrastructure of vascular endothelial cells and vascular smooth muscle cells of uterine endometrium in rabbits with copper intrauterine device].

OBJECTIVE: To observe the effects of herb therapy for benefiting qi and removing blood stasis on ultrastructure of vascular endothelial cells (VECs) and vascular smooth muscle cells (VSMCs) of uterine endometrium in rabbits with copper intrauterine device. METHODS: Fifty-six rabbits were randomly divided into seven groups, which were normal control group, sham-operation group, untreated group, indomethacin-treated group and low-, medium- and high-dose Gonghuan Zhixueling Recipe (GHZXLR)-treated groups. The rabbits in the last five groups were operated with copper IUD insertion and then orally given distilled water, indomethacin and low-, medium- and high-dose GHZXLR respectively for at least one week. Rabbits in the normal control group and sham-operation group were given distilled water orally. The ultrastructure of VECs and VSMCs of uterine endometrium in rabbits was observed by transmission electron microscopy. RESULTS: The morphological changes of VSMCs revealed intracellular edema, organelle disintegration and decrease of organelle amount, or cell atrophy and vacuolar degeneration of mitochondria in the untreated group, and the amount of collagen fibers also increased outside the VSMCs. Local interstitial edema in subendothelial substance and vacuolar degeneration of mitochondria in VECs were both observed. The ultrastructural damages to the mitochondria, Golgi bodies and myofilament of VECs and VSMCs and the intercellular substance in GHZXLR-treated groups were slighter than those in the untreated group, while these damages had no significant differences as compared with those in the indomethacin-treated group. CONCLUSION: The Chinese herb therapy for benefiting qi for removing blood stasis has the protective effect on VECs of uterine endometrium in the rabbits with copper intrauterine device. It appears to be a good treatment for menorrhagia induced by copper IUD insertion.

[Effects of sanqi qiancao recipe on hemorheological parameters of rabbits with copper intrauterine device].

OBJECTIVE: To explore the mechanism of Sanqi Qiancao Recipe (SQR) in treating metrorrhagia caused by copper intrauterine device (IUD) in rabbits and to provide experimental evidence for preventing and treating this disease. METHODS: Fifty-six rabbits were randomly divided into seven groups, which were normal control group, sham-operation group, untreated group, indomethacin-treated group, low-dose SQR-treated group, medium-dose SQR-treated group and high-dose SQR-treated group. Copper IUD insertion was operated in rabbits of the last five groups. Rabbits in the last four groups were treated orally with indomethacin and low-, medium- and high-dose SQR respectively for a week. Rabbits in the untreated group, normal control group and sham-operation group were given distilled water orally. Hematocrit, blood viscosity at low, medium and high shear rate, plasma viscosity and blood sedimentation were examined after treatment. RESULTS: The hematocrit, blood viscosity at low, medium and high shear rate and plasma viscosity were higher in the untreated group than those in the normal control group with significant differences (P<0.01) while those indexes in low-, medium- and high-dose SQR-treated groups were significantly lower than those in the untreated group (P<0.05 or P<0.01). CONCLUSION: SQR can lead to a decrease in blood viscosity and improve the blood flow, which may be one of the mechanisms of SQR in treating metrorrhagia after copper IUD insertion.

[Effect of ingredients of Astragalus-Salvia compound on vascular endothelial cell in placenta and vascular endothelial growth factor mRNA expression in trophocyte in pregnant rats with inhibited nitric oxide synthesis].

OBJECTIVE: To investigate the molecular mechanisms of effective ingredients of Astragalus-Salvia compound (ASC) in increasing placental blood supply, to provide thought for establishing an effective prevention and treatment of insufficient placental blood supply caused complications of pregnancy. METHODS: The effective ingredients of ASC was isolated and abstracted and the rat model of inhibited nitric oxide synthesis was established by using L-Arginine methyl ester (L-NAME), a nitric oxide synthase inhibitor. The mRNA expression of vascular endothelial growth factor (VEGF) in placental trophocyte and primordial micrangial endothelial cell was determined by using in situ hybridization at 12th day of pregnancy. RESULTS: The VEGF mRNA expression was significantly lower in nitric oxide synthesis inhibited model rats than that in rats non-modeled, or in model rats treated by ASC abstracts or nitroglycerin (P < 0.05, P < 0.01). CONCLUSION: Effective ingredients of ASC may improve VEGF mRNA expression in placental trophocyte and vascular endothelial cell in early pregnancy, and thus be favorable for placental vascular net formation, trophocyte infiltration and mother-placental circulation constitution for increasing placental blood supply to prevent and treat the insufficient placental blood supply caused diseases such as pregnancy-induced hypertension syndrome.

[Hemostatic and analgesic effect of Gonghuan Zhixue Tablet on mice].

OBJECTIVE: To explore the hemostatic and analgesic effect of Gonghuan Zhixue Tablet (GHZXT) on mice and to produce experimental evidence for exploiting new drug for endometrorrhagia caused by Cu-intrauterine contraceptive device (Cu-IUD). METHODS: Compared with 6-aminocaproic acid and notoginseng, the effects of GHZXT on clotting and bleeding time of mice with capillary method and severed tail were investigated; and compared with aspirin, the analgesic effects of GHZXT on mice were investigated with hot plate and torsive body method. RESULTS: The clotting time of mice was remarkably shortened with a rising of the dosage of GHZXT and the difference between each therapeutic group and distilled water group was remarkable. As compared with distilled water group, the bleeding time of each dosage group of GHZXT was obviously shortened; and each dosage of GHZXT could prolong the time of pain reaction to hot plate and decrease the degree of torsive body of the mice. CONCLUSION: Pharmacological experiment has proved that GHZXT has evident hemostatic and analgesic function.