Biomechanical analysis of the maxillary sinus floor membrane during internal sinus floor elevation with implants at different angles of the maxillary sinus angles.

OBJECTIVE: This study analyzed and compared the biomechanical properties of maxillary sinus floor mucosa with implants at three different maxillary sinus angles during a modified internal sinus floor elevation procedure. METHODS: 3D reconstruction of the implant, maxillary sinus bone, and membrane were performed. The maxillary sinus model was set at three different angles. Two internal maxillary sinus elevation models were established, and finite element analysis was used to simulate the modified maxillary sinus elevation process. The implant was elevated to 10 mm at three maxillary sinus angles when the maxillary sinus floor membrane was separated by 0 and 4 mm. The stress of the maxillary sinus floor membrane was analyzed and compared. RESULTS: When the maxillary sinus floor membrane was separated by 0 mm and elevated to 10 mm, the peak stress values of the implant on the maxillary sinus floor membrane at three different angles were as follows: maxillary sinus I: 5.14-78.32 MPa; maxillary sinus II: 2.81-73.89 MPa; and maxillary sinus III: 2.82-51.87 MPa. When the maxillary sinus floor membrane was separated by 4 mm and elevated to 10 mm, the corresponding values were as follows: maxillary sinus I: 0.50-7.25 MPa; maxillary sinus II: 0.81-16.55 MPa; and maxillary sinus III: 0.49-22.74 MPa. CONCLUSION: The risk of sinus floor membrane rupture is greatly reduced after adequate dissection of the maxillary sinus floor membrane when performing modified internal sinus elevation in a narrow maxillary sinus. In a wide maxillary sinus, the risk of rupture or perforation of the wider maxillary sinus floor is reduced, regardless of whether traditional or modified internal sinus elevation is performed at the same height.

Efficacy of coenzyme Q10 supplementation for male infertility with high sperm DNA fragmentation index: a protocol for a systematic review and meta-analysis.

INTRODUCTION: Infertility is a focal issue in public health and affects human reproduction and survival. Notably, an increasing number of studies in recent decades have found that sperm DNA integrity plays a critical role in the development of healthy embryos. Among the multiple pathogenic factors of sperm DNA fragmentation, oxidative stress has proven to be predominant. Coenzyme Q10 supplementation, which has been used for the treatment of male infertility, has shown good clinical efficacy due to its oxidation resistance, but its efficacy as measured by the sperm DNA fragmentation index remains controversial. To address this issue, we will perform a systematic review and meta-analysis to evaluate the efficacy of coenzyme Q10 for male infertility patients with a high sperm DNA fragmentation index. METHODS AND ANALYSIS: The PubMed, Embase, Cochrane Central Register of Studies and Web of Science databases will be comprehensively searched from inception to 31 December 2022 to identify relevant studies published in the English language using appropriate search strategies. The search terms will be derived from the following concepts: sperm DNA fragmentation, coenzyme Q10 and randomised controlled trials. Two review stages, that is, title and abstract screening and full-text screening, will be performed by two reviewers. The risk of bias, publication bias and evidence grade of the included studies will be assessed using a standardised protocol. Data will be used to calculate effect sizes. Heterogeneity among the studies will be evaluated graphically. Subgroup analysis and sensitivity analysis will be performed if necessary to validate the results. ETHICS AND DISSEMINATION: No ethical approval will be needed, as there will be no participants in this study. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to disseminate the findings through publication and conference presentation. PROSPERO REGISTRATION NUMBER: CRD42022293340.

Modified internal sinus elevation for patients with low residual bone height: A retrospective clinical study.

BACKGROUND: We have modified the internal sinus elevation by combining it with the sinus mucoperiosteum stripping procedure, which further increases the indications for the internal lift. Similar long-term clinical follow-up studies and three-dimensional finite element analyses are rare. OBJECTIVE: This study aimed to investigate the feasibility of the modified internal sinus floor elevation method in patients with low residual bone height using a three-dimensional (3D) finite element model and report on the long-term outcomes. MATERIALS AND METHODS: Overall, 99 implants were placed in 86 patients. All patients were followed-up for 3-24 months. The modified internal sinus floor elevation was dynamically simulated using a 3D finite element model, and the stress of the sinus membrane was measured. RESULTS: In trial group A (modified internal sinus floor elevation group), 57 implants were placed in 52 patients. The sinus floor height was lifted by 6.5 mm (95%confidence interval (CI): 6.2-6.8). The perforation rate was 8.8%, and the implant survival rate was 96.5%. In control group B (external sinus floor elevation group), 42 implants were placed in 34 patients. The sinus floor height was lifted by 8.8 mm (95%CI: 8.4-9.3). The perforation rate was 14.3%, and the implant survival rate was 100%. In trial group A, compared with the control group B, perforation decreased by 5.5% (odds ratio = 0.50 and 95%CI: 0.14-1.78; p = 0.282), and the sinus floor lift height was 2.3 mm lower (95%CI, 1.8-2.9; p < 0.001). The finite element analysis showed that the peak stress of the sinus membrane increased with an increase in height elevation and degree of membrane separation. CONCLUSION: Our findings indicate the positive clinical outcomes in patients with low RBH associated with the modified internal sinus elevation procedure.

Acrosomal vesicle protein in predicting progression of pancreatitis in Chinese patients with acute pancreatitis.

The present preliminary investigation was designed to identify biomarkers in the progression of pancreatitis in Chinese patients with acute pancreatitis. Chinese patients aged <60 years with a confirmed diagnosis of acute pancreatitis were enrolled. A saliva sample was collected using salimetrics oral swab in precooled polypropylene tubes to prevent degradation of sensitive peptides. All samples were then centrifuged at 700 × g for 15 min at 4°C to remove debris. The supernatant of each sample was fractionated into 100µL aliquots and frozen at -70°C until analyses using affymetrix HG U133 Plus 2.0 array technique. Bedside index for severity acute pancreatitis (BISAP) score and CT severity index were recorded for each enrolled patient to assess the progression and severity of acute pancreatitis. Data from a total of 210 patients (105 patients in each group) were analyzed. Among identified biomarkers, acrosomal vesicle protein 1 was significantly higher in patients with disease progression as compared to patient without disease progression. Logistic regression model showed that acrosomal vesicle protein 1 (ACRV1) were positively correlated with the progression of diseases. The present reports showed that a mRNA salivary biomarker (ACRV1) are associated with progression of pancreatitis in patients with early stage of pancreatitis. This study suggest that mRNA salivary biomarker (ACRV1) is a predictor of pancreatitis progression.

Transcriptomic study of the mechanism by which the Kai Yu Zhong Yu recipe improves oocyte quality in a stressed mouse model.

ETHNOPHARMACOLOGICAL RELEVANCE: The Kai Yu Zhong Yu recipe (KYZY) is a classic herbal formula in traditional Chinese medicine (TCM) that has been used to treat infertility associated with psychological stress for more than three hundred years. AIM OF THE STUDY: Psychological stress has major impacts on fertility, with variable outcomes depending on the nature, strength, and duration of the stress. Stress can directly disturb ovulation, oocyte quality, maturation, and embryo development. The aim of this study is to investigate the molecular mechanism by which KYZY improves oocyte developmental potential under psychological stress. MATERIALS AND METHODS: ICR female mice aged 4-5 weeks were randomly divided into five groups: control, stressed in the chronic unpredictable stress model (CUSM), and stressed plus KYZY treatment at 38.2 g/kg (KYZYH), 19.1 g/kg (KYZYM), or 9.6 g/kg (KYZYL). Ovary function was assessed by measuring serum levels of estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and anti-Müllerian hormone (AMH). Oocyte quality was evaluated in terms of reactive oxygen species (ROS) levels, apoptotic DNA fragmentation, and mitochondria distribution. We used RNA sequencing (RNAseq) to identify differentially expressed genes (DEGs) between groups and then further analyzed the DEGs for gene ontology (GO) term enrichment and protein-protein interactions. RESULTS: Mice in the stressed group had reduced serum E2, LH, and FSH as well as increased ROS levels, increased apoptosis, and disturbed mitochondria distribution in oocytes. Treatment with KYZY at all three doses reversed or ameliorated these negative effects of stress. DEG analysis identified 187 common genes between the two comparisons (stressed vs. control and KYZYM vs. stressed), 33 of which were annotated with six gene ontology (GO)'s biological process (BP) terms: cell differentiation, apoptosis, ATP synthesis, protein homo-oligomerization, neuron migration, and negative regulation of peptidase activity. Protein-protein interaction network analysis of DEGs identified key hub genes. Notably, the genes Atp5o and Cyc1 were both involved in the ATP synthesis and among the top three hub genes, suggesting that regulation of oocyte mitochondrial electron transport and ATP synthesis is important in the response to stress and also is a possible mechanism of action for KYZY. CONCLUSIONS: KYZY was effective in ameliorating the adverse effects of stress on oocyte competence, possibly by targeting the mitochondrial respiratory chain and ATP synthase.

Reduced growth capacity of preimplantation mouse embryos in chronic unpredictable stress model.

Psychological stress can affect female reproduction by deteriorating oocyte quality, but the molecular mechanism is unclear. In this study, we used the chronic unpredictable stress model to study the effect of psychological stress on mouse oocyte competence during preimplantation stage, and RNA sequencing in single oocytes to analyze differential gene expression at the transcription level. Stress changed the serum levels of glucocorticoids and reduced oocyte developmental potential, depending on the strength of the stress. Strong stress (two stressors per day) reduced the fertilization rate and induced significant apoptosis in blastocysts. Moderate stress (one stressor per day) reduced the cleavage rate and blastocyst formation rate. Weak stress (one stressor every 2 days) did not have any significant negative effect on the fertilization, cleavage, and blastocyst formation. Hatching rate was not affected by stress, but stress retarded the development of the expanded blastocysts and inhibited the embryo development at early stages. Transcriptome analysis revealed that stress disturbed the expression of cell cycle regulators and apoptotic genes. The hub genes identified through protein-protein interaction analysis include Msln, Ceacam12, Psg16, Psg17, and Psg23, which are all carcinoembryonic or related genes involved in cell adhesion, proliferation, and migration. Thus, stress was inhibitory on fertilization and early embryo development in mice.

Acupuncture for diminished ovarian reserve: Protocol for a systematic review and meta-analysis.

BACKGROUND: The choice of treatments for diminished ovarian reserve (DOR) still remains a challenging clinical problem in reproductive medicine. Acupuncture could be beneficial for patients with DOR. This study aims to systematically investigate the efficacy and safety of the acupuncture for women with DOR. METHODS: We will search electronic databases including PubMed (1946 to present), EMBASE (1974 to present), Cochrane Central Register of Controlled Trials (CENTRAL, all years), Web of Science (1900 to present), Chinese Biomedical Literatures Database (CBM, 1978 to present), China National Knowledge Infrastructure (CNKI, 1979 to present), WANFANG Data (from 2000 to present) to identify potentially eligible studies. Only randomized controlled trials (RCTs) will be included. Experimental interventions include traditional or contemporary acupuncture. Control interventions include no treatment, sham acupuncture, placebo acupuncture, or another active therapy. The primary outcomes include ongoing pregnancy rate and serum anti-Müllerian hormone level. A meta-analysis will be used to estimate a pooled intervention effect if possible. RESULTS: The results will be published in a peer-reviewed journal. CONCLUSION: The findings will provide further evidence for the management of DOR. PROSPERO REGISTRATION NUMBER: CRD42018114385.

Menstrual blood derived mesenchymal stem cells combined with Bushen Tiaochong recipe improved chemotherapy-induced premature ovarian failure in mice by inhibiting GADD45b expression in the cell cycle pathway.

BACKGROUND: To investigate the therapeutic effects of menstrual blood derived mesenchymal stem cells (MB-MSCs) combined with Bushen Tiaochong recipe (BSTCR) on epirubicin induced premature ovarian failure (POF) in mice. METHODS: Twenty-four female C57BL/6 mice of 6-8 weeks were intraperitoneally injected with epirubicin to induce POF, and then they were randomized into 4 groups of 6 mice each and treated with PBS, MB-MSCs, BSTCR, and MB-MSCs combined with BSTCR, respectively. Six mice of the same age were used as controls. Vaginal smear, TUNEL and hematoxylin-eosin staining were to observe estrous cycles, ovarian cell apoptosis and follicles. Enzyme-linked immunosorbent analysis determined serum estradiol, follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH) levels. RT-qPCR and Western Blot analysis were to determine GADD45b, CyclinB1, CDC2 and pCDC2 expressions. RESULTS: Epirubicin treatment resulted in a decrease in the number of primordial, primary, secondary and antral follicles, an increase in the number of atretic follicles and ovarian cell apoptosis, a decrease in estradiol and AMH levels, an increase in FSH levels, and estrous cycle arrest. However, MB-MSCs combined with BSTCR rescued epirubicin induced POF through down-regulating GADD45b and pCDC2 expressions, and up-regulating CyclinB1 and CDC2 expressions. The combined treatment showed better therapeutic efficacy than BSTCR or MB-MSCs alone. CONCLUSIONS: MB-MSCs combined with BSTCR improved the ovarian function of epirubicin induced POF mice, which might be related to the inhibition of GADD45b expression and the promotion of CyclinB1 and CDC2 expressions. The combined treatment had better therapeutic efficacy than BSTCR or MB-MSCs alone.

Systemic analysis of urinary stones from the Northern, Eastern, Central, Southern and Southwest China by a multi-center study.

BACKGROUND: To provide some basis for the prevention of urinary stones in general population, we did a systemic analysis of urinary stones from Northern, Eastern, Central, Southern and Southwest China by a multi-center study. METHODS: A total of 11,157 urinary stones from Northern, Eastern, Central, Southern and Southwest China were obtained and analyzed by Fourier transform infrared spectroscopy. Combined with scanning electron microscopy and X-ray energy spectrometer, urinary stones were classified into different types. Furthermore, the correlation between stone types and clinical characteristics, as well as their regional distribution were elucidated. RESULTS: Calcium oxalate stones were the most common type in each region, followed by calcium oxalate-calcium phosphate mixed stones, uric acid stones and calcium phosphate stones. The distribution of calcium oxalate stones were highest prevalence in Southwest China (67.9%, P < 0.05), followed by Eastern and Northern China. Anhydrous uric acid stones, with a constituent ratio of 19.3% in Southern China, and 13.7% in Central China, were significantly higher than that in other regions (P < 0.05). Elements analysis indicated varieties among stone types as well as distribution regions. Moreover, the clinical characteristics were highly correlated with stone types and anatomical locations but not their distribution regions. CONCLUSIONS: The material and elements composition of urinary stones among different regions showed some varieties. Calcium oxalate stone has the highest constituent ratio in Southwest China, while anhydrous uric acid stone has the highest constituent ratio in Southern China. Moreover, the clinical characteristics were highly correlated with stone types and anatomical locations but not their distribution regions.

Efficacy and safety of Ding-Kun-Dan for female infertility patients with predicted poor ovarian response undergoing in vitro fertilization/intracytoplasmic sperm injection: study protocol for a randomized controlled trial.

BACKGROUND: Women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) who have a predicted poor ovarian response (POR) present a challenge for reproductive medicine specialists. Traditional Chinese medicine (TCM) is commonly used in China for such patients, in the belief that it will improve the ovarian response and ultimately increase pregnancy rates. However, there is a lack of high-quality evidence about the effect of TCM on improving ovarian response in such patients. The purpose of this study is to evaluate ongoing viable pregnancy rate at 12 weeks' gestation and related indicators of ovarian response in fertile women who have a predicted poor ovarian response having immediate versus delayed IVF/ICSI after 3 months of Ding-Kun-Dan (DKD) pre-treatment. METHODS/DESIGN: This study is a multicenter, randomized controlled, parallel-group, phase III, superiority clinical trial. Two hundred and seventy-eight eligible female infertility patients with POR will be included in the study and randomly allocated into an immediate treatment group and a DKD group in a 1:1 ratio. Both groups will receive IVF or ICSI as a standard treatment while in the DKD group, a commercially available Chinese medicine, DKD, will be administrated for 3 months before the IVF/ICSI cycle starts. The primary outcome of the study is the ongoing pregnancy rate at 12 weeks' gestation. The secondary outcomes include total gonadotropin dosage, duration of stimulation, estradiol (E2) and progesterone (P) levels on human chorionic gonadotropin (hCG) trigger day, cycle cancellation rate, number of oocytes retrieved, high-quality embryo rate, biochemical pregnancy rate, the change of serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and E2 levels and all side effects, safety outcomes, and any adverse events. The protocol was approved by the Ethics Committee of the First Teaching Hospital of Tianjin university of TCM (approval no. TYLL2017[K] 004). DISCUSSION: IVF/ICSI is increasingly used to treat couples desiring a baby. Many of these women will have poor ovarian function. In China, DKD is commonly used for these patients prior to undergoing IVF/ICSI. There is no effective treatment for poor ovarian response in Western medicine currently. It is important, therefore, to undertake this randomized control trial to determine whether DKD is effective or not. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ID: ChiCTR-IOR-17011697 . Registered on 19 June 2017.

Mixture prepared with Chinese medicines in terms of releasing exterior cold and clearing interior heat: its efficacy and safety in patients with seasonal influenza-a randomized controlled trial.

OBJECTIVE: To assess the efficacy and safety in 105 patients with seasonal Influenza in Beijing, the mixture prepared with Chinese medicines follows the treatment regimen of releasing exterior cold and clearing interior heat. METHODS: Total 330 patients with seasonal influenza were enrolled and randomly and averagely divided into the Chinese herbal medicine, the western medicine and the Chinese patent medicine group. They were treated with Chinese medicine Oseltamivir Phosphate Capsules and the Scattering Wind and Resolving Toxins Capsules. The main efficacy indicators were the antifebrile onset time and recovery time of body temperature. The efficacy and safety of the mixture was scientifically evaluated. Comparisons of several variables were analyzed. RESULTS: Median antifebrile onset time of the Chinese herbal medicine group was significantly shorter than the western medicine group (P < 0.05) and the Chinese patent medicine group (P < 0.05). The median antifebrile recovery time of the Chinese herbal medicine group was significantly shorter than the Chinese patent medicine group (P < 0.05). The groups evaluated by TCM symptom pattern effect, both the Chinese herbal medicine group and Western Medicine group were better than the Chinese patent medicine group (P < 0.05). The disappearance rate of main symptoms and some minor symptom patterns of the Chinese herbal medicine group were higher than the other 2 groups. CONCLUSION: The mixture of releasing exterior cold and clearing interior heat could significantly shorten the fever time with safety.

Effects of liver depression and psychological stress on human uterine leiomyoma cells by an AR-cAMP-PKA signal transduction pathway.

OBJECTIVE: Based on the emotional theory of Traditional Chinese Medicine, and combined with the modern medicine theory of psychological stress, a research model of human uterine leiomyoma cells (ULM) was cultured in vitro to determine the effectiveness of adrenergic receptor (AR) agonists in human ULM cell growth. In addition, we studied the functional influence of "liver depression and psychological stress theory" on fibroid formation by intervening in the AR-cAMP-PKA signaling pathway. The intention was to establish a new method to prevent and cure fibroids through "liver depression and psychological stress theory" and provide an experimental basis for the Traditional Chinese Medicine emotional theory. MATERIALS AND METHODS: Primary human ULM cells were enriched by collagenase digestion. Immunohistochemistry and hematoxylin and eosin (HE) staining were used for cytological identification. Using this model, we studied intervention using specific AR agonists on ULM cells to observe the influence of "liver depression and psychological stress theory" on estrogen receptor (ER), progesterone receptor (PR), vascular endothelial growth factor (VEGF) and fibroblast growth factors (FGF). RESULTS: Norepinephrine (NE) and epinephrine (E) are adrenergic receptor agonists. They promoted ULM cell proliferation and increased the levels of ER, PR, VEGF and FGF. In contrast, isoproterenol (ISO) inhibited ULM cell proliferation and decreased the levels of ER, PR, VEGF and FGF. The protein expression of cAMP and PKA in ULM cells was reduced and the levels of ER, PR, VEGF and FGF were increased when co-treatment with the α-AR blocker (phentolamine). The ß-AR blocker (metoprolol) displayed an opposite effect. CONCLUSIONS: AR agonists modulated ER, PR, VEGF and FGF levels in ULM cells in an AR-cAMP-PKA-dependent signaling pathways to influence fibroid occurrence and development.

The systematic classification of urinary stones combine-using FTIR and SEM-EDAX.

BACKGROUND: To explore underlying mechanism of urinary stones formation, the composition and microstructure of urinary stones were analyzed systematically with a large sample study from China. MATERIALS AND METHODS: A total of 2437 urinary stones were obtained from the urology department at our Hospital. The composition of the stones was analyzed by Fourier transform infrared spectroscopy (FTIR). Meanwhile, the microstructure and element distribution were observed with scanning electron microscopy combined with element distribution analysis (SEM-EDAX). RESULTS: Urinary stones were classified into eight types, that were consisted of calcium oxalate stones (1301/2437, 53.39%), calcium phosphate stones (131/2437, 5.38%), anhydrous uric acid stones (434/2437, 17.81%), magnesium ammonium phosphate stones (12/2437, 0.49%), sodium urate stones (5/2437, 0.21%), brushite stones (4/2437, 0.16%), cystine stones (3/2437, 0.12%) and mixed stones (547/2437, 22.45%, ten subtypes were included). Under SEM, they displayed distinct microstructures: plank-like, brick-like, polyhedron or paliform crystals for calcium oxalate stones, similar sized echin-sphere or rough bulbiform or tree bark-like crystals for calcium phosphate stones, rotten-wood-like or petrous crystals for anhydrous uric acid stones, globular or gallet-like crystals for magnesium ammonium phosphate stones, sawdust-like crystals for sodium urate stones, broken-wood-like crystals for brushite stones, stacking hexagonal cystine crystals for cystine stones, and two or more of the above crystals for mixed stones. Meanwhile, they also presented distinct elemental composition and distribution by EDAX. CONCLUSIONS: Urinary stones can be classified into eight types, and exhibit a diversity of microstructure and elemental compositions in China. The formation process of different types of urinary stones may be diverse.

A comparative study of mud-like and coralliform calcium carbonate gallbladder stones.

To gain insight to underlying mechanism of the formation of calcium carbonate (CaCO3 ) gallbladder stones, we did comparative study of stones with mud appearance and those with coralliform appearance. A total of 93 gallbladder stones with mud appearance and 50 stones with coralliform appearance were analyzed. The appearance, color, texture, and the detection of Clonorchis sinensis eggs by microscopic examination were compared between the two groups. Then, the material compositions of stones were analyzed using Fourier Transform Infrared spectroscopy and the spectrogram characteristics were compared. Moreover, microstructure characteristics of the two kinds of stones were observed and compared with Scanning Electron Microscopy. Mud-like gallbladder stones were mainly earthy yellow or brown with brittle or soft texture, while coralliform stones were mainly black with extremely hard texture, the differences between the two groups was significant (p < .05). The analytic results of FTIR spectroscopy showed that 95.7% (89/93) of the mud-like gallbladder stones were CaCO3 stones, and mainly aragonite; while all of the coralliform stones were CaCO3 stones, and mainly calcite (p < .05). Meanwhile, microscopic examination indicated that the detection rate of Clonorchis sinensis eggs in mud-like CaCO3 stones was lower than that in coralliform CaCO3 stones (p < .05), and that in aragonite CaCO3 stones was lower than that in calcite CaCO3 stones(p < .05). Mud-like CaCO3 stones mainly happened to patients with cystic duct obstruction. Clonorchis sinensis infection was mainly associated with coralliform (calcite) CaCO3 stones. Cystic duct obstruction was mainly associated with mud-like (aragonite) CaCO3 stones.

Heyan Kuntai capsule versus dehydroepiandrosterone in treating Chinese patients with infertility caused by diminished ovarian reserve: a multicenter, randomized controlled trial.

OBJECTIVE: To evaluate the clinical efficacy and safety of Heyan Kuntai capsule (HYKT) in treating women with infertility caused by diminished ovarian reserve (DOR). METHODS: One hundred eight eligible patients from three Chinese hospitals were randomly divided into an HYKT treatment group (n = 55) or a dehydroepiandrosterone (DHEA) treatment group (n = 53). Patients in the HYKT group were treated orally with four 0.5 g HYKT three times a day; patients in the DHEA group were treated with one 25.0 mg DHEA capsule three times a day. All patients were treated for 3 months and followed up over a 3-month period. RESULTS: Of 108 patients, 12 dropped out: six from the HYKT group, and six from the DHEA group. Eleven patients got pregnant during the treatment. Serum anti-Müllerian hormone levels and antral follicle counts increased significantly in both groups after treatment (P < 0.05) especially in the HYKT group (P < 0.05). Serum follicle stimulating hormone (FSH) levels and FSH/luteinizing hormone ratios decreased (P < 0.05) with no significant difference between the two groups. Estradiol levels in the HYKT group and DHEA-sulfate levels in the DHEA group both increased (P < 0.05). The spontaneous pregnancy rates were 12% and 11% in the HYKT and DHEA groups, respectively (not significant). During the follow-up period, 16 patients in the HYKT group underwent in vitro fertilization-embryo transfer (IVF-ET) and the number of retrieved oocytes was (5.1 c1.8). In DHEA group, 20 patients underwent IVF-ET and the number of retrieved oocyte was (4.2 ± 1.9) (not significant); clinical pregnancy rates were 38% in the HYKT group and 20% in DHEA group (not significant). No significant adverse reactions were observed. CONCLUSION: HYKT can improve the ovarian reserve and hormone levels in patients with infertility caused by DOR. Pregnancy rates after HYKT treatment were similar to those of DHEA treatment. HYKT might be an alternative to the treatment of infertility caused by DOR.

Bu Shen Tiao Chong recipe restores diminished ovary reserve through the BDNF pathway.

PURPOSE: The purpose of this study was to explore the molecular pathway of BSTCR (Bu Shen Tiao Chong recipe) in retrieving diminished ovary reserve (DOR). METHODS: The DOR model was established through injecting cyclophosphamide and the effect of BSTCR was examined under this background. RESULTS: BSTCR was shown to restore depleted brain-derived neurotrophic factor (BDNF), CDC2, cyclin B, GSH1, and P38 levels as well as impaired oocyte maturation and the higher apoptosis induced in DOR. BSTCR also enhances the response of oocytes to in vitro fertilization, with higher implantation rate, birth rate, and placenta weight. CONCLUSION: BSTCR might exert its beneficial role in oocyte maturation and restore DOR through regulating the BDNF pathway. And this pathway itself is probably through the consequence on several serum hormones such as FSH, E2, Inhibin B, etc.

[Gallbladder Stone Types in Patients with Cholelithiasis and Clonorchis sinensis Infection in the Endemic Area of Clonorchiasis].

OBJECTIVE: To investigate the relationship between Clonorchis sinensis infection and the gallbladder stone type in patients with cholelithiasis in the endemic area of clonorchiasis. METHODS: Gallbladder stones were collected from 598 patients with cholelithiasis through minimally invasive gallbladder-preserving cholelithotomy in the Sixth People's Hospital of Nansha District from May 2009 to October 2012. The stone samples were analyzed for composition by Fourier transform infrared spectroscopy to identify their types. The Clonorchis sinensis eggs were detected in the stones by microscopic examination, and the detection rates of eggs were calculated for different stone types. Then the clinical characteristics and biochemical indicators were compared among patients with different types of stones, as well as between Clonorchis sinensis egg-positive and -negative patients with the calcium-carbonate type of stones. Some calcium-carbonate stones positive for Clonorchis sinensis eggs were randomly selected for further scanning electron microscopy (SEM) examination. RESULTS: Of the stones from 598 patients, 234 (39.1%) were cholesterol type, 133 (22.2%) bile pigment type, 112(18.7%) calcium-carbonate type, 86 (14.4%) mixed types and 33(5.5%) were others. The detection rate of Clonorchis sinensis eggs in these types was 6% (15/234), 44% (59/133), 60% (67/112), 36% (31/ 86) and 30% (10/33), respectively, being highest in calcium-carbonate stones while lowest in cholesterol stones. The Co2-combining power of the plasma was higher in patients with calcium-carbonate and mixed stones than in those with cholesterol stones (P < 0.05), and the CO2-combining power of the bile and biliary pH were both higher in patients with calcium-carbonate types than in those with other types (P < 0.05). In addition, in patients with calcium-carbonate stones, the CO2-combining powers of the plasma and the bile, as well as biliary pH were all higher in the egg-positives than in the egg-negatives. Further, both light microscopy and SEM revealed adherence of the Clonorchis sinensis eggs to calcium-carbonate crystals. CONCLUSION: The infection rate of Clonorchis sinensis is higher in patients with calcium-carbonate gallbladder stones than in those with other types of stones.

Clonorcis sinensis eggs are associated with calcium carbonate gallbladder stones.

Calcium carbonate gallbladder stones were easily neglected because they were previously reported as a rare stone type in adults. The aim of this study was to investigate the relationship between calcium carbonate stones and Clonorchis sinensis infection. A total of 598 gallbladder stones were studied. The stone types were identified by FTIR spectroscopy. The C. sinensis eggs and DNA were detected by microscopic examination and real-time fluorescent PCR respectively. And then, some egg-positive stones were randomly selected for further SEM examination. Corresponding clinical characteristics of patients with different types of stones were also statistically analyzed. The detection rate of C. sinensis eggs in calcium carbonate stone, pigment stone, mixed stone and cholesterol stone types, as well as other stone types was 60%, 44%, 36%, 6% and 30%, respectively, which was highest in calcium carbonate stone yet lowest in cholesterol stone. A total of 182 stones were egg-positive, 67 (37%) of which were calcium carbonate stones. The C. sinensis eggs were found adherent to calcium carbonate crystals by both light microscopy and scanning electron microscopy. Patients with calcium carbonate stones were mainly male between the ages of 30 and 60, the CO2 combining power of patients with calcium carbonate stones were higher than those with cholesterol stones. Calcium carbonate gallbladder stones are not rare, the formation of which may be associated with C. sinensis infection.

The systematic classification of gallbladder stones.

BACKGROUND: To develop a method for systematic classification of gallbladder stones, analyze the clinical characteristics of each type of stone and provide a theoretical basis for the study of the formation mechanism of different types of gallbladder stones. METHODOLOGY: A total of 807 consecutive patients with gallbladder stones were enrolled and their gallstones were studied. The material composition of gallbladder stones was analyzed using Fourier Transform Infrared spectroscopy and the distribution and microstructure of material components was observed with Scanning Electron Microscopy. The composition and distribution of elements were analyzed by an X-ray energy spectrometer. Gallbladder stones were classified accordingly, and then, gender, age, medical history and BMI of patients with each type of stone were analyzed. PRINCIPAL FINDINGS: Gallbladder stones were classified into 8 types and more than ten subtypes, including cholesterol stones (297), pigment stones (217), calcium carbonate stones (139), phosphate stones (12), calcium stearate stones (9), protein stones (3), cystine stones (1) and mixed stones (129). Mixed stones were those stones with two or more than two kinds of material components and the content of each component was similar. A total of 11 subtypes of mixed stones were found in this study. Patients with cholesterol stones were mainly female between the ages of 30 and 50, with higher BMI and shorter medical history than patients with pigment stones (P<0.05), however, patients with pigment, calcium carbonate, phosphate stones were mainly male between the ages of 40 and 60. CONCLUSION: The systematic classification of gallbladder stones indicates that different types of stones have different characteristics in terms of the microstructure, elemental composition and distribution, providing an important basis for the mechanistic study of gallbladder stones.

Microscopic examination of gallbladder stones improves rate of detection of Clonorchis sinensis infection.

To improve the rate of detection of Clonorchis sinensis infection, we compared different specimens from patients with cholecystolithiasis. Feces, gallbladder bile, and gallbladder stones collected from 179 consecutive patients with cholecystolithiasis underwent microscopic examination, and according to the results, 30 egg-positive and 30 egg-negative fecal, gallbladder bile, and gallbladder stone specimens, respectively, underwent real-time fluorescent PCR. The detection rates of eggs in feces, bile, and gallbladder stones were 30.7%, 44.7%, and 69.8%, respectively, and the differences were statistically significant (P<0.01). The PCR results confirmed that the eggs in the specimens were C. sinensis eggs. Eggs in the feces were "fresh" and in the gallbladder stones were "old." Microscopic examination of gallbladder stones may improve the detection rates of C. sinensis infection, which is important for developing individualized treatments to prevent the recurrence of gallbladder stones and to prevent the occurrence of severe liver damage and cholangiocarcinoma.