MAP kinases transduce signals that are involved in a multitude of cellular pathways and functions in response to a variety of ligands and cell stimuli. Aberrant or inappropriate functions of MAPKs have now been identi...MAP kinases transduce signals that are involved in a multitude of cellular pathways and functions in response to a variety of ligands and cell stimuli. Aberrant or inappropriate functions of MAPKs have now been identified in diseases ranging from cancer to inflammatory disease to obesity and diabetes. In many cell types, the MAPKs ERK1/2 are linked to cell proliferation. ERK1/2 are thought to play a role in some cancers, because mutations in Ras and B-Raf, which can activate the ERK1/2 cascade, are found in many human tumors. Abnormal ERK1/2 signaling has also been found in polycystic kidney disease, and serious developmental disorders such as cardio-facio-cutaneous syndrome arise from mutations in components of the ERK1/2 cascade. ERK1/2 are essential in well-differentiated cells and have been linked to long-term potentiation in neurons and in maintenance of epithelial polarity. Additionally, ERK1/2 are important for insulin gene transcription in pancreatic beta cells, which produce insulin in response to increases in circulating glucose to permit efficient glucose utilization and storage in the organism. Nutrients and hormones that induce or repress insulin secretion activate and/or inhibit ERK1/2 in a manner that reflects the secretory demand on beta cells. Disturbances in this and other regulatory pathways may result in the contribution of ERK1/2 to the etiology of certain human disorders.展开更多
Background Polycystic ovary syndrome （PCOS） is considered to be the most common endocrine disorder in women of reproductive age.The involvement of an abnormal menstrual cycle in the etiology of PCOS remains unclear....Background Polycystic ovary syndrome （PCOS） is considered to be the most common endocrine disorder in women of reproductive age.The involvement of an abnormal menstrual cycle in the etiology of PCOS remains unclear.We aimed to analyze the characteristics of abnormal menstrual cycles and their association with PCOS in community and hospital patient populations.Methods Women with PCOS identified from 2111 permanent female residents in the community of Beijing and 506 outpatients obtained from the reproductive clinic of Peking University Third Hospital were recruited for this study,comprising the PCOS community group and the PCOS hospital group, respectively.Each group was further divided into four subgroups according to the length of menstrual cycles： 〈21 days; 21-34 days; 35-60 days; and 〉60 days.Women in each group were interviewed using a questionnaire to assess factors including age, age of menarche, menstrual cycle history, related family history, and modified Ferriman-Gallwey （mF-G） score.All women received transvaginal ultrasound scan and had fasting blood samples taken for endocrine evaluation.A two-tailed P value of 〈0.05 was considered significant.Results In the community population, the prevalence of abnormal menstrual cycle was 27.19% （574/2111）.The prevalence of PCOS in the community was 6.11% （129/2111） according to Rotterdam criteria.In the community group,the most common menstrual cycle length was 35-60 days, whereas for the hospital group, it was 〉60 days.In both the community and hospital groups, the most common phenotype of PCOS was that of Oligo/amenorrhea＋PCO＋hyperandrogenism （HA） （O＋P＋H） （P=0.000）.With increasing cycle length of 35-60 days to 〉60 days, the percentages of Oligo/amenorrhea＋PCO （O＋P） and O＋P＋H were found to significantly decrease in the community group and significantly increase in the hospital group （P=0.000 for each）.In the hospital group, as the menstrual cycle length increased from 35-60 days to 〉60 days, the r展开更多
Objective： Ovarian fibrosis is characterized by excessive proliferation of ovarian fibroblasts and deposition ofextracellular matrix （ECM） and it is one of the principal reasons for ovarian dysfunction. This review...Objective： Ovarian fibrosis is characterized by excessive proliferation of ovarian fibroblasts and deposition ofextracellular matrix （ECM） and it is one of the principal reasons for ovarian dysfunction. This review aimed to investigate the pathogenetic mechanism of ovarian fibrosis and to clarify the relationship between ovarian diseases and fibrosis. Data Sources： We searched PubMed for English language articles published up to November 2016. The search terms included ovarian fibrosis OR fibrosis, ovarian chocolate cyst OR ovarian endometrioma, polycystic ovarian syndrome （PCOS）, premature ovarian failure, ECM, matrix rnetalloproteinases （MMPs）, tissue inhibitors of matrix metalloproteinases （TIMPs）, transforming growth factor-beta 1 （TGF-[31）, connective tissue growth factor （CTGF）, peroxisome proliferator-activated receptor gamma （PPAR-T）, vascular endothelial growth factor （VEGF）, endothelin-1 （ET-1）, and combinations of these terms. Study Selection： Articles were obtained and reviewed to analyze the pathogenic mechanism of ovarian fibrosis and related ovarian diseases. Results： Many cytokines, such as MMPs, TIMPs, TGF-β1, CTGF, PPAR-γ, VEGK and ET- 1, are involved in ovarian fibrogenesis. Ovarian fibrogenesis is associated with various ovarian diseases, including ovarian chocolate cyst PCOS, and premature ovarian failure. One finding of particular interest is that fibrogenesis in peripheral tissues around an ovarian chocolate cyst commonly causes ovarian function diminution, and therefore, this medical problem should arouse widespread concern in clinicians worldwide. Conclusions： Patients with ovarian fibrosis are susceptible to infertility and tend to have decreased responses to assisted fertility treatment. Thus, protection of ovarian function should be a priority for women who wish to reproduce when making therapeutic decisions about ovarian fibrosis-related diseases.展开更多
The present study aimed to investigate the clinical value of serum anti-mullerian hormone（AMH） and inhibin B（INHB） in predicting the ovarian response of patients with polycystic ovary syndrome（PCOS）. A total of ...The present study aimed to investigate the clinical value of serum anti-mullerian hormone（AMH） and inhibin B（INHB） in predicting the ovarian response of patients with polycystic ovary syndrome（PCOS）. A total of 120 PCOS patients were enrolled and divided into three groups in terms of the ovarian response： a low-response group（n=36）, a normal-response group（n=44）, and a high-response group（n=40）. The serum AMH and INHB levels were measured by enzyme-linked immunosorbent assay（ELISA）. The follicle stimulating hormone（FSH）, luteinizing hormone（LH）, and estradiol（E2） levels were determined by chemiluminescence microparticle immunoassay. The correlation of the serum AMH and INHB levels with other indicators was analyzed. A receiver operating characteristic（ROC） curve was established to analyze the prediction of ovarian response by AMH and INHB. The results showed that there were significant differences in age, body mass index（BMI）, FSH, total gonadotropin-releasing hormone（Gn RH）, LH, E2, and antral follicle counts（AFCs） between the groups（P〈0.05）. The serum AMH and INHB levels were increased significantly with the ovarian response of PCOS patients increasing（P〈0.05）. The serum AMH and INHB levels were negatively correlated with the age, BMI, FSH level, Gn, and E2 levels（P〈0.05）. They were positively correlated with the LH levels and AFCs（P〈0.05）. ROC curve analysis of serum AMH and INHB in prediction of a low ovarian response showed that the area under the ROC curve（AUC） value of the serum AMH level was 0.817, with a cut-off value of 1.29 ng/m L. The sensitivity and specificity were 71.2% and 79.6%, respectively. The AUC value of serum INHB was 0.674, with a cut-off value of 38.65 ng/m L, and the sensitivity and specificity were 50.7% and 74.5%, respectively. ROC curve analysis showed when the serum AMH and INHB levels were used to predict a high ovarian response, the AUC value of the serum AMH level was 0.742, with a cut-off value 展开更多
Adult polycystic liver disease (PCLD) is an autosomal dominant condition commonly associated with autosomal dominant polycystic kidney disease (ADPKD). However in the last decade, it has been recognized that there is ...Adult polycystic liver disease (PCLD) is an autosomal dominant condition commonly associated with autosomal dominant polycystic kidney disease (ADPKD). However in the last decade, it has been recognized that there is a distinct form of autosomal dominant PCLD that arises without concomitant ADPKD. Early knowledge of the pathogenesis was gained from the study of hepatic cysts in patients with ADPKD. Bile duct overgrowth after embryogenesis results in cystic hepatic dilatations that are known as biliary microhamartomas or von Meyenburg complexes. Further dilatation arises from cellular proliferation and fluid secretion into these cysts. There is a variable, broad spectrum of manifestations of PCLD. Although PCLD is most often asymptomatic, massive hepatomegaly can lead to disabling symptoms of abdominal pain, early satiety, persistent nausea, dyspnea, ascites, biliary obstruction, and lower body edema. Complications of PCLD include cyst rupture and cyst infection. Also, there are associated medical problems, especially intracranial aneurysms and valvular heart disease, which clinicians need to be aware of and evaluate in patients with PCLD. In asymptomatic patients, no treatment is indicated for PCLD. In the symptomatic patient, surgical therapy is the mainstay of treatment tailored to the extent of disease for each patient. Management options include cyst aspiration and sclerosis, open or laparoscopic fenestration, liver resection with fenestration, and liver transplantation. The surgical literature discussing treatment of PCLD, including techniques, outcomes, and complication rates, are summarized in this review.展开更多
Polycystic ovary syndrome （PCOS） is the most common metabolic and endocrine disorder in women. However, there is no agreement concerning how to diagnose and treat PCOS worldwide. Three practice guidelines or consens...Polycystic ovary syndrome （PCOS） is the most common metabolic and endocrine disorder in women. However, there is no agreement concerning how to diagnose and treat PCOS worldwide. Three practice guidelines or consensuses, including consensus from the European Society of Human Reproduction and Embryology （ESHRE）/the American Society for Reproductive Medicine （ASRM） in Rotterdam, diagnosis criteria and consensus in China, and clinical practice guideline from the Endocrine Society （ES） in the United States are widely recognized. The present paper may provide some guidance for clinical practice based on a comparative analysis of the above three practice guidelines or consensuses.展开更多
BACKGROUND： Polycystic ovary syndrome （PCOS） is an endocrine disease that affects gynecologica health. Treatment of PCOS remains a big challenge for clinicians. OBJECTIVE： This meta-analysis was developed to compa...BACKGROUND： Polycystic ovary syndrome （PCOS） is an endocrine disease that affects gynecologica health. Treatment of PCOS remains a big challenge for clinicians. OBJECTIVE： This meta-analysis was developed to compare the efficacy of co-treatment with traditiona Chinese medicine （TCM） and letrozole against letrozole monotherapy in the treatment of PCOS. SEARCH STRATEGY： Randomized controlled trials （RCTs） were electronically retrieved from PubMed, Cochrane Library, China Biomedical Literature Database, China National Knowledge Infrastructure and Wanfang Data; related papers that were not available electronically were manually checked. All papers were assessed according to the Cochrane Handbook for Systematic Reviews of Interventions and the valid data were analyzed using Revman software （The Cochrane Collaboration, Copenhagen, Denmark） INCLUSION CRITERIA： We included RCTs that compared co-treatment with TCM and letrozole against letrozole monotherapy in women with PCOS, which was defined by anovulation, biochemical or clinical hyperandrogenemia and polycystic ovaries. We included trials from all sources. DATA EXTRACTION AND ANALYSIS： Two independent reviewers extracted data, and evaluated study quality according to the Cochrane Handbook for Systematic Reviews of Interventions criteria for RCT, including issues of patient randomization, blinding and bias. RESULTS： Eight RCTs, involving a total of 537 patients, were included in the present study. The meta-analysis showed that the cycle ovulation rate, the pregnancy rate and the total effective rate of symptom treatment were higher in treatments combining TCM with letrozole, compared with letrozole monotherapy. Although the rate of luteinizing hormone （LH）/follicle-stimulating hormone （FSH） and the body mass index of the group receiving combined therapy were lower than in letrozole monotherapy, no statistical difference was found in the LH and FSH level between the two groups. CONCLUSION： Available evidence showed that co-treatmen展开更多
Polycystic ovary syndrome(PCOS) is the most common endocrine disorder in reproductive-aged women. Women with PCOS frequently have metabolic complications including insulin resistance(IR), early diabetes, hypertension ...Polycystic ovary syndrome(PCOS) is the most common endocrine disorder in reproductive-aged women. Women with PCOS frequently have metabolic complications including insulin resistance(IR), early diabetes, hypertension and dyslipidemia. Recent studies have demonstrated an association between PCOS and another metabolic complication: nonalcoholic fatty liver disease(NAFLD). NAFLD occurs as a result of abnormal lipid handling by the liver, which sensitizes the liver to injury and inflammation. It can progress to nonalcoholic steatohepatitis(NASH), which is characterized by hepatocyte injury and apoptosis. With time and further inflammation, NASH can progress to cirrhosis. Thus, given the young age at which NAFLD may occur in PCOS, these women may be at significant risk for progressive hepatic injury over the course of their lives. Many potential links between PCOS and NAFLD have been proposed, most notably IR and hyperandrogenemia. Further studies are needed to clarify the association between PCOS and NAFLD. In the interim, clinicians should be aware of this connection and consider screening for NAFLD in PCOS patients who have other metabolic risk factors. The optimal method of screening is unknown. However, measuring alanine aminotransferase and/or obtaining ultrasound on high-risk patients can be considered. First line treatment consists of lifestyle interventions and weight loss, with possible pharmacologic interventions in some cases.展开更多
Objective To explore the Intervention effect of Rosiglitozone in ovarian fibrosis of PCOS rats. Methods 60 female SD rats were randomly divided into 3 groups： control group, model group and treatment group. The model...Objective To explore the Intervention effect of Rosiglitozone in ovarian fibrosis of PCOS rats. Methods 60 female SD rats were randomly divided into 3 groups： control group, model group and treatment group. The model and treatment groups were established by subcutaneous injection of DHEA, while the treatment group was given RGZ. The serum hormone values, pathohistology of ovarian structure of rats, ovarian ultrastructure and the expressions of TGF-β1 and CTGF were detected. Results The PCOS model was established successfully. The expression intensity of TGF-β1 and CTGF in Oocytes of the PCOS groups was 9.545±2.954 and 9.665±2.400, respectively and was significantly higher than that of the control group 6.636±2.264 and 7.036±2.133; after treatment with rosiglitazone, the expression was significantly decreased 6.980±2.421 and 6.642±2.721 as compared with that of the model group （P〈0.05, P〈0.001）. The values in serum of the PCOS groups were 3.749±2.054 and 0.265±0.129, and 1.914±1.801 and 0.096±0.088 in the control group which had statistically significant difference （P〈0.05, P〈0.O01）. After treatment with rosiglitazone, the values were 2.3100±1.825 and 0.112±0.187 and were significantly different with those of the model group （P〈0.05, P〈0.O01）. Conclusion TGF-β1 and CTGF play an important role in the development of ovary fibrosis in PCOS. However, RGZ may postpone the development of fibrosis by decreasing the levels of TGF-β1 and CTGF.展开更多
Polycystic ovary syndrome （PCOS） is the most common endocrine and metabolic disorder of women, with complex pathogenesis and heterogeneous manifestations. Professor Jin Yu recently wrote an article entitled ＂Propos...Polycystic ovary syndrome （PCOS） is the most common endocrine and metabolic disorder of women, with complex pathogenesis and heterogeneous manifestations. Professor Jin Yu recently wrote an article entitled ＂Proposal of Diagnosis and Diagnostic Classification of PCOS in Integrated Traditional Chinese and Western Medicine.＂ From this, the Obstetrics and Gynecology branches of the Chinese Association of Integrative Medicine and the China Association of Chinese Medicine collaborated with the Gynecology branch of the Chinese Association for Research and Advancement of Chinese Medicine to draft a report on the consensus of criteria for the diagnosis and classification of PCOS in integrated traditional Chinese and Western medicine. The diagnosis for PCOS includes all three features： （1） oligo-ovulation or anovulation; （2） clinical and/or laboratory evidence of hyperandrogenism; （3） PCOS is classified into four types： types la, Ib, Ila, and lib. Syndrome differentiation types for PCOS in traditional Chinese medicine are as follows： Kidney deficiency with phlegm blockage syndrome, Kidney Yin deficiency with phlegm blockage and blood stasis syndrome, and Kidney deficiency with Liver Qi stagnation syndrome.展开更多
Background：Polycystic ovary syndrome （PCOS） is the commonest endocrinopathy in women of reproductive age.The patients often develop insulin resistance （IR） or hyperinsulinemia despite manifesting anovulation and ...Background：Polycystic ovary syndrome （PCOS） is the commonest endocrinopathy in women of reproductive age.The patients often develop insulin resistance （IR） or hyperinsulinemia despite manifesting anovulation and signs of hyperandrogenism.The cause and effect relationship of hyperinsulinemia and hyperandrogenemia （HA） is still debated.Micro-ribonucleic acids （miRNAs） have recently been shown to play a role in regulation of ovarian function.Our current study focused on the altered expression of miRNAs with PCOS.Methods：Ovarian theca intema tissues were obtained from 10 PCOS patients and 8 controls that were non-PCOS and had normal insulin sensitivity undergoing laparoscopy and/or ovarian wedge resection.Total RNA of all samples was extracted.We studied the repertoire of miRNAs in both PCOS and non-PCOS women by microarray hybridization.Bioinformatic analysis was performed for predicting targets of the differentially expressed miRNAs.Furthermore,selected miRNAs were validated by quantitative reverse transcriptase polymerase chain reaction （qRT-PCR）.Results：A total of 27 miRNAs were differentially expressed in PCOS patients with respect to the controls in our discovery evaluationand two （miR-92a and miR-92b） of them were significantly downregulated in PCOS women in followed validation （P 〈 0.05）.Targets prediction revealed that miR-92a targeted both GATA family of zinc finger transcription factor GATA-binding factor 6 （GATA6） and insulin receptor substrate proteins 2 （IRS-2）.Conclusions：MiRNAs are differentially expressed between PCOS patients and controls.We identified and validated two miRNAs-miR-92a and miR-92b.They are significantly downregulated and may be involved in the pathogenesis of PCOS.展开更多
Hepatic cysts are increasingly found as a mere coincidence on abdominal imaging techniques, such as ultrasonography (USG), computed tomography (CT) and magnetic resonance imaging (MRI). These cysts often present a dia...Hepatic cysts are increasingly found as a mere coincidence on abdominal imaging techniques, such as ultrasonography (USG), computed tomography (CT) and magnetic resonance imaging (MRI). These cysts often present a diagnostic challenge. Therefore, we performed a review of the recent literature and developed an evidence-based diagnostic algorithm to guide clinicians in characterising these lesions. Simple cysts are the most common cystic liver disease, and diagnosis is based on typical USG characteristics. Serodiagnostic tests and microbubble contrast-enhanced ultrasound (CEUS) are invaluable in differentiating complicated cysts, echinococcosis and cystadenoma/cystadenocarcinoma when USG, CT and MRI show ambiguous findings. Therefore, serodiagnostic tests and CEUS reduce the need for invasive procedures. Polycystic liver disease (PLD) is arbitrarily defined as the presence of > 20 liver cysts and can present as two distinct genetic disorders: autosomal dominant polycystic kidney disease (ADPKD) and autosomal dominant polycystic liver disease (PCLD). Although genetic testing for ADPKD and PCLD is possible, it is rarely performed because it does not affect the therapeutic management of PLD. USG screening of the liver and both kidneys combined with extensive family history taking are the cornerstone of diagnostic decision making in PLD. In conclusion, an amalgamation of these recent advances results in a diagnostic algorithm that facilitates evidence-based clinical decision making.展开更多
AIM: To evaluate the results of the treatment of simple liver cysts (solitary and multiple) and polycystic liver disease (PLD) using percutaneous sclerotherapy and/or surgical procedures in a single tertiary referral ...AIM: To evaluate the results of the treatment of simple liver cysts (solitary and multiple) and polycystic liver disease (PLD) using percutaneous sclerotherapy and/or surgical procedures in a single tertiary referral centre. METHODS: Retrospective analysis of 54 patients referred for evaluation and possible treatment of simple liver cysts (solitary and multiple) and PLD, from January 1997 to July 2006. RESULTS: Simple liver cysts were treated in 41 pts (76/) with a mean size of 12.6 cm. The most common reason for referral was abdominal pain or discomfort (85/). Percutaneous sclerotherapy was performed as initial treatment in 30 pts, showing cyst recurrence in 6 pts (20/). Surgical treatment was initially performed in 11 pts with cyst recurrence in 3 pts (27/). PLD was treated in 13 pts (24/) with a mean size of the dominant cyst of 13 cm. Percutaneous sclerotherapy for PLD was performed in 9 pts with recurrence in 7 pts (77.8/). Surgical treatment for PLD was undertaken in 4 pts (30.8/) with recurrence in all. Eventually, 2 pts with PLD in the presence of polycystic kidney disease underwent liver-and kidney transplantation because of deterioration of liver and kidney function. CONCLUSION: The majority of patients with simple liver cysts and PLD are referred for progressive abdominal pain. As initial treatment, percutaneous sclerotherapy is appropriate. Surgical deroofing is indicated in caseof cyst recurrence after percutaneous sclerotherapy. However, the results of percutaneous sclerotherapy and surgical treatment for PLD are disappointing. Partial liver resection is indicated when there is suspicion of a pre-malignant lesion.展开更多
Objective:To evaluate the effect of electro-acupuncture(EA)in infertile patients with phlegmdampness polycystic ovary syndrome-insulin resistance(PCOS-IR).Methods:Seventy-six PCOS-IR patients who underwnet in vitro fe...Objective:To evaluate the effect of electro-acupuncture(EA)in infertile patients with phlegmdampness polycystic ovary syndrome-insulin resistance(PCOS-IR).Methods:Seventy-six PCOS-IR patients who underwnet in vitro fertilization and embryo transfer(IVF-ET)were equally assigned to two groups according to a random digital table:the EA group and the control group,with 38 cases in each group.Before undergoing IVF,the two groups were treated with EA or pseudo-acupuncture,respectively,for 3 menstrual cycles.The intervention was 25 min twice a week until the day of oocyte collection.The selected acupoints were Zhongwan(RN 12),Tianshu(ST 25),Daheng(SP 15),Daimai(GB 26),Qihai(CV 6),Guanyuan(CV 4),and bilateral points including Xuehai(SP 10),Fenglong(ST 40),Zusanli(ST 36),and Yinlingquan(SP 9).Evaluation of phlegm-dampness syndrome score and IR score were carried out before and after treatment.Additionally,the number of oocytes retrieved,transplantable embryo rate,high-quality embryo rate,clinical pregnancy rate and live birth rate were compared between the two groups.Real-time polymerase chain reaction analysis was used to monitor the m RNA expression of the insulin receptor substrate(IRS-1),phosphatidylinositiol 3-kinase(PI3 K)and glucose transport factor 4(GLUT4)in ovarian granulosa cells.Results:EA treatment reduced the phlegm-dampness syndrome score as well as the IR scores compared with the control group(P<0.05).No significant differences in the number of oocytes retrieved and clinical pregnancy rate between the two groups(P>0.05).Moreover,the transplantable embryo rate[49.0%(284/580)vs.41.9%(273/652)],high-quality embryo rate[36.6%(104/284)vs.27.8%(76/273)],and live birth rate[50%(19/38)vs.26.3%(10/38)]in the EA group were significantly higher than in the control group(P<0.05).Gene expression analyses revealed significantly elevated IRS-1,PI3 K and GLUT4 m RNA in ovarian granulosa cells of the EA group compared with the control group(P<0.05).Conclusions:EA may ameliorate the effects of phlegm-dampness syndrome and o展开更多
Background： Polycystic ovary syndrome （PCOS） and its characteristic symptoms have been associated with physical and psychological issues in women of reproductive age. The current study was conducted in response to ...Background： Polycystic ovary syndrome （PCOS） and its characteristic symptoms have been associated with physical and psychological issues in women of reproductive age. The current study was conducted in response to the dearth of systematic research related to psychological functioning and quality of life in patients with PCOS in Southwest China, and to determine whether patients with PCOS exhibit poorer mental health （MH） compared to healthy women of the same age and living in the same region, without a PCOS diagnosis. Methods： We enrolled 120 outpatients with PCOS and 100 healthy controls in this study. Standardized questionnaires were administered to assess general MH conditions （General Health Questionnaire-12-item version）, anxiety （State-Trait Anxiety Inventory）, depression （Beck Depression Inventory）, as well as health-related quality of life （HRQoL） measured using the 36-item short-form health survey. The independent samples t-test was conducted for continuous study variables. For categorical variables, the Pearson Chi-square test, Fisher＇s exact test, and logistic regression were perlbrmed. Results： The prevalence of anxiety （13.3% vs. 2.0%） and depression （27.5% vs. 3.0%） was higher in patients with PCOS compared to the controls （both P 〈 0.05）. Patients with PCOS had decreased HRQoL. Patients with PCOS who had fertility requirements were more likely to be anxious and depressed than those without fertility requirements （anxiety： 22.6% [1 2/53] vs. 5.9% [4/67],Z： = 7.117, P = 0.008： depression： 37.7% （20/53） vs. 19.4% （13/67）, Х^2 = 4.988, P - 0.026）. Conclusions： PCOS and related synaptoms may be risk factors for depression and anxiety. Professionals should be concerned with the MH of women with PCOS, and psychological therapy should be considered.展开更多
Background：While combined oral contraceptives （COCs） are commonly used to treat polycystic ovary syndrome （PCOS）,comparative data regarding metabolic effects of different progestogens on this patient population a...Background：While combined oral contraceptives （COCs） are commonly used to treat polycystic ovary syndrome （PCOS）,comparative data regarding metabolic effects of different progestogens on this patient population are missing.This study aimed to compare the different effects of drospirenone （DRP）-containing COCs with cyproterone acetate （CPA）-containing COCs,combined with metformin and lifestyle modifications in women with PCOS and metabolic disorders.Methods：Ninety-nine women with PCOS and a metabolic disorder between January 2011 and January 2013 were enrolled into this prospective randomized clinical trial.Participants were randomized into two groups such as DRP-containing COCs,and CPA-containing COCs.Participants took COCs cyclically for 6 months,combined with metformin administration （1.5 g/d） and lifestyle modifications （diet and exercise）.Clinical measures and biochemical and hormone profiles were compared.Comparisons for continuous variables were evaluated with paired and unpaired Student＆#39;s t-tests.The Wilcoxon signed rank test was used when the data were not normally distributed.Analysis of covariance was used to control for age,body mass index （BMI）,and baseline data of each analyzed parameter when compared between the two groups.Results：A total of 68 patients have completed the study.The combination regimen of COCs,metformin,and lifestyle modifications in these patients resulted in a significant decrease in BMI,acne,and hirsutism scores when compared to baseline levels in both groups （P 〈 0.05）.Blood pressure （BP） was significantly different in the CPA group when compared to baseline （75.14 ± 6.77 mmHg vs.80.70 ± 5.60 mmHg,P 〈 0.01）,and after 6 months of treatment,only the change in systolic BP was significantly different between the two groups （4.00 [-6.00,13.00] mmHg vs.-3.50 [-13.00,9.00] mmHg,P =0.009）.Fasting glucose,fasting insulin,and homeostasis model assessment-insulin resistance decreased significantly in the DRP group （5.40 ± 0.41展开更多
The highly increasing prevalence of obesity and type 2 diabetes mellitus in the general population makes nonalcoholic fatty liver disease the most common diagnosis in every-day practices. Lifestyle changes （mainly ex...The highly increasing prevalence of obesity and type 2 diabetes mellitus in the general population makes nonalcoholic fatty liver disease the most common diagnosis in every-day practices. Lifestyle changes （mainly exercise withdrawal and weight gain） have probably heightened the prevalence of nonalcoholic fatty liver disease. Mortality in patients with Nonalcoholic Fatty Liver Disease is significantly higher when compared with that of the same age-gender general population. Hepatologists claim to bear a new burden, being Nonalcoholic Fatty Liver Disease strongly linked to systemic diseases.展开更多
OBJECTIVE： To explore the effect of electroacu- puncture and Chinese kidney-nourishing medicine on insulin （INS）, adiponectin （APN）, leptin （LEP）, and glucolipid metabolism of obese patients with polycystic ova...OBJECTIVE： To explore the effect of electroacu- puncture and Chinese kidney-nourishing medicine on insulin （INS）, adiponectin （APN）, leptin （LEP）, and glucolipid metabolism of obese patients with polycystic ovary syndrome （PCOS）. METHODS： Sixty-seven obese PCOS patients were randomly divided into two groups. Thirty-three pa- tients in the acupuncture-medicine group were treated three times a week with electroacupunc- ture at the Tianshu （ST 25）, Zhongwan （CV ] 2）, Qi- hai （CV 6）, Sanyinjiao （SP 6）, Geshu （BL 17）, and Cil-iao （BL 32） acupoints. They drug, Tiankui capsule, for 3 treatment. Point-taking and also took the Chinese months as a course of treatment in the elec- troacupuncture group of 34 patients was the same as those in the acupuncture-medicine group. We observed and compared the changes in the obesi- ty-related indexes of body weight （BW）, body mass index （BMI）, and waist-hip ratio （WHR）, as well as fasting plasma glucose （FPG）, fasting insulin （FINS）, APN, and LER RESULTS： BW, BMI, WHR, and FINS decreased and insulin sensitivity index （ISI） and APN were higher in the acupuncture-medicine group than in the electroacupuncture group （P〈0.01）. There was no obvious difference in LEP between the two groups （P〉0.05）. CONCLUSION： Acupuncture combined with medi- cine is better than just electroacupuncture for obese PCOS patients by improving obesity-related indexes, insulin sensitivity, and APN level. This indi- cates that acupuncture-medicine therapy is worth clinical popularization.展开更多
文摘MAP kinases transduce signals that are involved in a multitude of cellular pathways and functions in response to a variety of ligands and cell stimuli. Aberrant or inappropriate functions of MAPKs have now been identified in diseases ranging from cancer to inflammatory disease to obesity and diabetes. In many cell types, the MAPKs ERK1/2 are linked to cell proliferation. ERK1/2 are thought to play a role in some cancers, because mutations in Ras and B-Raf, which can activate the ERK1/2 cascade, are found in many human tumors. Abnormal ERK1/2 signaling has also been found in polycystic kidney disease, and serious developmental disorders such as cardio-facio-cutaneous syndrome arise from mutations in components of the ERK1/2 cascade. ERK1/2 are essential in well-differentiated cells and have been linked to long-term potentiation in neurons and in maintenance of epithelial polarity. Additionally, ERK1/2 are important for insulin gene transcription in pancreatic beta cells, which produce insulin in response to increases in circulating glucose to permit efficient glucose utilization and storage in the organism. Nutrients and hormones that induce or repress insulin secretion activate and/or inhibit ERK1/2 in a manner that reflects the secretory demand on beta cells. Disturbances in this and other regulatory pathways may result in the contribution of ERK1/2 to the etiology of certain human disorders.
文摘Background Polycystic ovary syndrome （PCOS） is considered to be the most common endocrine disorder in women of reproductive age.The involvement of an abnormal menstrual cycle in the etiology of PCOS remains unclear.We aimed to analyze the characteristics of abnormal menstrual cycles and their association with PCOS in community and hospital patient populations.Methods Women with PCOS identified from 2111 permanent female residents in the community of Beijing and 506 outpatients obtained from the reproductive clinic of Peking University Third Hospital were recruited for this study,comprising the PCOS community group and the PCOS hospital group, respectively.Each group was further divided into four subgroups according to the length of menstrual cycles： 〈21 days; 21-34 days; 35-60 days; and 〉60 days.Women in each group were interviewed using a questionnaire to assess factors including age, age of menarche, menstrual cycle history, related family history, and modified Ferriman-Gallwey （mF-G） score.All women received transvaginal ultrasound scan and had fasting blood samples taken for endocrine evaluation.A two-tailed P value of 〈0.05 was considered significant.Results In the community population, the prevalence of abnormal menstrual cycle was 27.19% （574/2111）.The prevalence of PCOS in the community was 6.11% （129/2111） according to Rotterdam criteria.In the community group,the most common menstrual cycle length was 35-60 days, whereas for the hospital group, it was 〉60 days.In both the community and hospital groups, the most common phenotype of PCOS was that of Oligo/amenorrhea＋PCO＋hyperandrogenism （HA） （O＋P＋H） （P=0.000）.With increasing cycle length of 35-60 days to 〉60 days, the percentages of Oligo/amenorrhea＋PCO （O＋P） and O＋P＋H were found to significantly decrease in the community group and significantly increase in the hospital group （P=0.000 for each）.In the hospital group, as the menstrual cycle length increased from 35-60 days to 〉60 days, the r
基金The work presented in this manuscript was supported by grants from the Natural Science Foundation of Zhejiang Province （No. LY 15H040004） and the Medical and Health Program in Zhejiang Province （No. 2015KYA 142）.
文摘Objective： Ovarian fibrosis is characterized by excessive proliferation of ovarian fibroblasts and deposition ofextracellular matrix （ECM） and it is one of the principal reasons for ovarian dysfunction. This review aimed to investigate the pathogenetic mechanism of ovarian fibrosis and to clarify the relationship between ovarian diseases and fibrosis. Data Sources： We searched PubMed for English language articles published up to November 2016. The search terms included ovarian fibrosis OR fibrosis, ovarian chocolate cyst OR ovarian endometrioma, polycystic ovarian syndrome （PCOS）, premature ovarian failure, ECM, matrix rnetalloproteinases （MMPs）, tissue inhibitors of matrix metalloproteinases （TIMPs）, transforming growth factor-beta 1 （TGF-[31）, connective tissue growth factor （CTGF）, peroxisome proliferator-activated receptor gamma （PPAR-T）, vascular endothelial growth factor （VEGF）, endothelin-1 （ET-1）, and combinations of these terms. Study Selection： Articles were obtained and reviewed to analyze the pathogenic mechanism of ovarian fibrosis and related ovarian diseases. Results： Many cytokines, such as MMPs, TIMPs, TGF-β1, CTGF, PPAR-γ, VEGK and ET- 1, are involved in ovarian fibrogenesis. Ovarian fibrogenesis is associated with various ovarian diseases, including ovarian chocolate cyst PCOS, and premature ovarian failure. One finding of particular interest is that fibrogenesis in peripheral tissues around an ovarian chocolate cyst commonly causes ovarian function diminution, and therefore, this medical problem should arouse widespread concern in clinicians worldwide. Conclusions： Patients with ovarian fibrosis are susceptible to infertility and tend to have decreased responses to assisted fertility treatment. Thus, protection of ovarian function should be a priority for women who wish to reproduce when making therapeutic decisions about ovarian fibrosis-related diseases.
文摘The present study aimed to investigate the clinical value of serum anti-mullerian hormone（AMH） and inhibin B（INHB） in predicting the ovarian response of patients with polycystic ovary syndrome（PCOS）. A total of 120 PCOS patients were enrolled and divided into three groups in terms of the ovarian response： a low-response group（n=36）, a normal-response group（n=44）, and a high-response group（n=40）. The serum AMH and INHB levels were measured by enzyme-linked immunosorbent assay（ELISA）. The follicle stimulating hormone（FSH）, luteinizing hormone（LH）, and estradiol（E2） levels were determined by chemiluminescence microparticle immunoassay. The correlation of the serum AMH and INHB levels with other indicators was analyzed. A receiver operating characteristic（ROC） curve was established to analyze the prediction of ovarian response by AMH and INHB. The results showed that there were significant differences in age, body mass index（BMI）, FSH, total gonadotropin-releasing hormone（Gn RH）, LH, E2, and antral follicle counts（AFCs） between the groups（P〈0.05）. The serum AMH and INHB levels were increased significantly with the ovarian response of PCOS patients increasing（P〈0.05）. The serum AMH and INHB levels were negatively correlated with the age, BMI, FSH level, Gn, and E2 levels（P〈0.05）. They were positively correlated with the LH levels and AFCs（P〈0.05）. ROC curve analysis of serum AMH and INHB in prediction of a low ovarian response showed that the area under the ROC curve（AUC） value of the serum AMH level was 0.817, with a cut-off value of 1.29 ng/m L. The sensitivity and specificity were 71.2% and 79.6%, respectively. The AUC value of serum INHB was 0.674, with a cut-off value of 38.65 ng/m L, and the sensitivity and specificity were 50.7% and 74.5%, respectively. ROC curve analysis showed when the serum AMH and INHB levels were used to predict a high ovarian response, the AUC value of the serum AMH level was 0.742, with a cut-off value
基金Supported by an educational grant from Novartis Pharma-ceuticals
文摘Adult polycystic liver disease (PCLD) is an autosomal dominant condition commonly associated with autosomal dominant polycystic kidney disease (ADPKD). However in the last decade, it has been recognized that there is a distinct form of autosomal dominant PCLD that arises without concomitant ADPKD. Early knowledge of the pathogenesis was gained from the study of hepatic cysts in patients with ADPKD. Bile duct overgrowth after embryogenesis results in cystic hepatic dilatations that are known as biliary microhamartomas or von Meyenburg complexes. Further dilatation arises from cellular proliferation and fluid secretion into these cysts. There is a variable, broad spectrum of manifestations of PCLD. Although PCLD is most often asymptomatic, massive hepatomegaly can lead to disabling symptoms of abdominal pain, early satiety, persistent nausea, dyspnea, ascites, biliary obstruction, and lower body edema. Complications of PCLD include cyst rupture and cyst infection. Also, there are associated medical problems, especially intracranial aneurysms and valvular heart disease, which clinicians need to be aware of and evaluate in patients with PCLD. In asymptomatic patients, no treatment is indicated for PCLD. In the symptomatic patient, surgical therapy is the mainstay of treatment tailored to the extent of disease for each patient. Management options include cyst aspiration and sclerosis, open or laparoscopic fenestration, liver resection with fenestration, and liver transplantation. The surgical literature discussing treatment of PCLD, including techniques, outcomes, and complication rates, are summarized in this review.
基金Project supported by the Zhejiang Province Science Foundation for Distinguished Young Scholars(No.LR16H040001)the National Natural Science Foundation of China(No.81401167)+1 种基金Medical and Health General Project of Zhejiang Province,China(No.2015KYA122)the Zhejiang Traditional Chinese Medicine Foundation(Nos.2017ZQ020 and 2017ZA091),China
文摘Polycystic ovary syndrome （PCOS） is the most common metabolic and endocrine disorder in women. However, there is no agreement concerning how to diagnose and treat PCOS worldwide. Three practice guidelines or consensuses, including consensus from the European Society of Human Reproduction and Embryology （ESHRE）/the American Society for Reproductive Medicine （ASRM） in Rotterdam, diagnosis criteria and consensus in China, and clinical practice guideline from the Endocrine Society （ES） in the United States are widely recognized. The present paper may provide some guidance for clinical practice based on a comparative analysis of the above three practice guidelines or consensuses.
基金supported by the Natural Science Foundation of China(No.81373683)
文摘BACKGROUND： Polycystic ovary syndrome （PCOS） is an endocrine disease that affects gynecologica health. Treatment of PCOS remains a big challenge for clinicians. OBJECTIVE： This meta-analysis was developed to compare the efficacy of co-treatment with traditiona Chinese medicine （TCM） and letrozole against letrozole monotherapy in the treatment of PCOS. SEARCH STRATEGY： Randomized controlled trials （RCTs） were electronically retrieved from PubMed, Cochrane Library, China Biomedical Literature Database, China National Knowledge Infrastructure and Wanfang Data; related papers that were not available electronically were manually checked. All papers were assessed according to the Cochrane Handbook for Systematic Reviews of Interventions and the valid data were analyzed using Revman software （The Cochrane Collaboration, Copenhagen, Denmark） INCLUSION CRITERIA： We included RCTs that compared co-treatment with TCM and letrozole against letrozole monotherapy in women with PCOS, which was defined by anovulation, biochemical or clinical hyperandrogenemia and polycystic ovaries. We included trials from all sources. DATA EXTRACTION AND ANALYSIS： Two independent reviewers extracted data, and evaluated study quality according to the Cochrane Handbook for Systematic Reviews of Interventions criteria for RCT, including issues of patient randomization, blinding and bias. RESULTS： Eight RCTs, involving a total of 537 patients, were included in the present study. The meta-analysis showed that the cycle ovulation rate, the pregnancy rate and the total effective rate of symptom treatment were higher in treatments combining TCM with letrozole, compared with letrozole monotherapy. Although the rate of luteinizing hormone （LH）/follicle-stimulating hormone （FSH） and the body mass index of the group receiving combined therapy were lower than in letrozole monotherapy, no statistical difference was found in the LH and FSH level between the two groups. CONCLUSION： Available evidence showed that co-treatmen
文摘Polycystic ovary syndrome(PCOS) is the most common endocrine disorder in reproductive-aged women. Women with PCOS frequently have metabolic complications including insulin resistance(IR), early diabetes, hypertension and dyslipidemia. Recent studies have demonstrated an association between PCOS and another metabolic complication: nonalcoholic fatty liver disease(NAFLD). NAFLD occurs as a result of abnormal lipid handling by the liver, which sensitizes the liver to injury and inflammation. It can progress to nonalcoholic steatohepatitis(NASH), which is characterized by hepatocyte injury and apoptosis. With time and further inflammation, NASH can progress to cirrhosis. Thus, given the young age at which NAFLD may occur in PCOS, these women may be at significant risk for progressive hepatic injury over the course of their lives. Many potential links between PCOS and NAFLD have been proposed, most notably IR and hyperandrogenemia. Further studies are needed to clarify the association between PCOS and NAFLD. In the interim, clinicians should be aware of this connection and consider screening for NAFLD in PCOS patients who have other metabolic risk factors. The optimal method of screening is unknown. However, measuring alanine aminotransferase and/or obtaining ultrasound on high-risk patients can be considered. First line treatment consists of lifestyle interventions and weight loss, with possible pharmacologic interventions in some cases.
基金supported by Science and Technology Planning Project of Guangdong Province,China (2009B030801270)
文摘Objective To explore the Intervention effect of Rosiglitozone in ovarian fibrosis of PCOS rats. Methods 60 female SD rats were randomly divided into 3 groups： control group, model group and treatment group. The model and treatment groups were established by subcutaneous injection of DHEA, while the treatment group was given RGZ. The serum hormone values, pathohistology of ovarian structure of rats, ovarian ultrastructure and the expressions of TGF-β1 and CTGF were detected. Results The PCOS model was established successfully. The expression intensity of TGF-β1 and CTGF in Oocytes of the PCOS groups was 9.545±2.954 and 9.665±2.400, respectively and was significantly higher than that of the control group 6.636±2.264 and 7.036±2.133; after treatment with rosiglitazone, the expression was significantly decreased 6.980±2.421 and 6.642±2.721 as compared with that of the model group （P〈0.05, P〈0.001）. The values in serum of the PCOS groups were 3.749±2.054 and 0.265±0.129, and 1.914±1.801 and 0.096±0.088 in the control group which had statistically significant difference （P〈0.05, P〈0.O01）. After treatment with rosiglitazone, the values were 2.3100±1.825 and 0.112±0.187 and were significantly different with those of the model group （P〈0.05, P〈0.O01）. Conclusion TGF-β1 and CTGF play an important role in the development of ovary fibrosis in PCOS. However, RGZ may postpone the development of fibrosis by decreasing the levels of TGF-β1 and CTGF.
文摘Polycystic ovary syndrome （PCOS） is the most common endocrine and metabolic disorder of women, with complex pathogenesis and heterogeneous manifestations. Professor Jin Yu recently wrote an article entitled ＂Proposal of Diagnosis and Diagnostic Classification of PCOS in Integrated Traditional Chinese and Western Medicine.＂ From this, the Obstetrics and Gynecology branches of the Chinese Association of Integrative Medicine and the China Association of Chinese Medicine collaborated with the Gynecology branch of the Chinese Association for Research and Advancement of Chinese Medicine to draft a report on the consensus of criteria for the diagnosis and classification of PCOS in integrated traditional Chinese and Western medicine. The diagnosis for PCOS includes all three features： （1） oligo-ovulation or anovulation; （2） clinical and/or laboratory evidence of hyperandrogenism; （3） PCOS is classified into four types： types la, Ib, Ila, and lib. Syndrome differentiation types for PCOS in traditional Chinese medicine are as follows： Kidney deficiency with phlegm blockage syndrome, Kidney Yin deficiency with phlegm blockage and blood stasis syndrome, and Kidney deficiency with Liver Qi stagnation syndrome.
基金This work was supported by grants from the National Natural Science Foundation of China （No. g1370680）, Key-projects of Clinical Research of Ministry of Health （No. WGCH[2010]439）, The Specialized Research Fund for the Doctoral Program of Chinese Minis- try of Education （No. 20130171130009）, and Science and Technology Project of Guangdong Province （No. 2013020012660）.. Conflict of Interest： None declared.
文摘Background：Polycystic ovary syndrome （PCOS） is the commonest endocrinopathy in women of reproductive age.The patients often develop insulin resistance （IR） or hyperinsulinemia despite manifesting anovulation and signs of hyperandrogenism.The cause and effect relationship of hyperinsulinemia and hyperandrogenemia （HA） is still debated.Micro-ribonucleic acids （miRNAs） have recently been shown to play a role in regulation of ovarian function.Our current study focused on the altered expression of miRNAs with PCOS.Methods：Ovarian theca intema tissues were obtained from 10 PCOS patients and 8 controls that were non-PCOS and had normal insulin sensitivity undergoing laparoscopy and/or ovarian wedge resection.Total RNA of all samples was extracted.We studied the repertoire of miRNAs in both PCOS and non-PCOS women by microarray hybridization.Bioinformatic analysis was performed for predicting targets of the differentially expressed miRNAs.Furthermore,selected miRNAs were validated by quantitative reverse transcriptase polymerase chain reaction （qRT-PCR）.Results：A total of 27 miRNAs were differentially expressed in PCOS patients with respect to the controls in our discovery evaluationand two （miR-92a and miR-92b） of them were significantly downregulated in PCOS women in followed validation （P 〈 0.05）.Targets prediction revealed that miR-92a targeted both GATA family of zinc finger transcription factor GATA-binding factor 6 （GATA6） and insulin receptor substrate proteins 2 （IRS-2）.Conclusions：MiRNAs are differentially expressed between PCOS patients and controls.We identified and validated two miRNAs-miR-92a and miR-92b.They are significantly downregulated and may be involved in the pathogenesis of PCOS.
文摘Hepatic cysts are increasingly found as a mere coincidence on abdominal imaging techniques, such as ultrasonography (USG), computed tomography (CT) and magnetic resonance imaging (MRI). These cysts often present a diagnostic challenge. Therefore, we performed a review of the recent literature and developed an evidence-based diagnostic algorithm to guide clinicians in characterising these lesions. Simple cysts are the most common cystic liver disease, and diagnosis is based on typical USG characteristics. Serodiagnostic tests and microbubble contrast-enhanced ultrasound (CEUS) are invaluable in differentiating complicated cysts, echinococcosis and cystadenoma/cystadenocarcinoma when USG, CT and MRI show ambiguous findings. Therefore, serodiagnostic tests and CEUS reduce the need for invasive procedures. Polycystic liver disease (PLD) is arbitrarily defined as the presence of > 20 liver cysts and can present as two distinct genetic disorders: autosomal dominant polycystic kidney disease (ADPKD) and autosomal dominant polycystic liver disease (PCLD). Although genetic testing for ADPKD and PCLD is possible, it is rarely performed because it does not affect the therapeutic management of PLD. USG screening of the liver and both kidneys combined with extensive family history taking are the cornerstone of diagnostic decision making in PLD. In conclusion, an amalgamation of these recent advances results in a diagnostic algorithm that facilitates evidence-based clinical decision making.
文摘AIM: To evaluate the results of the treatment of simple liver cysts (solitary and multiple) and polycystic liver disease (PLD) using percutaneous sclerotherapy and/or surgical procedures in a single tertiary referral centre. METHODS: Retrospective analysis of 54 patients referred for evaluation and possible treatment of simple liver cysts (solitary and multiple) and PLD, from January 1997 to July 2006. RESULTS: Simple liver cysts were treated in 41 pts (76/) with a mean size of 12.6 cm. The most common reason for referral was abdominal pain or discomfort (85/). Percutaneous sclerotherapy was performed as initial treatment in 30 pts, showing cyst recurrence in 6 pts (20/). Surgical treatment was initially performed in 11 pts with cyst recurrence in 3 pts (27/). PLD was treated in 13 pts (24/) with a mean size of the dominant cyst of 13 cm. Percutaneous sclerotherapy for PLD was performed in 9 pts with recurrence in 7 pts (77.8/). Surgical treatment for PLD was undertaken in 4 pts (30.8/) with recurrence in all. Eventually, 2 pts with PLD in the presence of polycystic kidney disease underwent liver-and kidney transplantation because of deterioration of liver and kidney function. CONCLUSION: The majority of patients with simple liver cysts and PLD are referred for progressive abdominal pain. As initial treatment, percutaneous sclerotherapy is appropriate. Surgical deroofing is indicated in caseof cyst recurrence after percutaneous sclerotherapy. However, the results of percutaneous sclerotherapy and surgical treatment for PLD are disappointing. Partial liver resection is indicated when there is suspicion of a pre-malignant lesion.
基金Supported by the Shandong Natural Science Foundation(No.ZR2019QH013)Shandong Natural Science Foundation(No.2018CXGC130)State Administration of Foreign Experts Affairs China(No.P192023031)。
文摘Objective:To evaluate the effect of electro-acupuncture(EA)in infertile patients with phlegmdampness polycystic ovary syndrome-insulin resistance(PCOS-IR).Methods:Seventy-six PCOS-IR patients who underwnet in vitro fertilization and embryo transfer(IVF-ET)were equally assigned to two groups according to a random digital table:the EA group and the control group,with 38 cases in each group.Before undergoing IVF,the two groups were treated with EA or pseudo-acupuncture,respectively,for 3 menstrual cycles.The intervention was 25 min twice a week until the day of oocyte collection.The selected acupoints were Zhongwan(RN 12),Tianshu(ST 25),Daheng(SP 15),Daimai(GB 26),Qihai(CV 6),Guanyuan(CV 4),and bilateral points including Xuehai(SP 10),Fenglong(ST 40),Zusanli(ST 36),and Yinlingquan(SP 9).Evaluation of phlegm-dampness syndrome score and IR score were carried out before and after treatment.Additionally,the number of oocytes retrieved,transplantable embryo rate,high-quality embryo rate,clinical pregnancy rate and live birth rate were compared between the two groups.Real-time polymerase chain reaction analysis was used to monitor the m RNA expression of the insulin receptor substrate(IRS-1),phosphatidylinositiol 3-kinase(PI3 K)and glucose transport factor 4(GLUT4)in ovarian granulosa cells.Results:EA treatment reduced the phlegm-dampness syndrome score as well as the IR scores compared with the control group(P<0.05).No significant differences in the number of oocytes retrieved and clinical pregnancy rate between the two groups(P>0.05).Moreover,the transplantable embryo rate[49.0%(284/580)vs.41.9%(273/652)],high-quality embryo rate[36.6%(104/284)vs.27.8%(76/273)],and live birth rate[50%(19/38)vs.26.3%(10/38)]in the EA group were significantly higher than in the control group(P<0.05).Gene expression analyses revealed significantly elevated IRS-1,PI3 K and GLUT4 m RNA in ovarian granulosa cells of the EA group compared with the control group(P<0.05).Conclusions:EA may ameliorate the effects of phlegm-dampness syndrome and o
文摘Background： Polycystic ovary syndrome （PCOS） and its characteristic symptoms have been associated with physical and psychological issues in women of reproductive age. The current study was conducted in response to the dearth of systematic research related to psychological functioning and quality of life in patients with PCOS in Southwest China, and to determine whether patients with PCOS exhibit poorer mental health （MH） compared to healthy women of the same age and living in the same region, without a PCOS diagnosis. Methods： We enrolled 120 outpatients with PCOS and 100 healthy controls in this study. Standardized questionnaires were administered to assess general MH conditions （General Health Questionnaire-12-item version）, anxiety （State-Trait Anxiety Inventory）, depression （Beck Depression Inventory）, as well as health-related quality of life （HRQoL） measured using the 36-item short-form health survey. The independent samples t-test was conducted for continuous study variables. For categorical variables, the Pearson Chi-square test, Fisher＇s exact test, and logistic regression were perlbrmed. Results： The prevalence of anxiety （13.3% vs. 2.0%） and depression （27.5% vs. 3.0%） was higher in patients with PCOS compared to the controls （both P 〈 0.05）. Patients with PCOS had decreased HRQoL. Patients with PCOS who had fertility requirements were more likely to be anxious and depressed than those without fertility requirements （anxiety： 22.6% [1 2/53] vs. 5.9% [4/67],Z： = 7.117, P = 0.008： depression： 37.7% （20/53） vs. 19.4% （13/67）, Х^2 = 4.988, P - 0.026）. Conclusions： PCOS and related synaptoms may be risk factors for depression and anxiety. Professionals should be concerned with the MH of women with PCOS, and psychological therapy should be considered.
文摘Background：While combined oral contraceptives （COCs） are commonly used to treat polycystic ovary syndrome （PCOS）,comparative data regarding metabolic effects of different progestogens on this patient population are missing.This study aimed to compare the different effects of drospirenone （DRP）-containing COCs with cyproterone acetate （CPA）-containing COCs,combined with metformin and lifestyle modifications in women with PCOS and metabolic disorders.Methods：Ninety-nine women with PCOS and a metabolic disorder between January 2011 and January 2013 were enrolled into this prospective randomized clinical trial.Participants were randomized into two groups such as DRP-containing COCs,and CPA-containing COCs.Participants took COCs cyclically for 6 months,combined with metformin administration （1.5 g/d） and lifestyle modifications （diet and exercise）.Clinical measures and biochemical and hormone profiles were compared.Comparisons for continuous variables were evaluated with paired and unpaired Student＆#39;s t-tests.The Wilcoxon signed rank test was used when the data were not normally distributed.Analysis of covariance was used to control for age,body mass index （BMI）,and baseline data of each analyzed parameter when compared between the two groups.Results：A total of 68 patients have completed the study.The combination regimen of COCs,metformin,and lifestyle modifications in these patients resulted in a significant decrease in BMI,acne,and hirsutism scores when compared to baseline levels in both groups （P 〈 0.05）.Blood pressure （BP） was significantly different in the CPA group when compared to baseline （75.14 ± 6.77 mmHg vs.80.70 ± 5.60 mmHg,P 〈 0.01）,and after 6 months of treatment,only the change in systolic BP was significantly different between the two groups （4.00 [-6.00,13.00] mmHg vs.-3.50 [-13.00,9.00] mmHg,P =0.009）.Fasting glucose,fasting insulin,and homeostasis model assessment-insulin resistance decreased significantly in the DRP group （5.40 ± 0.41
文摘The highly increasing prevalence of obesity and type 2 diabetes mellitus in the general population makes nonalcoholic fatty liver disease the most common diagnosis in every-day practices. Lifestyle changes （mainly exercise withdrawal and weight gain） have probably heightened the prevalence of nonalcoholic fatty liver disease. Mortality in patients with Nonalcoholic Fatty Liver Disease is significantly higher when compared with that of the same age-gender general population. Hepatologists claim to bear a new burden, being Nonalcoholic Fatty Liver Disease strongly linked to systemic diseases.
基金Supported by the National Basic Research Program of China(973 program,No.2009CB522900)Open Research Fund of Zhejiang First-foremost Key Subject-Acupuncture and Moxibustion(No.ZTK2010B02)Shanghai Municipal Health Bureau(No.20124049)
文摘OBJECTIVE： To explore the effect of electroacu- puncture and Chinese kidney-nourishing medicine on insulin （INS）, adiponectin （APN）, leptin （LEP）, and glucolipid metabolism of obese patients with polycystic ovary syndrome （PCOS）. METHODS： Sixty-seven obese PCOS patients were randomly divided into two groups. Thirty-three pa- tients in the acupuncture-medicine group were treated three times a week with electroacupunc- ture at the Tianshu （ST 25）, Zhongwan （CV ] 2）, Qi- hai （CV 6）, Sanyinjiao （SP 6）, Geshu （BL 17）, and Cil-iao （BL 32） acupoints. They drug, Tiankui capsule, for 3 treatment. Point-taking and also took the Chinese months as a course of treatment in the elec- troacupuncture group of 34 patients was the same as those in the acupuncture-medicine group. We observed and compared the changes in the obesi- ty-related indexes of body weight （BW）, body mass index （BMI）, and waist-hip ratio （WHR）, as well as fasting plasma glucose （FPG）, fasting insulin （FINS）, APN, and LER RESULTS： BW, BMI, WHR, and FINS decreased and insulin sensitivity index （ISI） and APN were higher in the acupuncture-medicine group than in the electroacupuncture group （P〈0.01）. There was no obvious difference in LEP between the two groups （P〉0.05）. CONCLUSION： Acupuncture combined with medi- cine is better than just electroacupuncture for obese PCOS patients by improving obesity-related indexes, insulin sensitivity, and APN level. This indi- cates that acupuncture-medicine therapy is worth clinical popularization.
