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Table of Content

    15 September 2024, Volume 43 Issue 5
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    Original Article
    Case Report
    Review
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    Original Article
    Associations between Phthalates Exposure and Inflammatory Cytokines in Ovarian Microenvironment
    XIAO Nan, LI Yong-cheng, YAO Yi-ming, SUN Hong-wen, YAO Ru-qiang, CHEN Yong-jun, YIN Yu-chen, LUO Hai-ning
    2024, 43 (5):  353-360.  doi: 10.12280/gjszjk.20240349
    Abstract ( 371 )   HTML ( 48 )   PDF (927KB) ( 20 )  

    Objective: To assess the associations between phthalates (PAEs) exposure and the levels of inflammatory cytokines in the ovarian microenvironment. Methods: 64 females who were undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) from April to December in 2020 were included in this cross-sectional study. The levels of 10 kinds of phthalate metabolites (mPAEs) and 2 kinds factors in follicular fluid were measured. Multivariable linear regression model and further stratified analysis by age were conducted to analyze the associations between mPAEs and inflammatory factors. Results: There were significant positive associations between mono-butyl phthalate(MBP) and tumor necrosis factor-α (β=0.446, P=0.003) and interleukin-6 (β=0.425, P=0.003) in the follicular fluid. Similarly, there was a significant positive relationship between mono (2-ethyl-5-oxohexyl) phthalate (MEOHP) and tumor necrosis factor-α(β=0.411, P=0.019). In the stratified analysis, MBP still showed significantly the positive association with tumor necrosis factor-α (β=0.667, P=0.000) and interleukin-6 (β=0.407, P=0.028) in the group aged≥30 years. In contrast, there were no correlations between mPAEs and inflammatory factors within the group aged <30 years. Conclusions: Our results suggest that there is strongly association between PAEs exposure and the altered levels of inflammatory factor, and that PAEs exposure may bring changes of inflammatory burden in the ovarian microenvironment.

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    The Phased Application of Traditional Chinese Medicine in Assisted Reproductive Technology: A Data Mining
    GONG Zheng, WANG Cong, SONG Jia-yi, XIA Tian
    2024, 43 (5):  361-367.  doi: 10.12280/gjszjk.20240156
    Abstract ( 398 )   HTML ( 25 )   PDF (1282KB) ( 34 )  

    Objective: To integrate and analyze the application of traditional Chinese medicine (TCM) with assisted reproductive technology (ART) at the different periods of the treatment from those famous TCM experts, based on a data mining. Methods: To search the related documents of the application of TCM and ART from famous TCM experts in the CNKI、CQVIP、Wanfang、CBM databases of Chinese. We aimed to establish a literature analysis database for the integration and induction to obtain the distribution of commonly used drugs. Results: This study included 112 qualified documents, involving 36 famous TCM experts. The total number of drugs in the down-regulation period was 13, with 77 flavors of related drugs and 224 cumulative frequencies of occurrence. The higher frequencies were 55.94% of "drugs for tonifying deficiency", 10.89% of "drugs for activating blood circulation and removing blood stasis", 6.44% of "heat-clearing drugs", 5.45% of "astringent drugs", and 5.45% of "water-inducing and dampness-expelling drugs". In the ovulation promotion period, the total number of drugs was 13, with 92 flavors of related drugs and 398 cumulative frequencies of occurrence. In this period, the higher frequencies were of 61.34% of "drugs for tonifying deficiency", 8.68% of "drugs for activating blood circulation and removing blood stasis", 8.40% of "astringent drugs", 5.88% of "heat-clearing drugs", 5.32% of "water-inducing and dampness-expelling drugs", etc. In the transplantation period, the total number of drugs was 14, with 70 flavors of the relevant drugs and 372 cumulative frequencies. In the transplantation period, the higher frequencies were 68.78% of "drugs for tonifying deficiency", 5.80% of "drugs for dispelling wind-dampness" and 5.52% of "drugs for activating blood circulation and removing blood stasis". The drugs used after pregnancy were confirmed to have a total of 11 categories, with 47 flavors and 182 cumulative frequencies. During pregnancy, the higher frequencies were 59.88% of "drugs for tonifying deficiency", 9.30% of "drugs for dispelling wind-dampness", 7.56% of "heat-clearing drugs" and 5.23% of "astringent drugs". The correlation analysis of drugs of the four phases showed that there were 18 drug combinations in the down-regulation period, 14 drug combinations in the ovulation promotion period, 41 drug combinations in the transplantation period and 22 drug combinations after confirmation of pregnancy. Cluster analysis of the drugs used in the four periods showed that the core drug group was obtained in the down-regulation period: codonopsis pilosulae-licorice-atractylodes macrocephala-astragalus-jujube seed, radix dipsaci-fructus lycii -prepared rehmannia root-radix angelicae sinensis-rhizoma cyperi, prepared rehmannia root-radix paeonia lactiflora-donkey hide gelatin-radix dipsaci-rehmannia root. Ovulation promotion period got the core drug group including radix dipsaci-prepared rehmannia root-Chinese yam-fructus lycii-mulberry, radix dipsaci-prepared rehmannia root-radix angelicae sinensis-fructus lycii-salvia miltiorrhiza, prepared rehmannia root-fructus corni-Chinese yam-radix dipsaci-rehmannia root. The core drug groups obtained during the transplantation period were atractylodes macrocephala-radix dipsaci-Chinese taxillus herb-codonopsis pilosula-semen cuscutae, Chinese taxillus herb-semen cuscutae-radix dipsaci-scutellaria baicalensis-donkey hide gelatin, radix angelicae sinensis-semen cuscutae-liquorice-Chinese yam-morinda officinalis. The core group of drugs obtained after confirmation of pregnancy was atractylodes macrocephala-astragalus-liquorice-codonopsis pilosulae-radix dipsaci, semen cuscutae-radix dipsaci-atractylodes macrocephala-Chinese taxillus herb-donkey hide gelatin, atractylodes macrocephala-radix dipsaci-liquorice-radix boehmeriae- tuchung. Conclusions: The "drugs for tonifying deficiency" are commonly used in the four periods, which belong to the liver, kidney and spleen meridian. The common drug characteristics of the four periods is "Based on tonic, laxative and tonic used together, mainly with warm, flat, sweet and bitter nature of TCM". According to the different characteristics of the four periods, TCM with different prescription drugs can be used to improve the curative effect. In the period of down regulation, preventing the agitation of qi and blood is the main focus. In the period of ovulation induction, tonifying the kidney essence is the main focus. At the same time, a small amount of warming drugs should be added. Tonifying the kidney should be combined with astringent and promotion, so as to prevent the excessive depletion of the kidney essence. After the transplantation and embryo implantation, the efficacy of TCM lies in the "stabilization of the fetus" and the tonicity of mother′s qi and blood.

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    Efficacy of Chinese Medicine Compound on Abnormal Glucose and Lipid Metabolism in Patients with Obese Polycystic Ovary Syndrome: A Meta Analysis
    GAO Zheng, LI Meng-yuan, LI Bo, LIANG Jing-qiao, ZHANG Ya-dong, XU Xin
    2024, 43 (5):  368-377.  doi: 10.12280/gjszjk.20240194
    Abstract ( 380 )   HTML ( 16 )   PDF (2593KB) ( 53 )  

    Objective: To explore the efficacy and safety of traditional Chinese medicine (TCM) on the metabolic abnormalities in the patients with obese polycystic ovary syndrome (PCOS) through a Meta-analysis and literature review. Methods: The randomized controlled trials (RCTs) on the treatment of PCOS with TCM or/and the combination of TCM and western medicine (WM), and WM only as control, were searched by computer from the mainstream medical databases at home and abroad. The quality of the design scheme was evaluated by reference to the Cochrane Systematic Review manual, and Meta-analysis was performed by using RevMan 5.4 software. Results: In this study, 22 RCTs were included for Meta-analysis. TCM or TCM plus WM was superior to WM alone not only in improving ovulation rate (P<0.05), but also in improving homeostasis model assessment of insulin resistance (HOMA-IR), fasting insulin (FINS), body mass index (BMI), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and other aspects (all P<0.05). However, there was no difference in the regulation of fasting blood glucose (FBG) and waist-to-hip ratio (WHR) in the TCM or TCM plus WM groups when compared with the WM alone group (both P>0.05). Conclusions: TCM or TCM plus WM has better efficacy in the treatment of abnormal glucose and lipid metabolism in the patients with obese PCOS by multi-pathway and multi-target, without adverse outcomes, suggesting that TCM or TCM plus WM is superior to WM alone.

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    Disease Spectrum and Gene Variation Analysis of Neonatal Inherited Metabolic Diseases in Gansu Region
    LIU Fu-rong, WANG Xing, LI Yan-ting, ZHANG Chuan, GUO Yuan-yuan, HUI Ling, HAO Sheng-ju
    2024, 43 (5):  378-383.  doi: 10.12280/gjszjk.20240239
    Abstract ( 412 )   HTML ( 17 )   PDF (725KB) ( 37 )  

    Objective: To retrospectively analyze the disease spectrum, incidence rate and gene variation spectrum of neonatal inherited metabolic diseases in Gansu province, and to explore the genetic characteristics of these diseases. Methods: 213 786 cases with the dried blood spots were screened by tandem mass spectrometry from January 2021 to December 2023. The suspected positive children were diagnosed by urine gas chromatography mass spectrometry or (and) high-throughput gene sequencing. The spectrum of disease, incidence and gene variation were analyzed. Results: 145 cases were diagnosed in 189 high risk newborns, including 15 kinds of inherited metabolic diseases. The total incidence of inherited metabolic diseases in Gansu was 1/1 474, among which 68.28% (99 cases) were hyperphenylalanine. A total of 268 mutation sites related to 20 mutation genes were found, such as some hot spot mutations: c.728G>A, c.611A>G mutations in PAH gene, c.609G>A, c.567dupT mutations in MMACHC gene, and the new variants not reported: c.298G>T mutation in MMACHC gene, c.2000A>G mutation in MUT gene, c.734-7A>G mutation in MMAA gene. Conclusions: Mass spectrometry combined with gene detection can effectively explore the genetic characteristics of inherited metabolic diseases, which provides data support for follow-up clinical diagnosis and genetic counseling of these diseases.

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    Application of Chromosome Microarray Technology in Genetic Etiology Diagnosis of Fetuses with Polyhydramnios
    WANG Jun-yu, CHEN Wen-li, WU Rong-quan, JIANG Yu-ying, ZHUANG Jian-long
    2024, 43 (5):  384-389.  doi: 10.12280/gjszjk.20240232
    Abstract ( 421 )   HTML ( 13 )   PDF (2220KB) ( 43 )  

    Objective: To explore the genetic diagnosis of fetuses with polyhydramnios using chromosomal microarray analysis (CMA). Methods: A total of 112 cases of the polyhydramnios diagnosed by prenatal ultrasound at Quanzhou Women′s and Children′s Hospital from January 2017 to April 2023 were collected. All of the enrolled subjects underwent chromosomal karyotype and CMA analysis. According to the results of ultrasound, the subjects were divided into three groups, the isolated polyhydramnios group (16 cases), the group of polyhydramnios with ultrasound structural abnormalities (27 cases), and the group of polyhydramnios with abnormal ultrasound soft markers (69 cases). Results: Chromosome karyotype analysis found 4 cases of chromosomal aneuploidy, 1 case of aneuploid chromosomal chimerism, and 1 case of chromosomal structural abnormality chimerism, with an abnormal detection rate of 5.36% (6/112). CMA detected all chromosomal abnormalities, and 4 additional cases of pathogenic or likely pathogenic copy number variants, with an additional detection rate of 3.57% (4/112). In addition, there was no statistical difference in the positive detection rate among three groups (P=0.571). Conclusions: Pregnancy with polyhydramnios may be related to fetal chromosomal abnormalities. The chromosome karyotype analysis combined with CMA technique is beneficial to detect more pathogenic copy number variants. Therefore, the chromosome karyotype analysis combined with CMA detection can be recommended in the genetic etiology analysis and prognosis evaluation of fetuses with polyhydramnios.

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    Clinical Analysis of 17 Cases of Cervical Lipoleiomyoma
    XU Qian, CHENG Jiu-mei
    2024, 43 (5):  390-394.  doi: 10.12280/gjszjk.20240171
    Abstract ( 402 )   HTML ( 10 )   PDF (610KB) ( 23 )  

    Objective: To improve the diagnosis and treatment of cervical lipoleiomyoma. Methods: 17 cases of cervical lipoleiomyoma admitted between September 2011 and April 2023 in the Beijing Obstetrics and Gynecology Hospital of Capital Medical University were analyzed retrospectively, including their pathogenesis, clinical characteristics, diagnosis and differential diagnosis, and treatment. Results: The average age of onset was (44.6±9.6) years. Patients mainly presented with lower abdominal pain or flank pain, menorrhagia, or asymptomatic. Ultrasound examination in all patients did not suggest cervical lipoleiomyoma, while 5 patients (29.4%) were suggested the degeneration of the myoma. Six patients underwent magnetic resonance imaging (MRI), and 2 cases detected fatty component. All 17 patients underwent surgical treatment. The cervical lipoleiomyoma ranged from 2.0 to 15.0 cm in diameter. Postoperative pathology of all cases showed cervical lipoleiomyoma. Follow-up ranged from 3 to 141 months, and only one patient had a cervical mass rediscovered at 9 months postoperatively and underwent radical surgery. Conclusions: Cervical lipoleiomyoma is a rare benign tumor, lacking specific clinical symptoms and imaging. The diagnosis mainly depends on surgical exploration and postoperative pathology, and surgery is the main treatment. Long-term follow-up after operation is required.

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    Case Report
    Genetic Etiology Analysis of A Case of Fetal Lymphedema
    CHEN Xin-ying, HUANG Ting-ting, ZENG Shu-hong, JIANG Yu-ying, ZHUANG Jian-long
    2024, 43 (5):  395-398.  doi: 10.12280/gjszjk.20240169
    Abstract ( 408 )   HTML ( 12 )   PDF (4459KB) ( 81 )  

    We reported a case of fetal lymphedema. The chromosome karyotype analysis of fetus and single nucleotide polymorphism array (SNP array) of the amniotic fluid cells showed no abnormalities in the mid pregnancy. However, the pregnant woman perceived a decrease in fetal movement in the late pregnancy, and ultrasound indicated intrauterine stillbirth. Whole exome sequencing (WES) showed that the fetus carried loss of heterozygosity of CELSR1 gene c.5060-1_ 5069 delGCCATGCCTCA. The WES results also showed that the fetal father also carried the mutation and had a normal phenotype. There is a certain correlation between loss of heterozygosity in the CELSR1 gene and lymphedema, but its clinical phenotype is incomplete penetrance.

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    Genetic Analysis of A Rare Family of Complex Heterozygotic Beta Thalassemia
    ZHUANG Qian-mei, LIU Chun-qiang, YAN Mei-zhen, WANG Geng, CAI Li-yi
    2024, 43 (5):  398-400.  doi: 10.12280/gjszjk.20240024
    Abstract ( 407 )   HTML ( 11 )   PDF (778KB) ( 16 )  

    A rare family of complex heterozygotic beta thalassemia was analyzed to explore the relationship between its molecular basis and clinical phenotype. The results of routine genetic testing for thalassemia in the proband showed a homozygous mutation of IVS-Ⅱ-654 (C>T), and her hematologic phenotype was consistent with this genotype. The conventional thalassemia genotype of the proband′s mother was β654MN, and the hematologic phenotype was consistent with her genotype. The conventional thalassemia genotype of the elder brother of the proband was βNN, and the hematologic phenotype was consistent with his genotype. Notably, the conventional thalassemia genotype of the proband′s father was βNN, while his hematologic phenotype did not match with the genotype. Since the genetic results of this family did not conform to the Mendelian inheritance rule, the gene detection of deletion HPFH was conducted additionally in the proband′s father and the proband. When the results of conventional thalassemia gene detection and deletion HPFH gene detection were combined, we found that the genotype of the proband′s father was βSEA-HPFHN, and that the genotype of the proband was βSEA-HPFH654M. Clinical attention should still be paid to the phenotypic analysis of beta thalassemia. When the phenotype and genotype are inconsistent, it is necessary to re-test or adopt multiple methods to avoid the false negative.

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    A Case Report of Ovarian Hyperstimulation Syndrome Combined with Ovarian Torsion after Assisted Reproductive Technology Assisted Pregnancy
    ZHU Hai-ying, QI Dan-dan, SUN Ping-ping, SUN Na, LUAN Su-xian
    2024, 43 (5):  401-405.  doi: 10.12280/gjszjk.20240138
    Abstract ( 367 )   HTML ( 11 )   PDF (6134KB) ( 18 )  

    With the development of assisted reproductive technology (ART), ovarian hyperstimulation syndrome (OHSS) as a main iatrogenic complication is also inevitable, which further increases the risk of ovarian torsion. The clinical symptoms and imaging characteristics of the patient with OHSS combined with ovarian torsion are relatively atypical, which means that the early identification and diagnosis of this acute abdomen is difficult. We report a case of OHSS combined with ovarian torsion before egg retrieval during ART treatment. The conservative treatment after egg retrieval was ineffective, and ultimately surgical treatment was still inevitable. This case suggests that the understanding of OHSS complicated with ovarian torsion should be strengthened during ART treatment, so as to achieve the early identification, early diagnosis and early treatment of this acute abdomen.

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    A Case of Full-Term Pregnancy after Single-Port Laparoscopic Debulking of Multiple Uterine Fibroids in Mid-Pregnancy
    WU Ying-ying, DU Xin
    2024, 43 (5):  406-409.  doi: 10.12280/gjszjk.20240105
    Abstract ( 405 )   HTML ( 24 )   PDF (4493KB) ( 29 )  

    The pedicle torsion or red degeneration of uterine fibroids during pregnancy can cause abdominal pain and induce miscarriage. The conservative treatment with drugs is considered the gold standard. However, the surgical treatment may be performed during pregnancy if necessary, if the abdominal pain cannot be relieved. Surgery can be performed by laparotomy or laparoscopy to remove uterine fibroids, based on the type, size and location of uterine fibroids, the gestational age and the doctor′s experience. However, the surgery by single-port laparoscopy to remove uterine fibroids during the second trimester of pregnancy is rarely reported. This case was a threatened abortion caused by degeneration of multiple uterine fibroids in the second trimester. It was diagnosed as type Ⅵ uterine fibroids by magnetic resonance imaging. After the conservative treatment failed, a single-port laparoscopic myomectomy was performed. After operation, the pregnancy was going on, and successfully carried to term birth. This case provides a practical reference of the laparoscopic application in uterine myomectomy during pregnancy.

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    Mesonephric-Like Adenocarcinoma of the Endometrium Involving Cervical Interstitium: A Case Report
    RAO Hui, LU Jiao-lan, ZHOU Huan, LI Xiong
    2024, 43 (5):  410-414.  doi: 10.12280/gjszjk.20240185
    Abstract ( 473 )   HTML ( 12 )   PDF (4991KB) ( 25 )  

    Mesonephric-like adenocarcinoma of the endometrium is a rare gynecological malignancy. Due to the low incidence, strong invasiveness, easy recurrence and metastasis, patients with this kind of disease are usually seen at an advanced stage. There is no clear treatment plan at present, and the prognosis is poor. We report the diagnosis and treatment process of a patient with mesonephric-like adenocarcinoma of the endometrium involving cervical interstitium. The patient was treated for two times of postmenopausal vaginal fluid and irregular vaginal bleeding for more than 20 days. Hysteroscopy (primary surgery) was performed on November 18, 2022, and the postoperative pathological examination results showed endometrioid adenocarcinoma. Therefore, transabdominal extrascial hysterectomy, bilateral ovarian arteriovenous high ligation, bilateral salpingo-oophorectomy, abdominal para-aortic lymphadenectomy and pelvic lymph node dissection (secondary surgery) was performed on December 1, 2022. Combined with the results of pathological examination of the two surgeries, stage Ⅱ of mesonephric-like adenocarcinoma of the endometrium was diagnosed. After surgery, the patient was given five cycles of paclitaxel combined with carboplatin chemotherapy, one course of pelvic external beam radiotherapy and one vaginal brachytherapy. No disease recurrence or metastasis was observed during follow-up until April 10, 2024.

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    Review
    Research Progress on the Correlation between Oxidative Stress and Aneuploidy in Oocytes of Aging Women
    JIANG Nan, ZHAO Xiao-li, LUAN Zu-qian, HUANG Zhi-yun, XIA Tian
    2024, 43 (5):  415-419.  doi: 10.12280/gjszjk.20240196
    Abstract ( 417 )   HTML ( 22 )   PDF (597KB) ( 89 )  

    The oocytes of aging women are more prone to aneuploidy. Oocyte aneuploidy is a significant factor contributing to the reduced fertility in aging women and the unfavorable pregnancy outcomes, including miscarriage, chromosomal abnormalities and birth defects. With the increase of age, the accumulation of reactive oxygen species (ROS) in oocytes causes the oxidative stress damage that interferes with the signal transduction of spindle assembly and spindle assembly checkpoints, shortens telomeres and reduces chromosome cohesion. The oxidative stress is therefore an important reason for the increase of aneuploidy of oocytes. We review the relationship between oxidative stress and aneuploidy in oocytes of aging women, in order to provide a reference for saving the fertility of aging women.

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    Analysis of Influencing Factors of Frozen-Thawed Embryo Transfer Pregnancy Outcome
    LUO Sha-sha, WANG De-jing
    2024, 43 (5):  420-424.  doi: 10.12280/gjszjk.20240149
    Abstract ( 406 )   HTML ( 14 )   PDF (618KB) ( 98 )  

    With the advancement of vitrification freezing technology, frozen-thawed embryo transfer (FET) plays a crucial role in assisted reproductive technology by preventing ovarian hyperstimulation syndrome, reducing ectopic pregnancy rates, and enhancing cumulative pregnancy rates. The proportion of FET cycles in assisted reproduction has been increasing annually, establishing FET as a key component of reproductive technologies. The outcome of FET pregnancies is influenced by various factors, including age, embryo quality, endometrial thickness, endometrial preparation protocols, DNA fragmentation, and Y chromosome microdeletions. Age, embryo quality, and endometrial receptivity are pivotal factors determining the success of FET treatments, directly impacting embryo development, implantation, and pregnancy success rates. Therefore, identifying the influencing factors of FET pregnancy outcome, so as to implement more precise, personalized and targeted prevention to improve pregnancy rates, has become a research hotspot. This review aims to summarize the relevant factors affecting the outcome of FET pregnancies, providing a reference for clinical decision.

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    Research Progress of Ferroptosis in Pathogenesis of Polycystic Ovary Syndrome
    LI Xuan-ang, WANG Ting-ting, XIANG Shan, ZHAO Shuai, LIAN Fang
    2024, 43 (5):  425-429.  doi: 10.12280/gjszjk.20240328
    Abstract ( 385 )   HTML ( 30 )   PDF (841KB) ( 49 )  

    Polycystic ovary syndrome (PCOS) is a common metabolic disorder of the reproductive system in women of adolescent and childbearing age. In addition to ovulatory dysfunction, menstrual dysfunction and infertility, most patients suffer from endocrine abnormalities such as insulin resistance (IR), hyperandrogenemia (HA) and abdominal obesity. Ferroptosis, a highly iron-dependent programmed cell death mediated by the lipid peroxidation and the imbalance in the oxidative-antioxidant system is a hot research topic in reproductive medicine. The relevance of ferroptosis in PCOS has received much attention in recent years, and recent studies suggest that ferroptosis may be involved in the regulation of PCOS-associated metabolic disorders and affect reproductive function in women with PCOS by disrupting oocyte quality and uteroplacental function. To further enrich and improve the system of diagnosis, prevention, and prognosis assessment of PCOS, we summarize the mechanisms related to ferroptosis, systematically discusses the correlation between ferroptosis and the pathophysiology of PCOS, and its research progress in the treatment of PCOS.

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    The Role of Annexin A Family at Maternal-Fetal Interface and Related Adverse Pregnancy
    XIE Yu-xin, WANG Rui-xue, CHEN Meng-na, CHU Ji-jun
    2024, 43 (5):  430-434.  doi: 10.12280/gjszjk.20240211
    Abstract ( 371 )   HTML ( 7 )   PDF (588KB) ( 22 )  

    The maternal-fetal interface is essential for successful embryo implantation and subsequent placental development. Many studies have showed that the maternal-fetal interface is rich in the annexin A (AnxA) family, and that AnxA family not only regulates the biological behavior of trophoblast cells at the maternal-fetal interface, but also participates in the metaphase reaction. Therefore, the aberrant expression of the AnxA family is associated with a range of adverse pregnancy outcomes, such as recurrent implantation failure and recurrent pregnancy loss. Clarifying the role of the AnxA family at the maternal-fetal interface will help to understand better the mechanism of action of AnxA leading to adverse pregnancy outcomes, and to provide new targets for the treatment of related diseases. The possible roles of the AnxA family at the maternal-fetal interface and in the related adverse pregnancy are summarized in this review, to show a potential direction of the treatment of adverse pregnancy outcomes.

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    Recurrent Spontaneous Abortion Related to Oxidative Stress at Maternal-Fetal Interface
    LI Jia-li, TU Xu-xu, WANG Shi-meng, NIU Ding-ren, FENG Xiao-ling
    2024, 43 (5):  435-440.  doi: 10.12280/gjszjk.20240269
    Abstract ( 333 )   HTML ( 19 )   PDF (772KB) ( 20 )  

    Recurrent spontaneous abortion (RSA) has a complex and diverse etiology, and many pathophysiological mechanisms of RSA remain unknown. In the reproductive system of women, reactive oxygen species (ROS) play an important role in hormone signaling, oocyte maturation, ovarian steroidogenesis, ovulation, luteal dissolution, luteal maintenance during pregnancy, embryo implantation, blastocyst development, reproductive cell function, and luteal formation. The abnormal expression of hypoxia inducible factor-1α, iron death, exposure to trace elements and heavy metals, and other factors directly or indirectly induce oxidative stress (OS). The imbalance between oxidative and antioxidant mechanisms has a negative impact on cell proliferation and apoptosis, leading to pathological phenomena such as cellular dysfunction, decreased biological activity, immune and inflammatory activation. The maternal-fetal interface plays a role in the exchange of gases, nutrients and metabolites during pregnancy, while producing various hormones and growth factors to support the normal development of the fetus and to maintain pregnancy. Therefore, OS in maternal-fetal interface is related to the occurrence and progression of RSA.

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