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Evaluation of fetoplacental oxygenation in a rat model of gestational diabetes mellitus using BOLD-MRI at 7.0-T

Reproductive and Developmental Medicine 2023年第2期7卷 88-95页

作者： Ying-Fang Wang Chang-An Chen Ming-Qing Li Xiang Tao Xian-Ce Zhao Cheng-Jie Wang Guo-Fu Zhang He Zhang department of Radiology Hospital of Obstetrics and GynecologyFudan UniversityShanghai 200090China Laboratory for Reproductive Immunology Hospital of Obstetrics and GynecologyShanghai Medical SchoolFudan UniversityShanghai 200090China department of Pathology Hospital of Obstetrics and GynecologyFudan UniversityShanghai 200090China Philips Healthcare Shanghai 200070China Institute of obstetrics and gynecology Hospital of Obstetrics and GynecologyFudan UniversityShanghai 200090China

Objective:To compare the differences in blood oxygen level-dependent(BOLD)parameters following maternal hyperoxia between normal pregnancy and pregnancy in the rat model of gestational diabetes mellitus(GDM).Methods:GDM was induced by high-fat and sucrose diet(HFS)combined with an intraperitoneal injection of streptozotocin(STZ).On embryonic day 19(E19),the two groups of pregnant rats were imaged using a 7.0-T animal MRI scanner.TurboRARE was initially used to localize the fetoplacental units(FPUs).Next,multiple gradient echo BOLD was performed during the air and oxygen inhalation periods.T2^(*)map was then generated,and the baseline T2^(*)and absolute changes in T2^(*)value(ΔT2^(*),difference between T2^(*)oxy and T2^(*)air)were calculated.Following the MRI scan,the placentas and fetuses were aseptically stripped,weighed,and immunostained.Results:Nine rats were used in this study.After maternal oxygen inhalation,T2^(*)increased significantly in all subjects in both groups.TheΔT2^(*)for the placenta(5.97 vs.7.81 msec;P=0.007)and fetal brain(2.23 vs.3.97 msec;P=0.005)differed significantly between the GDM and control groups.Histochemical detection of placental glycogen content and inflammatory cytokines(IL-6 and TNF-α)showed significantly higher levels in the GDM than in the normal placenta.Conclusions:BOLD-MRI revealed abnormalities in the fetoplacental response to maternal hyperoxygenation in rats with GDM.We believe that this approach can potentially be used to evaluate placental dysfunction and assess the state of the fetus during pregnancy with GDM.

关键词： BOLD-MRI Gestational diabetes mellitus Fetoplacental oxygenation Rats Placenta

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Clinical factors in predicting extreme preterm birth after cerclage

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Chinese medical Journal 2023年第3期136卷 370-372页

作者： Xuping Ye Yuezhou Yang Jun Li Kaikai Chang Huan Xu department of obstetrics Obstetrics and Gynecology Hospital affiliated to Fudan UniversityShanghai 200011China shanghaiJiai Genetics and IVF Center Obstetrics and Gynecology Hospital affiliated to Fudan UniversityShanghai 200011China

To the Editor:Cerclage reduces the rate of preterm birth and improves perinatal outcomes in patients with cervical insufficiency.However,previous findings on this subject are discordant.Many clinical factors affect the outcome of cerclage.The morbidity rate of neonates born after 32 weeks of gestation is reported to be significantly reduced.[1]Therefore,the use of a gestational age of<32 weeks at delivery as the main efficacy measure for cerclage is of practical significance.

关键词： insufficiency cervical clinical

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Clinical practice guidelines for pregnancy-associated breast cancer:Chinese society of breast surgery(CSBrS)practice guidelines 2021

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Chinese medical Journal 2021年第20期134卷 2395-2397页

作者： Qing Chen Yi-Ran Qiu Ming-Di Zhang Wei Zhu Wei-Rong Gu Ke-Jin Wu department of Breast Surgery Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200011China shanghai medical College Fudan UniversityShanghai 200032China department of General Surgery Zhongshan Hospital of Fudan UniversityShanghai 200032China department of obstetrics Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200011China

Pregnancy-associated breast cancer(PABC),including breast cancer during pregnancy(BCP)and postpartum breast cancer(PBC),has become a critical issue for clinicians in consideration of both maternal and offspring safety during diagnosis and treatment.The recommendations in this guideline are mainly based on currently available high-quality prospective studies,retrospective cohort studies,meta-analyses,and guidelines and consensus documents published by internationally recognized or national societies or associations.Clinicians should carefully analyze the potential benefits and risks of each treatment before recommending whether to terminate the pregnancy or lactation,balance the advantages and disadvantages of the treatments,and respect the wishes of patients.

关键词： pregnancy diagnosis treatment

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Clinicopathological Evaluation of Ovarian Juvenile Granulosa Cell Tumor: Is Fertility-Sparing Surgery Safe?

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Reproductive and Developmental Medicine 2019年第1期3卷 24-29页

作者： Lu Guo Xiao-Cheng Liu Xiu-Ying Chen Xi-Rong Xiao Yu-Qing Qu Bin Li department of obstetrics and gynecology Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200090China shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200090China department of obstetrics and gynecology of shanghai medical school Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200090China

Objective:To retrospectively investigate the clinicopathological characteristics of ovarian juvenile granulosa cell tumors(JGCTs)and to evaluate the safety of fertility-sparing surgery.Methods:In this study,surgically treated patients with JGCTs diagnosed between January 2004 and October 2018 in our center were identified.Clinicopathological data,survival outcomes,and recurrence rates were examined in these patients.Results:A total of 8 patients were included.All patients were premenarchal girls or young women(age range,9-32 years).Irregular vaginal bleeding was the most common presenting symptom.Of them,seven patients were classified with Stage I JGCTs,and they underwent fertility-sparing surgery.One patient who had Stage IIIC JGCT and had completed childbearing underwent complete surgery.Seven patients received adjuvant chemotherapy.The median follow-up duration in the total cohort was 64 months(range,2-117 months).The overall survival rate in the fertility-sparing group was 100%,whereas the patient with Stage IIIC JGCT died 1 month after the treatment.Conclusions:Fertility-sparing surgery might not show a negative impact on oncologic outcomes.Fertility sparing could be considered a modified option for patients with Stage I JGCTs.However,due to the limited number of patients,the conclusion must be interpreted with caution,and larger or multicenter studies are needed before conclusions can be drawn.

关键词： Adjuvant Chemotherapy Complete Surgery Fertility-Sparing Surgery Ovarian Juvenile Granulosa Cell Tumor

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Clinical features related to lymphatic metastasis in grade 3 endometroid endometrial cancer:a retrospective cross-sectional study

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Chinese medical Journal 2021年第17期134卷 2102-2109页

作者： Bo Wang Qian Wang Yue Shi Wen-Yu Shao Jiong-Bo Liao Xue-Zhen Luo Xiao-Jun Chen Chao Wang department of gynecology Obstetrics and Gynecology HospitalFudan UniversityShanghai 200011China department of gynecology Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesObstetrics and Gynecology HospitalFudan UniversityShanghai 200011China

Background Endometrial cancer(EC)has been one of the most general cancers with respect to gynecological malignancies;however,there are debates on clinical strategies concerning treatments especially for patients with grade 3(G3)endometroid endometrial cancer(EEC).Present study aimed to evaluate the lymphatic metastasis(LM)related factors and figure out the necessity of lymphadenectomy for G3 EEC patients.Methods From January 2009 to April 2019,3751 EC patients were admitted to obstetrics and gynecology Hospital of fudan university.Clinical characteristics include age,grade,stage,and clinical pathological features.A total of 1235 EEC patients were involved in the multivariable analysis.Three hundred and eighty-one patients were involved in the survival analysis and the data attributed to sufficient follow-up information.Kaplan-Meier curve and log-rank test were utilized to analyze the survival rate.Results Among the 1235 EEC patients,181(14.7%)were categorized as G3 and 1054(85.3%)were grade 1 to grade 2(G1-2).Multivariate analysis demonstrated that lymphovascular space invasion,adnexal involvement,and cervical stroma involvement were independent risk factors of LM in G3 cohort with odds ratio 3.4,5.8,and 8.9;95%confidence interval 1.1–10.6,1.5–22.4,and 2.8–28.0,respectively.LM rates increased from 3.3%(3/92)to 75%(9/12)for G3 EEC cohort as related factor numbers increased from one to three.There were no differences between G3 and G1-2 EEC in overall survival and progression free survival.Additionally,no survival advantage was observed for G3 EEC patients at early stage with different plans of adjuvant treatment.Conclusions For G3 EEC patients without other pathological positive factor,theLMrate is lower than those with other pathological positive factor.Survival analysis showed no difference between G3 cohort and G1-2 cohort.Also,different adjuvant treatments had no impact on the overall survival for G3 EEC patients.

关键词： Endometrial cancer Lymphatic metastasis Multivariate analysis Survival

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Liquiritin ameliorates metabolic and endocrine alterations in a mouse model of polycystic ovary syndrome

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Reproductive and Developmental Medicine 2022年第2期6卷 104-112页

作者： Zhi Li Yan Liu Hai-Ou Liu Zhi-Yong Wu Cong-Jian Xu Fei-Fei Zhang obstetrics and gynecology Hospital Fudan UniversityShanghai 200011China shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases Shanghai 200011China department of obstetrics and gynecology Shanghai Medical CollegeFudan UniversityShanghai 200032China

Objective::Altered bile acid transformation induces low-grade chronic inflammation and may play an important role in the pathophysiology of polycystic ovary syndrome (PCOS). Liquiritincan regulate bile acid metabolism and anti-inflammatory properties;however, limited information is available regarding its therapeutic potential in PCOS.Methods::Female C57BL/6 mice were randomly assigned into four groups ( n = 6 mice/group): the control, letrozole or dehydroepiandrosterone-induced PCOS groups, PCOS + 20 mg/kg liquiritin group, and control + liquiritin groups. After 21 days of treatment, the mice were euthanized, and the associated metabolism indications were investigated. Ovarian histological examinations were performed, and serum hormone concentration was measured. The expression of key genes involved in steroid hormone synthesis, ovarian follicle development, and ovulation was assessed. Results::Liquiritin reduced fasting blood glucose levels and increased insulin sensitivity compared to the PCOS group. Liquiritin also significantly decreased serum levels of total testosterone ( P < 0.001) and dehydroepiandrosterone sulfate ( P < 0.05) in the PCOS group. Histomorphological inspection of ovaries from the liquiritin group revealed fewer cystic dilated follicles than in the PCOS group. Moreover, liquiritinsignificantly ( P < 0.01) decreased Cyp17a1, Cyp19a1, Fshr, Hsd3b2, Runx2, and Ccn2 mRNA expression compared to letrozole-induced PCOS. Conclusion::Liquiritin may be safe and helpful in ameliorating PCOS-associated hyperandrogenemia and hyperglycemia. However, clinical trials investigating different liquiritin dosages are needed to confirm these findings.

关键词： Liquiritin Metabolic phenotypes Polycystic ovary syndrome Reproductive phenotypes

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Focal adhesion kinase signaling is necessary for the hydrogen sulfide-enhanced proliferation,migration,and invasion of HTR8/SVneo human trophoblasts

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Reproductive and Developmental Medicine 2023年第2期7卷 75-82页

作者： Xian-Li Wang Jing Tang department of Pharmacy Obstetrics and Gynecology HospitalFudan UniversityShanghai 200011China

Objective:Hydrogen sulfide(H_(2)S)has been elucidated that it promotes migration and invasion in human placenta trophoblasts.However,the signaling pathway underlying H_(2)S-based regulation of trophoblasts remains unknown.Hence,we investigated the potential effect of sodium hydrosulfide(NaHS),an exogenous H_(2)S donor,on extravillous trophoblasts.Methods:The Cell Counting Kit-8 was used to detect the proliferative activity of trophoblasts and to screen the optimal concentration of NaHS.The migration and invasion of HTR8/SVneo cells were measured by Transwell assays.Gene expression was determined by quantitative real-time PCR analysis.Protein expression was determined by western blot.Results:We found that NaHS could promote the proliferation,migration,and invasion of HTR8/SVneo cells.The phosphorylation of focal adhesion kinase(FAK),Src,and extracellular signal-regulated kinase(ERK)were activated by NaHS.Moreover,NaHS also upregulated the expression of matrix metalloproteinase-2(MMP-2)and MMP-9,downregulated the expression of E-cadherin in HTR8/SVneo cells.The application of NaHS could increase the expression of cystathionine-β-synthase.Conclusion:Both FAK-Src signaling and the upstream signaling cascade of ERK activation play a significant important role in NaHS-induced proliferation,migration,and invasion via upregulating activity of MMP-2,MMP-9,and downregulating E-cadherin in HTR8/SVneo cells.These novel findings may provide a strong foundation for the clinical application of H_(2)S donor drugs.

关键词： Hydrogen sulfide Trophoblast Proliferation Migration Invasion Focal adhesion kinase signaling

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NLRP3 inhibitor dopamine receptors agonist as a potential therapeutic strategy for treatment of overactive immune responses in COVID-19

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Reproductive and Developmental Medicine 2023年第2期7卷 65-67页

作者： Jia-Lei Zhu Jing Jin Jing Tang department of Pharmacy Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200090China

Patients infected with coronavirus disease 2019(COVID-19)have high serum levels of proinflammatory cytokines.The"cytokine storm"has become one of the major causes of death for critically ill patients infected by COVID-19.Glucocorticoids,plasma from convalescent patients,blood purification,and tocilizumab are currently recommended for use when the body’s inflammatory response is overactivated.However,there are limitations in terms of medicinal effects,equipment reserves,and treatment expense.These challenges prompted us to assess classical agents with good safety and mature production technology.A recent study showed that nucleotide-binding oligomerization domain(NOD)-,leucine-rich repeat(LRR)-,and pyrin domain-containing protein 3(NLRP3)inflammasomes drive COVID-19 pathology.We speculate that suppression of NLRP3 inflammasome-derived cytokine production may be beneficial in COVID-19-infected patients.Dopamine receptors are present in almost all immune cells and can modulate their activation,proliferation,and cytokine production of immune cells.Previous studies have shown that dopamine receptor agonists can control systemic inflammation through inhibition of the NLRP3 inflammasome.This suggests that dopamine receptor agonists may be a new strategy for the treatment of overactive immune responses in COVID-19 patients.This is worthy of further investigation in clinical practice.

关键词： NLRP3 inflammasome Cytokine storm COVID-19 Dopamine receptors Medication regimen Interleukin

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A Defective CXCL16/CXCR6 Axis Increases the Risk of Pregnancy Loss via the Abnormal Crosstalk between Decidual γδ T Cells and Trophoblasts

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Reproductive and Developmental Medicine 2021年第3期5卷 129-139页

作者： Deng-Xuan Fan Ming-Qing Li Wen-Jie Zhou Hong-Lan Huang Hui-Li Yang Cong-Jian Xu department of gynecology Obstetrics and Gynecology HospitalFudan UniversityShanghai 200011China department of obstetrics and gynecology of shanghai medical school Fudan UniversityShanghai200011China shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases Fudan UniversityShanghai200011China NHC Key Lab of Reproduction Regulation(shanghai Institute of Planned Parenthood Research) Hospital of Obstetrics and GynecologyFudan UniversityShanghai200080China department of obstetrics and gynecology Reproductive Medical CenterRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai200025China

Objective::The maternal-fetal interface undergoes dynamic changes to allow the fetus to grow and develop in the uterus.The interaction between decidualγδT cells and trophoblasts plays a pivotal role during successful pregnancy;however,their physiological functions in early-term human pregnancy are still not completely illustrated.This study was undertaken to illustrate the functional roles of CXCL16/CXCR6 to prevent pregnancy loss via the crosstalk between decidualγδT cells and HTR8/SVneo trophoblast cells.Methods::The percentile of CXCR6+γδT cells in the peripheral blood from normal female and recurrent spontaneous abortion(RSA)patients was analyzed by flow cytometry.The expression of CXCR6 was detected in decidual immune cells via flow cytometry,and the expression of CXCL16 was analyzed in HTR8/SVneo trophoblast cells and lentivirus(LV)-HTR8/SVneo trophoblast cells via enzyme-linked immunosorbent assay.Reverse transcriptase-polymerase chain reaction was used to verify the expression of the CXCL16 gene in LV-HTR8/SVneo trophoblast cells.Expression of granzyme B and cytokines and proliferation of decidualγδT cocultured with HTR8/SVneo trophoblast cells were analyzed by flow cytometry.Invasion of HTR8/SVneo trophoblast cells was assessed via Matrigel transwell assay.Adoptive transfer was induced in vivo further to illustrate that the normal expression of CXCL16/CXCR6 could prevent pregnancy loss.Results::The percentile of CXCR6+γδT cells in the peripheral blood from RSA patients was lower than normal pregnancies.The expression of CXCR6 was highest in the decidualγδT cells among decidual immune cells,and the expression of CXCL16 increased as the amount of HTR8/SVneo trophoblast cells increased.Expression of granzyme B in the decidualγδT cells was downregulated by cocultured with HTR8/SVneo cells dependent of CXCL16,and HTR8/SVneo trophoblast cells induced the Th2 cytokines production in the decidualγδT cells.Both the expression of CXCR6 in the decidualγδT cells and proliferation of the decidualγδT cells were promot

关键词： CXCL16 CXCR6 DecidualγδT Cells Maternal-fetal Interface Recurrent Spontaneous Abortion Trophoblasts

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Current Updates on Salpingectomy for the Prevention of Ovarian Cancer and Its Practice Patterns Worldwide

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Chinese medical Sciences Journal 2017年第3期32卷 185-192页

作者： Sweta Dhakal Yunxi Zheng Xiaofang Yi department of gynecology Obstetrics and Gynecology Hospital of Fudan University department of obstetrics and gynecology Shanghai Medical College Fudan University shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases

A paradigm shift of the origin of ovarian cancer to fallopian tube has brought more focus on bilateral salpingectomy as a preventive method for ovarian cancer. Bilateral salpingectomy has shown a dramatic reduction in the risk of ovarian cancer. Bilateral salpingo-oophorectomy has been a long-used practice to prevent ovarian cancer, but it brings surgical menopause and an increased mortality rate to women undergoing such a surgery at the age of <47.5. With the prophylactic bilateral salpingectomy, however, the ovarian function remains unaltered. Recent studies have shown that prophylactic salpingectomy was helpful not only in preventing high-grade serous type ovarian cancer, but also in decreasing adnexal pathologies. With the publication of committee opinion, more practitioners have accepted this proposal, but some are more concerned about its disadvantages. This review illustrates the latest updates on salpingectomy as a preventive method for ovarian cancer, including its advantages and disadvantages, clinicians' opinions, public opinions, so as to find out Obstetricians' and Gynecologists' practice pattern related to opportunistic salpingectomy worldwide.

关键词：卵巢切除术预防方法输卵管卵巢癌世界临床医生卵巢功能从业人员

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