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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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Modified strict sperm morphology threshold aids in the clinical selection of conventional in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI)

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Asian Journal of Andrology 2022年第1期24卷 62-66页

作者： Yong Zhu Feng Zhang Hua Cheng Xiao-Xi Sun Feng Jiang Obstetrics and Gynecology Hospital Fudan UniversityShanghai 200011China Shanghai Ji Ai Genetics and IVF Institute Obstetrics and Gynecology HospitalFudan UniversityShanghai 200011China

For infertility treatment,the selection of in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI)is decided by multiplying indicators(including fallopian tube factors,semen count,and semen motility),except for sperm morphology.In this study,we conducted a retrospective analysis,from implantation to birth,over a period of 5 years.A total of 1873 couples with primary or secondary fallopian tube factors and an increased defective sperm morphology rate(DSMR)were divided into different groups to receive IVF or ICSI cycles.By comparing the outcomes,we found that the F1 group(DSMR98%,IVF group 3;P98%,ICSI group 3)had higher cleavage rate(P<0.001),biochemical pregnancy rate(P<0.05),clinical pregnancy rate(P<0.05)and live birth rate(P<0.05)than the F3 group.However,the ICSI subgroup had a lower two pronuclei fertilization rate than the IVF subgroup(P<0.05).Our data suggest that the sperm morphology should also be considered when selecting IVF or ICSI combined with other semen parameters before the first assisted reproductive technologies(ART)cycle,especially for males with severe sperm defects.

关键词： clinical outcome in vitro fertilization intracytoplasmic sperm injection sperm morphology

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Maternal weight,blood lipids,and the offspring weight trajectories during infancy and early childhood in twin pregnancies

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World Journal of Pediatrics 2023年第10期19卷 961-971页

作者： Wei Zheng Ke-Xin Zhang Xian-Xian Yuan Jin-Ying Luo Jia Wang Wei Song Sheng-Nan Liang Xiao-Xin Wang Cui-Mei Guo Guang-Hui Li Division of Endocrinology and Metabolism Department of ObstetricsBeijing Obstetrics and Gynecology HospitalCapital Medical UniversityBeijing 100026China Beijing Maternal and Child Health Care hospital Beijing 100026China obstetrics and gynecology Department Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics&Gynecology and PediatricsFujian Medical UniversityFuzhou 350001China

Background The intrauterine environment has a profound and long-lasting influence on the health of the offspring.However,its impact on the postnatal catch-up growth of twin children remains unclarified.Therefore,this study aimed to explore the maternal factors in pregnancy associated with twin offspring growth.Methods This study included 3142 live twin children born to 1571 mothers from the Beijing Birth Cohort Study conducted from 2016 to 2021 in Beijing,China.Original and corrected weight-for-age standard deviation scores of the twin offspring from birth to 36 months of age were calculated according to the World Health Organization Child Growth Standards.The corresponding weight trajectories were identified by the latent trajectory model.Maternal factors in pregnancy associated with the weight trajectories of the twin offspring were examined after adjustment for potential confounders.Results Five weight trajectories of the twin children were identified,with 4.9%(154/3142)exhibiting insufficient catch-up growth,30.6%(961/3142),and 46.8%(1469/3142)showing adequate catch-up growth from different birth weights,and 15.0%(472/3142)and 2.7%(86/3142)showing various degrees of excessive catch-up growth.Maternal short stature[adjusted odds ratio(OR)=0.691,95%confidence interval(CI)=0.563–0.848,P=0.0004]and lower total gestational weight gain(GWG)(adjusted OR=0.774,95%CI=0.616–0.972,P=0.03)were associated with insufficient catch-up growth of the offspring.Maternal stature(adjusted OR=1.331,95%CI=1.168–1.518,P<0.001),higher pre-pregnancy body mass index(BMI)(adjusted OR=1.230,95%CI=1.090–1.387,P<0.001),total GWG(adjusted OR=1.207,95%CI=1.068–1.364,P=0.002),GWG rate(adjusted OR=1.165,95%CI=1.027–1.321,P=0.02),total cholesterol(TC)(adjusted OR=1.150,95%CI=1.018–1.300,P=0.03)and low-density lipoprotein-cholesterol(LDL-C)(adjusted OR=1.177,95%CI=1.041–1.330)in early pregnancy were associated with excessive growth of the offspring.The pattern of weight trajectories was similar between monochorionic and dichorionic twins.Materna

关键词： Maternal weight Multifetal Offspring growth Twin pregnancy

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Efficacy of Chinese Herbal Medicines on Pregnancy Outcomes in Patients with Endometriosis in Long-Term Management:A Multicenter Retrospective Cohort Study

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Chinese Journal of Integrative Medicine 2023年第11期29卷 971-979页

作者： YANG Xin-chun LIU Yong SUN Wei-wei SHI Guang WU Ying XU Cai MENG Qing-wei HAO Zeng-ping HAN Qian ZHAO Rui-hua Department of gynecology Guang'anmen HospitalChina Academy of Chinese Medical SciencesBeijing(100053)China Department of Traditional Chinese Medicine Beijing Obstetrics and Gynecology HospitalCapital Medical UniversityBeijing(100026)China Department of gynecology Dongfang HospitalBeijing University of Chinese MedicineBeijing(100078)China Department of obstetrics and gynecology Beijing HospitalBeijing(100730)China Department of obstetrics and gynecology Beijing Friendship HospitalCapital Medical UniversityBeijing(100050)China

Objective:To analyze the factors related to pregnancy of endometriosis and whether Chinese herbal medicines(CHMs)can improve pregnancy outcomes in patients with endometriosis in long-term management.Methods:This multicenter cohort study retrospectively analyzed the clinical data of endometriosis patients with fertility needs from January 2019 to November 2019.A total of 252 patients with endometriosis from 5 level-ⅢGrade A hospitals in Beijing were included in this study.Univariate and multivariate logistic regression analysis were performed for the relevant factors.The propensity score matching(PSM)function of SPSS software was used to match the CHMs group with the non-CHMs group.The pregnancy rate and live birth rate were analyzed.Results:The results of univariate analysis showed that age,disease course,presence of infertility,presence of adenomyosis,time after surgery or use of gonadotropin-releasing hormone agonist(Gn RH-a),use of CHMs and follow-up time were influencing factors of pregnancy in endometriosis patients(P6 months were independent risk factors(OR=0.445,0.348,0.140,respectively,P<0.05),time after surgery or use of Gn RH-a 6 months and use of CHMs were independent protective factors(OR=3.839,3.842,respectively,P<0.05).After PSM,99 pairs of two groups were matched successfully.The pregnancy rate of the CHMs group was higher than that of the non-CHMs group[55.56%(55/99)vs.36.36%(36/99),P<0.05].The live birth rate of the CHMs group was higher than that of the non-CHMs group[49.49%(49/99)vs.35.35%(35/99),P<0.05].Conclusion:CHMs can effectively improve clinical pregnancy rate and live birth rate of patients with endometriosis in the chronic disease management.

关键词： protective herbal releasing

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Systematic analysis of protein expression in Candida albicans exposed to farnesol

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Chinese Medical Journal 2019年第19期132卷 2348-2353页

作者： Feng-Juan Wang Zhao-Hui Liu Department of obstetrics and gynecology Beijing Obstetrics and Gynecology HospitalCapital Medical UniversityBeijing 100026China

Background:The phenotypic switching of Candida spp.plays an important role in the development of vulvovaginal candidiasis(VVC).Farnesol,as a quorum-sensing molecule in Candida albicans,has the ability to prevent yeast-to-hyphal conversion in vitro.However,the mechanism underlying this ability is unclear.This study aimed to investigate changes in protein levels to better understand how farnesol impacts processes contributing to VVC.Methods:The isobaric tag for relative and absolute quantitation technique was used to detect protein expression in C.albicans strain SC5314(ATCC MYA-2876)with or without farnesol exposure.Proteins with a threshold fold change greater than 1.5 were screened and considered differentially expressed proteins.All the altered proteins were analyzed using Gene Ontology annotation,Kyoto Encyclopedia of Genes and Genomes(KEGG)annotation,and metabolic pathway annotation.Results:Between the farnesol-exposed group and the farnesol-unexposd group,we detected 297 altered proteins among all 2047 tested proteins based on a threshold fold change of more than 1.5(P<0.05).Eighty-seven of the 297 altered proteins exhibited metabolic enzyme activity and participated in 85 metabolic pathways according to KEGG pathway analysis.Most of these metabolic pathways were associated with central carbon metabolism processes.In the sterol synthesis pathway,which involves the synthesis of farnesol,ERG25(methylsterol monooxygenase)and ERG4(delta 24(24(1))-sterol reductase)were both down-regulated in the farnesol-exposed group.All six altered proteases associated with the oxidative phosphorylation process were down-regulated in the farnesol-exposed group relative to the farnesol-unexposed group.Conclusions:The mechanisms underlying farnesol-induced phenotype switching involves the adjustment of metabolic activities and epigenetic modification.Exogenous farnesol had an evident,but non-deterministic effect on the synthesis of ergosterol.The potential drug activity of farnesol warrants further investigation.

关键词： Farnesol Candida albicans Proteomic analysis Morphogenesis

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Effects of menopausal hormone therapy-based on the role of estrogens,progestogens,and their metabolites in proliferation of breast cancer cells

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Cancer Biology & Medicine 2022年第4期19卷 432-449页

作者： Yu Deng Hongyan Jin Department of obstetrics and gynecology Peking University First HospitalBeijing 100034China

Menopausal hormone therapy(MHT)has been widely used for the clinical treatment of symptoms associated with menopause in women.However,the exact nature of the relationship between MHT and the increased risk of breast cancer has not been fully elucidated.The results of the Women’s Health Initiative’s randomized controlled clinical studies showed that estrogen monotherapy was associated with a lower incidence of breast cancer as compared to estrogen-progesterone combined therapy,with an elevated risk of breast cancer.The evidence currently available from randomized trials and observational studies is based on data from different populations,drug formulations,and routes of administration.Even though the risks of MHT and breast cancer have received a great deal of attention,information regarding the unpredictable toxicological risks of estrogen and progestogen metabolism needs to be further analyzed.Furthermore,the diversity and complexity of the metabolic pathways of estrogen and different progestogens as well as the association of the different estrogen and progestogen metabolites with the increased risk of breast cancer need to be adequately studied.Therefore,this review aimed to describe the biological effects of estrogen,progesterone,and their metabolites on the proliferation of breast cancer cells,based on relevant basic research and clinical trials,to improve our understanding of the biological functions of estrogen and progestogen as well as the safety of MHT.

关键词： Menopausal hormone therapy estrogen progestogens breast cancer

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Early life 1000 days: opportunities for preventing adult diseases

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Chinese Medical Journal 2022年第5期135卷 516-518页

作者： Juan Juan Huixia Yang Department of obstetrics and gynecology Peking University First HospitalBeijing 100034China

With the rapid socioeconomic development, improvements in living standards, and changes in lifestyle, adult diseases, such as cardiovascular diseases, type 2 diabetes mellitus (T2DM), hypertension, obesity, and so on, are increasing dramatically over the past decades, which have caused a huge economic and health burden at both population and individual levels in China.[1] The increased burden of adult diseases has become the main public health issue, and prevention of adult diseases in China has become a formidable task during recent years. In 2016, China has put forward the concept of whole life-course health and efforts have been made on shifting the focus from treating diseases to prevention. In view of the poor effects of prevention of diseases in adulthood, it is suggested that prevention and management of adult diseases should be extended to early life, which is the critical window for physiological programming and has profound and enduring effects on the whole life-cycle health.[2,3,4] In 2018, an article named "To Prevent Cardiovascular Disease, Pay Attention to Pregnancy Complications" published in Journal of the American Medical Association (JAMA) also illustrated that pregnancy is a window to future health[5].

关键词： diseases prevention cardiovascular

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Effectiveness of Zhenqi Buxue Oral Liquid Combined with Progesterone for Treatment of Oligomenorrhea and Hypomenorrhea with Qi-Blood and Kidney(Shen)Essence Deficiency:A Randomized Controlled Trial

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Chinese Journal of Integrative Medicine 2023年第11期29卷 963-970页

作者： GAN Jing-wen LV De-xin FU Jin SHI Liang-yan YUAN Chun-yan ZENG Xiao-qin LI Jun SUN Ai-jun National Clinical Research Center for Obstetric&Gynecologic Diseases Department of Obstetrics and GynecologyPeking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical College Address:Peking Union Medical College Hospital(East)Beijing(100730)China Department of obstetrics and gynecology Liuzhou Maternal and Child Health Care HospitalLiuzhouGuangxi Zhuang Autonomous Region(545001)China Department of obstetrics and gynecology Sichuan University West China Second University HospitalChendu(610066)China Department of obstetrics and gynecology Maternal and Child Health Hospital of Hubei ProvinceWuhan(430070)China Department of obstetrics and gynecology Southeast University Zhongda HospitalNanjing(210009)China Department of obstetrics and gynecology Guangzhou Women and Children's Medical CenterGuangzhou(510623)China Department of obstetrics and gynecology the First Hospital of Hebei Medical UniversityShijiazhuang(050000)China

Objective:To evaluate the effectiveness and safety of Zhenqi Buxue Oral Liquid(ZQ),progesterone capsules,and their combination in treating oligomenorrhea and hypomenorrhea with qi-blood and Kidney(Shen)essence deficiency.Methods:This was a prospective,randomized,multi-center controlled trial between June 2022 to December 2022.Ninety-six oligomenorrhea and hypomenorrhea patients with qi-blood and Shen essence deficiency were randomly assigned to receive ZQ(ZQ group,29 cases),progesterone capsules(PG group,32 cases),or the combined Chinese and Western medicine(COM group,31 cases)at a ratio of 1:1:1.Patients in the ZQ or PG group took daily 10 m L twice a day of ZQ or 200 mg once a day of progesterone capsules for 10 consecutive days on day 15 of the menstrual cycle respectively,and patients in the COM group received the same ZQ combined with progesterone capsules.The treatment course lasted for 3 months and follow-up was performed at 1 and 3 months after the end of treatment.Primary endpoint was the menstrual Traditional Chinese Medicine Syndrome Scale(TCMSS)scores.Secondary endpoints included pictorial blood loss assessment chart(PBAC)scores,clinical efficacy rate,36-item Short Form Health Survey(SF-36)scores,sex hormones and thickness of endometrium.Adverse events(AEs)were recorded.Results:TCMSS scores after 1-and 3-month treatment in all groups were significantly lower than those at baseline(P<0.05).Only TCMSS scores after 3-month treatment in the ZQ and COM groups continuously decreased compared with those after 1-month treatment in the same group(P<0.01).TCMSS scores after 3-month treatment in the ZQ and COM groups were significantly lower than those in the PG group(P<0.05,P<0.01).Compared with baseline,PBAC scores in the ZQ and COM groups after 3 months of treatment were also significantly higher(both P<0.01).The total effective rates of TCM syndrome of 3-month treatment were significantly improved in all groups compared with that after 1 month of treatment(P<0.05).The total effective rate of the COM group wa

关键词： Kidney Blood treatment

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Risk Factors for Gestational Diabetes Mellitus(GDM)in Subsequent Pregnancy Among Women Without GDM History in China:A Multicenter Retrospective Study

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Maternal-Fetal Medicine 2023年第1期5卷 9-15页

作者： Geng Song Yumei Wei Juan Juan Rina Su Jianying Yan Mei Xiao Xianlan Zhao Meihua Zhang Yuyan Ma Haiwei Liu Jingxia Sun Kejia Hu Huixia Yang Department of obstetrics and gynecology Peking University First HospitalBeijing 100034China Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus Beijing 100034China Department of obstetrics and gynecology Fujian Province Maternal and Child Health HospitalFuzhou 350005China Department of obstetrics and gynecology Maternal and Child Health Hospital of Hubei ProvinceWuhan 430064China Department of obstetrics and gynecology Zhengzhou University First Affiliated HospitalZhengzhou 450052China Department ofobstetrics and gynecology Taiyuan Maternal and Child Health HospitalTaiyuan 030012China Department of obstetrics and gynecology Shandong University Qilu HospitalJinan 250063China Department of obstetrics and gynecology Hainan General HospitalHaikou 570311China Department of obstetrics and gynecology First Affiliated Hospital of Harbin Medical UniversityHarbin 150007China Department of obstetrics and gynecology Beijing Shunyi District HospitalBeijing 101312China

Objective:This study aimed to determine the likelihood of gestational diabetes mellitus(GDM)in subsequent pregnancy among women without GDM history and to identify risk factors for GDM in subsequent pregnancy.Methods:This retrospective cohort study involved participants who delivered twice in same hospital of 18 research centers when delivered the second baby from January 2018 to December 2018.Finally 6204 women were enrolled and 5180 women without GDM history were analyzed further.Women were categorized as non-GDM or GDM based on the blood glucose values of the subsequent pregnancy,and the characteristics and GDM risk of these groups were compared.A univariate analysis of potential risk factors was performed using the Chi-squared test and/ort-test for qualitative or quantitative variables,respectively.Associations withP values<0.1 were chosen to be included in the multivariate binary logistic regression model.Results:In primary analysis of 6204 women,the incidence of GDM in subsequent pregnancy is 48.9%(490/1002)in women with GDM history and 16.1%(835/5202)in women without GDM history.In a further analysis for 5180 women without GDM at index pregnancy,compared with the non-GDM group,the GDM group had a significantly higher age,prepregnancy body mass index,and blood glucose value at each oral glucose tolerance test(OGTT)timepoint(fasting,1 h and 2 h)during the index and subsequent pregnancies,as well as higher weight retention during the interval between the two pregnancies(P<0.001).Age above 35 years in subsequent pregnancy(odds ratio(OR)=1.540,95%confidence interval(CI)=1.257-1.886,P<0.001),macrosomia in index pregnancy(OR=1.749,95%CI=1.277-2.395,P=0.001),OGTT blood glucose values in index pregnancy(fasting,OR=2.487,95%CI=1.883-3.285,P<0.001;1 h,OR=1.142,95%CI=1.051-1.241,P=0.002;2 h,OR=1.290,95%CI=1.162-1.432,P<0.001)and weight retention(OR=1.052,95%CI=1.035-1.068,P<0.001)were independent risk factors for GDM in subsequent pregnancy.Conclusion:For women without GDM history,GDM risk factors including age,macros

关键词： Diabetes gestational Without GDM history Risk factors Subsequent pregnancy.

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Perinatal outcomes of re-recurrent gestational diabetes mellitus and their prognostic factors:A retrospective cohort study in China

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Chinese Medical Journal 2024年第4期137卷 499-501页

作者： Xia Xu Yanni Guo Tingting Liao Huale Zhang Rumeng Jiang Shuyao Huang Jianying Yan Department of obstetrics and gynecology Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics&Gynecology and PediatricsFujian Medical UniversityFuzhouFujian 350001China

To the Editor:Gestational diabetes mellitus(GDM)is a pathologic condition in which glucose intolerance and insulin resistance develop to different degrees during pregnancy.Women with GDM have higher odds of adverse maternal and fetal outcomes.Patients with a history of GDM were at a significantly increased risk for recurrence of GDM in subsequent pregnancies.Our previous and some other studies found an increased incidence of adverse perinatal outcomes in pregnant with recurrent GDM.^([1])So far,women with a prior history of GDM are not recommended to refrain from subsequent pregnancy in light of the limited available data.What about those women with a history of recurrent GDM?Should women with recurrent GDM be recommended to avoid further pregnancy?Currently,studies on perinatal outcomes of women with re-recurrent GDM and their prognostic factors are very rare.Therefore,this retrospective cohort study was performed to explore perinatal outcomes of pregnant woman with re-recurrent GDM and their prognostic factors.

关键词： mellitus pregnancy diabetes

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