Effect of Mitochondrial Function of Ovarian Granulosa Cells on In Vitro Fertilization and Embryo Transfer Outcomes in Obese Polycystic Ovary Syndrome Patients

Objective:To investigate the effect of abnormal ovarian granulosa cell metabolism on in vitro fertilization and embryo transfer(IVF-ET)outcomes in obese polycystic ovary syndrome(PCOS)patients.Methods:Patients with PCOS who met the study criteria were screened according to the inclusion criteria.A total of 32 patients with obese PCOS were recruited into the study group,and 39 patients with non-obese PCOS were recruited into the control group.The general data(age,body mass index,and years of infertility),insulin resistance index(HOMA-IR),follicle-stimulating hormone(FSH),luteinizing hormone(LH),granulosa cell mitochondrial function,and IVF-ET outcome of patients in the study group and control group were retrospectively analyzed.Results:The differences in age and years of infertility between the study group and the control group were insignificant(P>0.05),and the body mass index(BMI)of the study group and control group was 30.5±1.24 kg/m2 and 22.3±1.12 kg/m2,respectively,in which the difference was statistically significant(P<0.05);the HOMA-IR of the study group was significantly higher than that of the control group(P<0.05);the reactive oxygen species(ROS)in the study group was significantly higher than that in the control group(P<0.05),and the ATP content in the study group was significantly lower than that in the control group(P<0.05);comparing the FSH and LH levels between the two groups,the difference was not statistically significant(P>0.05);the rate of IVF-ET failure was significantly higher in the study group than in the control group.Conclusion:PCOS is a complex endocrine disorder,and obesity is one of the independent risk factors for the development of PCOS.

Adult-Type Granulosa Cell Tumor with Similar Clinical Findings Seen during Ovarian Cystectomy Performed at the Same Time as Laparoscopic Ovarian Drilling for Polycystic Ovarian Syndrome: An Extremely Rare Case

Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions and the provision of diagnostic treatment. This study reports a case of PCOS with an ovarian mass in which LOD was aggressively used and a granulosa cell tumor (GCT) was found. A 34-year-old woman with secondary amenorrhea and irregular menstrual cycles presented to the emergency department with abdominal pain of unknown etiology. Imaging studies revealed a 6-cm left ovarian mass with an internal appearance suggestive of a hemorrhage. The patient’s secondary amenorrhea was subsequently diagnosed as PCOS, and LOD was performed to preserve her fertility. Simultaneously, a cystectomy was performed to evaluate the tumor in the left ovary;the diagnosis was adult-type GCT. Although concomitant GCT and PCOS are extremely rare, the two conditions have similar clinical manifestations. In women of reproductive age, the impact of surgery on future fertility should be considered, and the initial surgical technique should be chosen carefully.

Reprogramming of ovarian granulosa cells by YAP1 leads to development of high-grade cancer with mesenchymal lineage and serous features

Understanding the cell-of-origin of ovarian high grade serous cancer(HGSC)is the prerequisite for efficient prevention and early diagnosis of this most lethal gynecological cancer.Recently,a mesenchymal type of ovarian HGSC with the poorest prognosis among ovarian cancers was identified by both TCGA and AOCS studies.The cell-of-origin of this subtype of ovarian cancer is unknown.While pursuing studies to understand the role of the Hippo pathway in ovarian granulosa cell physiology and pathology,we unexpectedly found that the Yes-associated protein 1(YAP1),the major effector of the Hippo signaling pathway,induced dedifferentiation and reprogramming of the ovarian granulosa cells,a unique type of ovarian follicular cells with mesenchymal lineage and high plasticity,leading to the development of high grade ovarian cancer with serous features.Our research results unveil a potential cell-of-origin for a subtype of HGSC with mesenchymal features.

Knockdown of the Premature Ovarian Insufficiency Candidate Gene NUP107 in Ovarian Granulosa Cells Affects Cell Functions, Including Receptor Expression and Estrogen Synthesis

Objective:Mutations in NUP107 have been discovered in patients with premature ovarian insufficiency and may have tissue-specific effects in ovarian development.However,the role of NUP107 in human granulosa cell(GC)function and female fertility still remains unknown.In this study,we used RNA interference to investigate how NUP107 dysfunction influences GCs and ovarian development.Methods:Immunohistochemical staining was used to detect the expression of NUP107 in ovaries.Cell counting kit-8 assay,real-time cell analysis,and flow cytometry were used to explore cell proliferation and apoptosis,and an enzyme-linked immunosorbent assay was used to assess the estrogen concentrations.Quantitative real-time reverse transcription-quantitative polymerase chain reaction and Western blot analyses were used to determine the expression of NUP107 and functional receptors.Results:Knockdown of NUP107 expression had little effect on the growth and number of GCs.Further study confirmed that knockdown of NUP107 may interfere with estrogen synthesis in GCs and their sensitivity to the regulation of follicle-stimulating hormone(FSH)by decreasing the expression of estrogen synthesis-related genes AR,CYP17A1,CYP19A1,STAR,and NR5A1.Moreover,knockdown of NUP107 decreased the expression of AMHR2,FSHR,LHR,and ESR1 in GCs,but had no effect on the expression of ESR2.Conclusions:These data revealed that NUP107 may impede follicle growth and maturation by regulating hormone synthesis,sensitivity to follicle-stimulating hormone,and expression of functional receptors in GCs,and may,therefore,interfere with female fertility.

Apoptosis and Expression of Protein TRAIL in Granulosa Cells of Rats with Polycystic Ovarian Syndrome

The relationship between apoptosis of granulosa cells and follicle development arrest in polycystic ovarian syndrome (PCOS) rats, and the contribution of tumor necrosis factor related apoptosis inducing ligand (TRAIL) in apoptosis of granulosa cells were explored. By using sodium prasterone sulfate rat PCOS model was induced. The apoptosis of granulosa cells in ovaries of rats was observed by TdT-mediated dUTP-biotin nick end-labeling (TUNEL), and the expression of TRAIL protein and mRNA in granulosa cells was detected by using immunhistochemical staining and reverse transcription polymerase chain reaction (RT-PCR) respectively. The apoptotic rate and the expression of protein TRAIL in granulosa cells were significantly higher in antral follicles from the PCOS rats than in those from the control rats (P<0.01, P<0.05). There was no significant difference in apoptotic rate and the expression of TRAIL protein in granulosa cells of preantral follicles between the PCOS rats and the control rats (P>0.05). No apoptosis and the expression of TRAIL protein in granulosa cells of primordial follicles were found in the two groups. The expression of TRAIL mRNA was significantly stronger in granulosa cells from the PCOS rats than in those from the con- trol rats (P<0.01). It was suggested that the apoptotic rate in granulosa cells was significantly higher in antral follicle from the PCOS rats than in those from the control rats. TRAIL played a role in regu- lating the apoptosis of granulosa cells in PCOS rats.

Ovarian Follicle Disaggregation to Assess Granulosa Cell Viability

Background: Mammalian ovaries contain follicles containing an oocyte enclosed by layers of granulosa cells (GC). Follicle growth and oocyte maturation are largely dependent on GC numbers and viability, but there is no established, reliable method for assessing the number of viable GC within an isolated follicle. Methods: Centrifugation conditions and the Trypan Blue (TB) Exclusion assay were optimised for low cell densities compatible with the numbers of GC in follicles. Mouse ovarian follicles were disaggregated to produce a single cell suspension of GC which were examined by TB (n = 4), but also by crystal violet assay in a 96-well plate format after 24 h in vitro (n = 3). GC viability in vitro was characterised further by using enzyme-linked immunoassays to quantify GC production of anti-Mullerian hormone (AMH) and estrogen. Results: The centrifugation and low cell density TB protocol could accurately measure the viability of 78 GC in 10 &mu;L, with an intra-assay coefficient of variation (CoV) 22%, and inter-assay CoV 7%. The best follicle disaggregation method (30 min 37°C exposure to 2 mg/mL collagenase prior to 30 min exposure to 0.025% hyaluronidase) yielded (656 &plusmn;87) GC per antral follicle of which 82% &plusmn;5% were viable. Culturing 312 - 20,000 GC per well for 24 hours and assessing viability by crystal violet assay generated a linear correlation between OD value and viable GC number (R2 = 0.98) and estrogen concentration per well (R2 = 0.92). 20,000 GC per well produced 143 &plusmn;16 pg/mL estrogen during 24 hours in vitro, but no detectable AMH. Conclusion: This is the first report describing the isolation of viable, estrogen-producing GC from murine follicles, and their subsequent culture. These procedures are transferrable to other species including humans and can be applied to screening the reproductive toxicity of pharmaceutical agents.

干细胞抗卵巢颗粒细胞衰老的作用机制及进展

背景:干细胞疗法作为一种新兴的治疗手段,有望改善卵巢环境,延缓卵巢颗粒细胞的衰老,为高龄妊娠女性带来新的希望。目的:综述干细胞抗卵巢颗粒细胞衰老的机制及研究进展。方法:检索中国知网和PubMed数据库中关于干细胞抗卵巢颗粒细胞衰老的文献,以“干细胞,卵巢颗粒细胞,衰老”为中文检索词,以“stem cells,ovary granulosa cells,aging”为英文检索词,最终纳入67篇文献进行分析。结果与结论:①总结了5种卵巢颗粒细胞衰老的机制:DNA损伤和修复能力下降、氧化应激、线粒体功能受损、炎症反应、激素水平变化;②整理了当前干细胞治疗卵巢颗粒细胞衰老的5种机制:促进增殖和抑制凋亡、分化潜能及再生能力、分泌因子、抗氧化、抗炎症反应和免疫调节;③目前有多种类型的干细胞可通过多种方式协同治疗卵巢颗粒细胞衰老,干细胞疗法在恢复女性生育能力方面具有广阔前景。

THE MODIFIED RADIOIMMUNOASSAY OF SERUM INHIBIN AND ITS VALUE IN MONITORING OVARIAN TUMOR

Objectives and Methods: A modified radioimmunoassay (RIA) of serum inhibin (INH) was developed and applied to measure serum INH contents in 39 fertile and 16 postmenopausal women. Thirty-three cases of ovarian tumors, including granulosa cell tumors and other kinds of ovarian tumors, were monitored by serum INH RIA. Results: The mean value of serum INH contents in follicular, peri-ovulatory and mid-luteal phases of fertile women were 9.48±7.10 pg/ml (2.04～18.53pg/ml), 19.04±9.73 pg/ml (3.49～33.26 pg/ml) and 131.13±110.81 pg/ml (3.49～ 341.10 pg/ml), respectively. Serum INH concentration was negatively correlated with serum FSH concentration, (rs=?0.483,P<0.01). Serum IHN contents were less than 3.6 pg/ml in normal postmenopausal women. The mean value of serum INH contents in ovarian granulosa cell tumor, thecoma, mucinous cystadenocarcinoma and malignant teratoma cases were significantly higher than that of other ovarian tumors, (P<0.01). Serum INH contents were elevated in ovarian granulosa cell tumor, thecoma, mucinous cystadenocaricinoma and endometrioid carcinoma cases with serum CA-125 values in normal range before operation, but serum INH contents decreased to normal range within one week after operation. And consecutive serum INH RIA could be a valuable tool in monitoring for therapeutic effect. Conclusion: Modified INH RIA was of convenient, time-saving and quantitative characteristics, especially with its high sensitivity (<1 pg/ml). There was a regular change of serum INH concentrations during menstrual cycle. INH could inhibit the synthesis and secretion of follicle stimulating hormone (FSH). INH would become a valuable marker for ovarian tumor. INH RIA combined with the measurement of serum CA-125 would be helpful to the early diagnosis, treatment and follow-up for ovarian cancer.

Ovarian Sex Cord-Stromal Tumors in Postmenopausal Women and Total Laparoscopical Management

BACKGROUND: Ovarian sex-cord stromal tumors (SCST) take up 5% of the ovarian neoplasm and may develop in?to?an ovarian mass or a haemoperitoneum. The surgical management of SCST in early-stage adult patients is not well?defined. CASE REPORT: A 69 year-old postmenopausal woman was admitted for metrorrhagia, a right ovary mass and?increasing pelvic pain. Preoperative clinical and instrumental examination suspected an ovarian tumor, and the?laparoscopic right ophorectomy and the frozen section suggested an ovarian SCST. To fast restore and preserve woman?integrity, total laparoscopic hysterectomy (TLH) plus left salpingo-ophorectomy (SO) were performed, without complications?in the short and long term follow-up. CONCLUSION: In the authors’ opinion, the minimally invasive management?of SCST by TLH plus bilateral SO followed by a prolonged surveillance and without intensive surgical staging,?could be an appropriate clinical and surgical choice in elder patient at early stage, since these tumors are slow at?growth, recurring locally and only a long time after initial treatment. We suggest, after a minimally invasive treatment,?a possible “wait and see” option, as in our case report.

微RNA-93-5p对多囊卵巢综合征患者卵巢颗粒细胞增殖的影响及机制

目的探讨血浆微RNA(miR)-93-5p对多囊卵巢综合征(PCOS)患者卵巢颗粒细胞增殖的影响及其可能机制。方法选择2022年1月至2023年1月焦作市人民医院收治的120例育龄期PCOS患者为PCOS组,选择同期在本院体检的18例育龄期健康女性为对照组。收集2组受试者的年龄、体质量和身高,计算体质量指数(BMI)。2组受试者均在自然月经周期的卵泡期或黄体酮诱导的撤退性出血期采集空腹静脉血,采用电化学法测定血清黄体生成素(LH)、促卵泡激素(FSH)、总睾酮(TT)、抗米勒管激素(AMH)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、空腹胰岛素(FINS)、空腹血糖(FBG)水平,并计算胰岛素抵抗稳态模型(HOMA-IR);采用实时荧光定量聚合酶链反应(qRT-PCR)检测2组受试者血浆中miR-93-5p表达水平。取对数生长期人卵巢颗粒细胞KGN,以每孔3×10^(5)个细胞接种至6孔板中,随机分为miR-93-5p mimics组、LY294002+miR-93-5p组、AZD5363+miR-93-5p组、阴性对照(NC)组、空白对照组。miR-93-5p组KGN细胞转染miR-93-5p mimics;LY294002+miR-93-5p组KGN细胞转染miR-93-5p mimics,并于转染前1 h给予50 mmol·L^(-1) LY294002处理;AZD5363+miR-93-5p组KGN细胞转染miR-93-5p mimics,并于转染前1 h给予50μmol·L^(-1) AZD5363处理;NC组KGN细胞转染阴性对照质粒;空白对照组KGN细胞不做任何处理。应用qRT-PCR法检测各组KGN细胞中miR-93-5p表达,细胞计数试剂盒-8试验检测各组KGN细胞增殖情况。结果PCOS组与对照组受试者的年龄及FSH、ALT、AST水平比较差异无统计学意义(P>0.05);PCOS组患者的BMI、TT、AMH、LH、FINS、FBG、HOMA-IR显著高于对照组(P<0.05)。PCOS组患者血浆中miR-93-5p相对表达量显著高于对照组(t=-5.549,P<0.001)。miR-93-5p与TT、FINS、HOMA-IR呈中度正相关(r=0.434、0.622、0.586,P<0.001),与FBG和LH呈低度正相关(r=0.398、0.398,P<0.001)。ROC曲线显示,血浆miR-93-5p诊断PCOS的最佳临界值为1.380,曲线下面积为0.906(95%置信区间:0.839~0.973,P<0.001),敏感度为0.858,特异度为0.833,约登指数为0.691。miR-93-5p mimics组、LY294002+miR-93-5p组、AZD5363+miR-93-5p组KGN细胞中miR-93-5p相对表达量均显著高于空白对照组和NC组(P<0.05)。培养24、48、72 h时,miR-93-5p mimics组、LY294002+miR-93-5p组、AZD5363+miR-93-5p组KGN细胞的增殖能力显著高于空白对照组和NC组(P<0.05);LY294002+miR-93-5p组、AZD5363+miR-93-5p组细胞的增殖能力显著低于miR-93-5p mimics组(P<0.05)。结论PCOS患者血浆miR-93-5p呈过表达,miR-93-5p可能通过基于调控磷脂酰肌醇-3-激酶/蛋白激B信号通路介导PCOS卵巢颗粒细胞增殖来参与PCOS的发生发展,血浆miR-93-5p水平对PCOS有一定的诊断价值。

miR⁃7靶向调控CTSK对贵州黑山羊卵巢颗粒细胞增殖和迁移的影响

【目的】探明miR⁃7与CTSK基因相互作用关系及其对贵州黑山羊卵巢颗粒细胞增殖和凋亡的影响,为贵州黑山羊优良品种保藏、选育与开发利用提供依据。【方法】采用在线数据库筛选miR⁃7与CTSK基因3′UTR的结合靶点,通过将CTSK基因3′UTR插入双荧光素酶报告系统中进行互作位点检测;采用CCK⁃8和划痕试验检测miR⁃7是否靶向调控CTSK基因影响贵州黑山羊卵巢颗粒细胞的增殖和迁移;过表达miR⁃7后采用RT⁃qPCR检测其对促增殖蛋白PCNA、抗凋亡蛋白BCL2和促凋亡相关蛋白BAX、caspase⁃3、caspase⁃9表达水平的影响。【结果】成功构建CTSK基因3′⁃UTR 2个预测靶点的野生型和突变型双荧光素酶报告载体;双荧光素酶试验结果表明CTSK基因3′UTR区的2个预测靶位点均受miR⁃7调控;CCK⁃8和细胞划痕结果表明,转染miR⁃7试验组的卵巢颗粒细胞增殖和迁移能力均显著高于对照(NC)组;RT⁃qPCR结果表明,上调miR⁃7能极显著上调PCNA和BCL2的表达,抑制BAX、caspase⁃3和caspase⁃9的表达。【结论】miR⁃7可以靶向结合CTSK的3′UTR区2个靶位点并极显著抑制CTSK基因的表达;过表达miR⁃7可以显著促进贵州黑山羊卵巢颗粒细胞增殖和迁移能力,并促进增殖标志基因、抗凋亡基因的表达和抑制促凋亡相关基因的表达。研究结果可为进一步研究miR⁃7靶向调控CTSK表达影响贵州黑山羊繁殖性能的分子机制提供理论依据。

多囊卵巢综合征患者卵巢颗粒细胞miR-144-3p及其靶基因PTEN的表达及作用研究

目的探讨多囊卵巢综合征患者(polycystic ovary syndrome,PCOS)卵巢颗粒细胞miR-144-3p及其靶基因PTEN的表达及作用。方法选取2020年10月至2022年3月在淮安市妇幼保健院生殖医学科行IVF/ICSI治疗的20例PCOS患者作为研究对象即为PCOS组,选取行IVF/ICSI治疗的输卵管因素或男方因素患者20例作为对照组。收集两组患者颗粒细胞,并分析颗粒细胞miR-144-3p的表达情况。利用Tar-getScan数据库预测miR-144-3p的靶基因,并采用双荧光素酶活性检测验证靶基因。复苏人卵巢颗粒细胞(ovarian granulosa cells,KGN),转染并建立miR-144-3p模拟物组、模拟物阴性对照组、miR-144-3p抑制物组、抑制物阴性对照组、si-PTEN和siRNA-NC组。采用流式细胞仪检测各组的细胞凋亡情况,RT-PCR及蛋白质印迹技术检测颗粒细胞中miR-144-3p、PTEN mRNA及蛋白的表达情况。结果RT-PCR结果显示P-COS组miR-144-3p表达水平显著低于对照组(P<0.05),流式细胞仪检测结果显示miR-144-3p mimic组的颗粒细胞凋亡百分比显著低于mimic-NC组(P<0.05),miR-144-3p inhibitor组颗粒细胞凋亡水平显著高于inhibitor-NC组(P<0.05)。生物信息学预测miR-144-3p的靶基因为PTEN,荧光素酶结合实验证实miR-144-3p能特异结合PTEN-3′UTR并下调PTEN基因表达。RT-PCR测定结果显示PCOS组PTEN mRNA表达显著高于对照组(P<0.05),且与miR-144-3p表达水平呈负相关(r=-0.91,P<0.001)。qRT-PCR及蛋白质印迹检测结果显示与mimic NC组相比,miR-144-3p mimic组中PTEN mRNA及蛋白表达量显著低于mimic NC组(P<0.05)。miR-144-3p inhibitor组PTEN mRNA及蛋白表达量显著高于inhibitor NC组(P<0.05)。流式细胞仪检测结果显示si-PTEN组颗粒细胞凋亡水平显著低于siRNA-NC组(P<0.05),而miR-144-3p inhibitor+si-PTEN组的颗粒细胞凋亡比例显著低于miR-144-3p inhibitor组(P<0.05)。结论PCOS患者卵巢颗粒细胞miR-144-3p表达水平显著降低,而PTEN基因表达水平显著增高,进而促进PCOS患者卵巢颗粒细胞凋亡。

DENND1A desensitizes granulosa cells to FSH by arresting intracellular FSHR transportation

Polycystic ovary syndrome(PCOS)is a complex disorder.Genome-wide association studies(GWAS)have identified several genes associated with this condition,including DENND1A.DENND1A encodes a clathrin-binding protein that functions as a guanine nucleotide exchange factor involved in vesicular transport.However,the specific role of DENND1A in reproductive hormone abnormalities and follicle development disorders in PCOS remain poorly understood.In this study,we investigated DENND1A expression in ovarian granulosa cells(GCs)from PCOS patients and its correlation with hormones.Our results revealed an upregulation of DENND1A expression in GCs from PCOS cases,which was positively correlated with testosterone levels.To further explore the functional implications of DENND1A,we generated a transgenic mouse model overexpressing Dennd1a(TG mice).These TG mice exhibited subfertility,irregular estrous cycles,and increased testosterone production following PMSG stimulation.Additionally,the TG mice displayed diminished responsiveness to FSH,characterized by smaller ovary size,less well-developed follicles,and abnormal expressions of FSH-priming genes.Mechanistically,we found that Dennd1a overexpression disrupted the intracellular trafficking of follicle stimulating hormone receptor(FSHR),promoting its internalization and inhibiting recycling.These findings shed light on the reproductive role of DENND1A and uncover the underlying mechanisms,thereby contributing valuable insights into the pathogenesis of PCOS and providing potential avenues for drug design in PCOS treatment.

蒲公英提取物通过抗凋亡作用治疗卵巢功能减退的机制研究

目的研究蒲公英提取物(T1口服液)对于卵巢功能减退的治疗作用,并初步探讨其机制。方法以绝经过渡期健康雌性小鼠为卵巢功能衰退的研究对象,青年雌性小鼠作为阳性对照,观察绝经过渡期小鼠饲养蒲公英提取物30 d后,卵巢窦状卵泡(AFC)的数量变化。同时培养人卵巢颗粒细胞系(KGN细胞),利用流式细胞技术、TUNEL法和细胞凋亡PCR芯片,比较蒲公英提取物孵育前后,KGN细胞的凋亡改变及差异性表达的基因。结果经蒲公英提取物饲养的绝经过渡期小鼠,卵巢窦状卵泡数量显著高于对照组(P<0.01)。且蒲公英提取物孵育后,KGN细胞凋亡率显著低于对照组(P<0.05)。细胞凋亡PCR芯片筛选出差异性表达的20个下调基因和4个上调基因(P<0.05)。结论动物模型中,蒲公英提取物可有效治疗雌性小鼠的卵巢功能减退,其机制可能是通过降低卵巢颗粒细胞的凋亡率。

A Retrospective Study of Ovarian Sex Cord Stromal Tumors at the Egyptian National Cancer Institute

Background: Ovarian sex cord-stromal tumors are an uncommon heterogeneous group of tumors with different biological behaviors and clinico-patho- logic aspects. Aim of the Work: This study will review the clinico-pathologic aspects of sex-cord stromal ovarian tumors at the National Cancer Institute (NCI), Cairo University, Egypt, as well as their management and follow-up regarding disease free survival and overall survival. Patients and Methods: This retrospective study was conducted at the National Cancer Institute Cairo University, Egypt on female patients with ovarian sex cord stromal tumors in the period from January 2008 to December 2012 with a follow-up period of 24 to 84 months. The age of the patients, different clinical presentations, radiological findings, associated uterine bleeding (need for endometrial biopsy), pre-operative CA125 levels, surgical management done, different histopathological types, different biological behaviors, presence of ascites (and its correlation with the histopathology), Adjuvant chemotherapy (according to biological behavior and pathological type), and follow-up of non-benign cases for up to 84 months will all be documented and studied. Results: The mean age at presentation was 47.34;abdominal pain and mass were the commonest presentations 54.5% and 53.2% respectively;the main radiologic findings were a pelvic mass +/- ascites which had no correlation to the pathological type (p = 0.075). Endometrial hyperplasia and endometrial carcinoma were associated with 22% and 2.5% of cases respectively. Stages I and II represented 95% of patients with non-benign tumors (48 patients). Panhysterectomy +/- infracolic omentectomy or fertility sparing surgery were done in 70.1% and 29.9% of patients respectively. AGCTs were the commonest pathological type (49.4%). Adjuvant chemotherapy was given to 14 patients (46.7%) with non-benign tumors. 6 recurrences (20%) in 30 patients with non-benign tumors on regular follow-up were documented. The median of disease free survival (DFS) was 50.5 months. The median overall survival was 49.5 months. Conclusion: Ovarian SCSTs are uncommon neoplasms with different biological behaviors where AGCTs are the commonest among Egyptian females. Hormonal manifestations are uncommon where abnormal vaginal bleeding is the commonest one. The presence of ascitic fluid has no correlation with the pathological type of the tumor. Early stages (I and II) represented about 95% of non-benign tumors. Surgical management without lymphadenectomy +/- adjuvant chemotherapy is the main line of treatment at our institute. The OS was shorter than that documented in the literature. A small number of patients, reluctance of follow-up and unavailability of some patients’ data were the main drawbacks in this study.

多囊卵巢综合征患者程序性细胞死亡因子4表达及睾酮与胚胎质量相关性研究

目的:探讨控制性超促排卵(COH)中多囊卵巢综合征(PCOS)患者卵巢颗粒细胞中程序性细胞死亡因子4(PDCD4)表达及睾酮的临床意义。方法:选取于枣庄市妇幼保健院生殖遗传中心行体外受精-胚胎移植(IVF-ET)助孕的COH周期PCOS患者(28例)和非PCOS患者(40例),经阴道超声引导下取卵后,收集卵泡液及卵丘周围颗粒细胞,提取RNA,逆转录后应用实时定量PCR检测PDCD4表达情况,分析PDCD4表达及睾酮与胚胎质量的相关性。结果:PCOS组和非PCOS组患者的年龄、不孕年限、体质量指数(BMI)、基础FSH、E_(2)、PRL和睾酮比较,差异均无统计学意义(P>0.05)。两组的正常受精率、卵裂率、优胚率、可用胚率和卵母细胞利用率比较,差异均无统计学意义(P>0.05)。PCOS组的PDCD4表达略高于非PCOS组,但差异无统计学意义(P>0.05)。低可用胚组的PDCD4表达高于正常可用胚组(P=0.04)。高睾酮水平组的正常受精率(P=0.00007)和卵母细胞利用率(P=0.038)低于低睾酮水平组。结论:COH中卵巢颗粒细胞PDCD4表达增高与低可用胚率相关,睾酮水平与受精率和卵母细胞利用率密切相关,睾酮水平升高,受精率和卵母细胞利用率降低。

猪卵泡液外泌体处理卵巢颗粒细胞的SNP/Indel筛选分析

旨在分析卵泡液外泌体对卵巢颗粒细胞基因的影响,了解卵泡液外泌体在卵泡发育过程中的调控机理,为母猪繁殖研究提供理论依据。本研究选取6月龄、健康状态良好且体重相近的二元母猪为材料,屠宰后收集卵巢150枚,利用梯度离心法获取卵泡液外泌体与猪卵巢颗粒细胞(porcine ovarian granulosa cells,POGCs),并在体外将卵泡液外泌体与猪卵巢颗粒细胞共培养。通过RNA-seq技术对猪卵巢颗粒细胞(granulosa cell samples,GC,n=3)和与外泌体共培养的猪卵巢颗粒细胞(granulosa-exosome co-culture samples,GCE,n=3)进行测序。结果显示,在GC和GCE组中平均每个样品获得5.54×10^(7)条clean reads,Q20和Q30质量得分均在92%以上。在GC和GCE组的6个样品中共获得1310979个SNPs突变和104498个InDel突变,其中纯合型SNP/Indel突变数量为170426个,杂合型SNP/Indel突变数量为1245052个,突变杂合子数目明显高于纯合子且SNP的发生率较高。另外,在突变类型中,转换类型共计973003个,颠换类型339974个,转换的类型显著高于颠换类型。经基因注释,突变主要发生在基因3′UTR、5′UTR、内含子区域,其次为外显子和基因间隔区。另外,通过与差异基因对比后,够筛选出1583个候选基因,经GO和KEGG功能富集发现,候选基因主要与细胞周期以及细胞增殖/凋亡过程相关。此外,共发现14个与细胞周期、增殖/凋亡通路相关的关键候选基因,其中11个基因存在互作关系。本研究获得的这些SNP/Indel信息可为后续研究外泌体在母猪生殖上的调控奠定科学基础。

基于卵巢颗粒细胞功能探讨调周法治疗卵巢储备功能减退的临床研究

目的:基于卵巢颗粒细胞功能探讨中医药调周法对卵巢储备功能减退(diminished ovarian reserve,DOR)患者体内抗穆勒氏管激素(anti-mullerian hormone,AMH)水平的影响及临床疗效。方法:对60例DOR肾虚证患者给予中医药调周法治疗,观察治疗前后患者血清性激素各项水平[AMH、雌二醇(estradiol,E_(2))、黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle stimulating hormone,FSH)]和临床疗效。结果:治疗前后E_(2)、LH、FSH水平比较差异无统计学意义(P>0.05);治疗后AMH水平较治疗前升高(P<0.05),中医证候积分较治疗前减少(P<0.05),总有效率为86.7%(52/60);治疗期间均无明显不良反应。结论:中药调周法通过提高AMH、FSH水平来提升DOR肾虚证患者卵巢储备功能,调整月经周期,增加月经量,改善临床症状。

柚皮素下调RIP1-RIP3-MLKL信号通路抑制多囊卵巢综合征大鼠卵巢颗粒细胞凋亡

目的基于受体相互作用蛋白激酶(receptor interacting protein kinase,RIP)1-RIP3-混合谱系激酶结构域样蛋白(mixed lineage kinase domain-like proteins,MLKL)介导的细胞坏死性凋亡途径,探究柚皮素对多囊卵巢综合征(polycystic ovary syndrome,PCOS)大鼠卵巢颗粒细胞凋亡的影响。方法SD大鼠随机分为正常对照组、模型组、柚皮素组、RIP1抑制剂(Nec-1)组、RIP1-RIP3-MLKL坏死信号激活剂(Z-VAD-fmk)组、柚皮素+Z-VAD-fmk组,每组15只。ELISA法检测卵巢组织IL-1β、TNF-α水平;HE法观察卵巢形态;分离卵巢组织颗粒细胞,流式细胞术检测凋亡率及坏死率;免疫组化法检测卵巢组织磷酸化RIP1(p-RIP1)阳性表达;Western blot法检测RIP1-RIP3-MLKL途径相关蛋白表达。结果RIP1特异性抑制剂Nec-1和柚皮素可阻断RIP1磷酸化活化,抑制RIP1-RIP3-MLKL信号通路,并降低PCOS大鼠炎症水平,缓解卵巢颗粒细胞坏死及凋亡(P<0.05)。Z-VAD-fmk可促进RIP1-RIP3-MLKL途径活化,加重卵巢颗粒细胞凋亡,并部分减弱柚皮素的抗卵巢颗粒细胞凋亡作用(P<0.05)。结论柚皮素可能通过阻断RIP1-RIP3-MLKL介导的坏死性凋亡途径活化,抵抗PCOS大鼠卵巢颗粒细胞凋亡。

基于氧化应激探讨疏肝补肾法对卵巢早衰大鼠颗粒细胞凋亡的影响

目的:探讨疏肝补肾法对卵巢早衰大鼠颗粒细胞凋亡的作用机制。方法:将48只SD大鼠随机分为正常组、模型组、柴胡疏肝散合左归饮低剂量组、柴胡疏肝散合左归饮中剂量组、柴胡疏肝散合左归饮高剂量组、雌激素组,每组8只。除正常组外,其余大鼠腹腔注射环磷酰胺连续15 d建立卵巢早衰大鼠模型,同时采用慢性不可预知温和应激方式建立肝郁证模型,连续21 d。造模成功后,柴胡疏肝散合左归饮低、中、高剂量组分别灌服柴胡疏肝散合左归饮混悬液3.39 g·kg^(-1)、6.77 g·kg^(-1)、13.55 g·kg^(-1),雌激素组灌胃戊酸雌二醇(补佳乐)0.105 mg·kg^(-1),正常组和模型组灌胃等体积的灭菌水,连续干预3周。采集阴道脱落细胞监测大鼠动情周期变化,行为学检测肝郁证造模情况,HE染色观察卵巢组织病理学情况,ELISA法检测血清雌二醇(E_(2))、促卵泡激素(FSH)、抗缪勒管激素(AMH)、抑制素B(INHB)含量,TUNEL法检测卵巢颗粒细胞凋亡指数,q-PCR和Western Blot法检测卵巢组织Bcl-2、Bax、活性氧(ROS)、SOD-2 mRNA和蛋白表达量。结果:与正常组相比,模型组大鼠动情周期紊乱,卵巢组织结构不清晰,颗粒细胞层明显变薄,旷场实验移动总距离和蔗糖水消耗率降低(P<0.05,P<0.01),血清FSH水平升高,E_(2)、AMH、INHB水平显著降低(P<0.01),颗粒细胞凋亡指数升高(P<0.01),Bcl-2、SOD-2的mRNA和蛋白表达量降低,Bax的mRNA和蛋白表达量升高,ROS的mRNA表达量升高(P<0.05,P<0.01)。与模型组相比,各给药组卵巢组织病理形态和行为学实验结果有所改善,血清FSH水平降低,E_(2)、INHB水平升高(P<0.05,P<0.01),Bax、ROS的mRNA表达水平降低,柴胡疏肝散合左归饮中、高剂量组和雌激素组颗粒细胞凋亡指数降低(P<0.01)、Bcl-2蛋白表达水平升高,柴胡疏肝散合左归饮高剂量组和雌激素组Bax蛋白表达降低、SOD-2和Bcl-2的mRNA和蛋白表达升高(P<0.05,P<0.01)。与柴胡疏肝散合左归饮低剂量组相比,中剂量组INHB水平升高,高剂量组FSH降低、E_(2)升高、SOD-2的蛋白表达升高,中、高剂量组颗粒细胞凋亡指数降低(P<0.05,P<0.01)。与柴胡疏肝散合左归饮中剂量组相比,高剂量组E_(2)水平升高、Bax的mRNA表达水平降低(P<0.05)。结论:疏肝补肾法可能通过减轻氧化应激而降低颗粒细胞凋亡率,进而改善卵巢功能,且以高剂量组作用最佳。