Objective To assess the effectiveness and safety of traditional Chinese medicine（TCM）for women with diminished ovarian reserve（DOR）.Methods A literature search was conducted in eight electronic databases for rando...Objective To assess the effectiveness and safety of traditional Chinese medicine（TCM）for women with diminished ovarian reserve（DOR）.Methods A literature search was conducted in eight electronic databases for randomized controlled trials.Results Seventeen randomized controlled trials involving 1174 patients were included.Meta-analysis indicated that TCM was superior to Western medicine（WM）in reducing basal serum FSH level[MD=-1.70,95%CI（-2.63,-0.77）;P=0.0004]and FSH/LH（MD=-0.43,95%CI[-0.56,-0.30];P=0.0001）,and the effect was more obvious two months after the last treatment（MD=-4.60,95%CI[-6.26,-2.90],P〈0.000 01 and MD=-0.56,95%CI[-0.85,-0.28],P=0.0001）,and increasing antral follicle count（AFC）（MD=0.44,95%CI[0.04-0.83];P=0.03）.The review also revealed the positive role of CMM as an adjuvant to IVF-ET in improving pregnancy rate（PR=1.75,95%CI[1.25,2.46];P=0.001）.Conclusion TCM,with its unique way of replenishing the kidney,may provide an effective and safe alternative therapy to patients with DOR.展开更多
The endoplasmic reticulum （ER） is the principal organelle responsible for several specific cellular functions including synthesis and folding of secretory or membrane proteins, lipid metabolism, and Ca^2＋ storage. ...The endoplasmic reticulum （ER） is the principal organelle responsible for several specific cellular functions including synthesis and folding of secretory or membrane proteins, lipid metabolism, and Ca^2＋ storage. Different physiological as well as pathological stress conditions can, however, perturb ER homeostasis, giving rise to an accumulation of unfolded or misfolded proteins in the ER lumen, a condition termed ER stress. To deal with an increased folding demand, cells activate the unfolded protein response （UPR）, which is initially protective but can become detrimental if ER stress is severe and prolonged. Accumulating evidence demonstrates a link between the UPR and ovarian development and function, including follicular growth and maturation, follicular atresia, and corpus luteum biogenesis. Additionally, ER stress and the UPR may also play an important role in the ovary under pathological conditions. Understanding the molecular mechanisms related to the dual role of unfolded protein response in the ovarian physiology and pathology may reveal the pathogenesis of some reproductive endocrine diseases and provide a new guidance to improve the assisted reproductive technology. Here we review the current literature and discuss concepts and progress in understanding the UPR, and we also analyze the role of ER stress and the UPR in the ovary.展开更多
基金National Natural Science Foundation of China(81273791)
文摘Objective To assess the effectiveness and safety of traditional Chinese medicine（TCM）for women with diminished ovarian reserve（DOR）.Methods A literature search was conducted in eight electronic databases for randomized controlled trials.Results Seventeen randomized controlled trials involving 1174 patients were included.Meta-analysis indicated that TCM was superior to Western medicine（WM）in reducing basal serum FSH level[MD=-1.70,95%CI（-2.63,-0.77）;P=0.0004]and FSH/LH（MD=-0.43,95%CI[-0.56,-0.30];P=0.0001）,and the effect was more obvious two months after the last treatment（MD=-4.60,95%CI[-6.26,-2.90],P〈0.000 01 and MD=-0.56,95%CI[-0.85,-0.28],P=0.0001）,and increasing antral follicle count（AFC）（MD=0.44,95%CI[0.04-0.83];P=0.03）.The review also revealed the positive role of CMM as an adjuvant to IVF-ET in improving pregnancy rate（PR=1.75,95%CI[1.25,2.46];P=0.001）.Conclusion TCM,with its unique way of replenishing the kidney,may provide an effective and safe alternative therapy to patients with DOR.
基金This work was supported in part by the National Basic Research Program （973 Program） （No. 2014CB943203）, ＂Reproductive health and major birth defects prevention and control research＂ Key Special Fund （No. 2016YFC1000601）, the National Natural Science Foundation of China （Grant Nos.31371521 and 81571400）, Beijing Nova Program （xxjh2015011）, and Special Projects for Cultivation and Development of Science and Technology Innovation Base （No. Z151100001615023）.
文摘The endoplasmic reticulum （ER） is the principal organelle responsible for several specific cellular functions including synthesis and folding of secretory or membrane proteins, lipid metabolism, and Ca^2＋ storage. Different physiological as well as pathological stress conditions can, however, perturb ER homeostasis, giving rise to an accumulation of unfolded or misfolded proteins in the ER lumen, a condition termed ER stress. To deal with an increased folding demand, cells activate the unfolded protein response （UPR）, which is initially protective but can become detrimental if ER stress is severe and prolonged. Accumulating evidence demonstrates a link between the UPR and ovarian development and function, including follicular growth and maturation, follicular atresia, and corpus luteum biogenesis. Additionally, ER stress and the UPR may also play an important role in the ovary under pathological conditions. Understanding the molecular mechanisms related to the dual role of unfolded protein response in the ovarian physiology and pathology may reveal the pathogenesis of some reproductive endocrine diseases and provide a new guidance to improve the assisted reproductive technology. Here we review the current literature and discuss concepts and progress in understanding the UPR, and we also analyze the role of ER stress and the UPR in the ovary.
