An Intervention Study of Reproductive Tract Infections among Married Women of Reproductive Age in Shanghai

Objective To evaluate the impacts of reproductive tract infections （RTIs） intervention on RTIs-related knowledge, attitudes, practices and prevalence of married women at reproductive age. Methods Four sub-districts from Xuhui district, Shanghai were selected by multistage cluster random sampling and residence committees were randomly assigned to either an intervention group or a control one. RTIs intervention was implemented in intervention group, while routine family planning program was conducted in control group. Results Compared with control group, intervention group have improved the following targets： the increment of RTI knowledge score was higher than that in control group （OR=9. 22, 95%CI： 7.01 - 2.14）; the increment score of individual health behaviors （6. 31） was higher than that in control group （4.50） （OR=1.60, 95%CI： 1.21 -2.10）; the increase of condom use frequency in intervention group was higher than that in control group （4.12% vs 0.69%） （OR=1.84, 95%CI： 1.31-2.57）; the decreased RTIs rate was higher than that in control group （7.45% vs 0.96%） （OR=0.68, 95%CI： 0.49-0.95）. Conclusion It is an effective way to conduct community-based intervention to increase women＇s RTIs knowledge, improve RTIs-related attitudes, promote good individual health behaviors, so as to decrease RTIs prevalence.

Weighted gene co-expression network analysis identiffes potential regulators in response to Salmonella Enteritidis challenge in the reproductive tract of laying ducks

Salmonella Enteritidis(SE)is a zoonotic and vertically transmitted pathogen,often colonized in the reproductive tract of adult poultry,which can result in direct contamination of eggs and threaten human health.Previous studies have revealed that some pattern recognition receptors and resistance genes were involved in regulating immune responses to SE invasion in birds.However,the role of these immune response genes was not independent,and the interactions among the genes remained to be further investigated.In this study,SE burden and colonization were determined in reproductive tissue after the ducks were SE-infected,and RNA-sequencing was performed to construct co-expression networks by weighted gene co-expression network analysis(WGCNA).The result showed that SE could be isolated from 22% of infected-birds in any segment of the reproductive tract and the SE was readily colonized in the stroma,small follicle,isthmus,and vagina of the reproductive tracts in morbid ducks.The top central,highly connected genes were subsequently identified three specific modules in the above four tissues at the defined cut-offs(P<0.01),including 60 new candidate regulators and 125 transcription factors.Moreover,those 185 differentially expressed genes(DEGs)in these modules were co-expressed.Moreover,the hub genes(TRAF3,CXCR4 and IL13RA1)were identified to act with many other genes through immune response pathways including NF-kappaB,Toll-like receptor,steroid biosynthesis,and p53signaling pathways.These data provide references that will understand the immune regulatory relationships during SE infection,but also assist in the breeding of SE-resistant lines through potential biomarkers.

Etiopathogenesis of reproductive tract infections and the emerging role of bitter taste receptors:A scoping review

Reproductive tract infections pose an immense public health concern worldwide as over 600 million new cases are recorded annually along with several complications,including infertility,ectopic pregnancy,preterm delivery,and neonatal death.Despite improved understanding of the mechanisms of pathogenic invasion,the etiopathogenesis of reproductive tract infections is yet to be completely understood.Recent data has suggested a critical role of bitter taste receptors of the reproductive tract in etiopathogenesis of reproductive tract infections.Here,we review the literature on current etiopathogenesis of reproductive tract infections and the role of bitter taste receptors of the reproductive tract in etiopathogenesis of reproductive tract infections.Emerging evidence suggests a critical role of microbiota disorder of the reproductive tract in reproductive tract infections.Several bacterial,protozoan parasitic,helminthic parasitic and viral pathogens have been identified as causative agents of reproductive tract infections.These pathogens subvert host defenses and activate specific architectural units of the uroepithelium such as Toll-like receptors,which recognize conserved motifs on the pathogens.The activated Toll-like receptors mediate downstream signaling,stimulating nuclear factor-κB,which in turn activates the production of proinflammatory cytokines.This pathway is also associated with recruitment of immunocytes to the site of aggression and release of proteinases,which drive tissue damage in the reproductive tract.Defects in detection of pathogenic components by the bitter taste receptors of the reproductive tract may play a critical role in the etiopathogenesis of reproductive tract infections.This review provides important information for identification of novel frontiers for the treatment of reproductive tract infections.

Expression of Inflammatory Factors in Bovine Reproductive Tract During Follicular and Luteal Phases

In order to improve reproduvtive efficieny and understand reproduvtive defense mechanism, the oviduct, uterine horn and uterine body of bovine were used to detect the changes of inflammatory factors and the relationship between estrogen and progesterone receptor protein during estrous cycle by real-time PCR and Elisa method. The results showed that interleukin-4（IL-4）, interleukin-6（IL-6）, interleukin-10（IL-10）, interleukin-1α（IL-1α） and interleukin-1β（IL-1β） were expressed in cow oviduct, uterine horn and uterine body. In the follicular phase and the luteal phase, m RNA expression of five inflammatory factors in the uterine horn and uterine body was higher than that in the oviduct. In the follicular phase, IL-10 was highly expressed in the uterine horn and uterine body, IL-4 was highly expressed in the uterine horn, uterine body and oviduct. Additionally, in the luteal phase, IL-6 and IL-1β were highly expressed in the uterine horn, uterine body and oviduct, and the highest expression of IL-1β was observed in the uterine horn. The levels of Estrogen Receptor（ERα） protein in the oviduct, uterine horn and uterine body significantly increased in the follicular phase. The levels of Progesterone Receptor（PR） protein in the same portions of the reproductive tract in the luteal phase were significantly higher than those in the follicular phase. IL-4 and IL-10 in the cow reproductive tract might play a major role in the follicular phase, while IL-6 and IL-1β might play a major role in the luteal phase. The expression of five inflammatory factors was not directly regulated by ERα and PR.

Prevalence and risks of reproductive tract infections among women of urban slums in North India: A cross-sectional study

Objective:To identify the prevalence,determinants of reproductive tract infection,and healthcare seeking behavior among ever married women of reproductive age residing in an urban slum of Faridabad,Haryana,North India.Methods:This community based cross-sectional study was conducted among ever married women aged between 15 and 49 years insured under employees state insurance scheme and residing in an urban slum of Faridabad.Simple random sampling technique was used to interview 149 eligible women using a predesigned structured questionnaire.Study variables included sociodemographic profile,family planning methods,menstrual absorbent usage,and symptoms of reproductive tract infection.Binary logistic regression was used to investigate the determinants of reproductive tract infection.Results:Of the women,46.3%had at least one reproductive tract infection or sexually transmitted infection symptom and 28.9%among them sought treatment for the symptom.Vaginal discharge,itching(14.1%)and lower abdominal pain(30.2%)were the major symptoms reported.Non-usage of condoms as contraceptive was significantly associated with a higher rate of symptoms(50.4%vs.20.0%).Abortion had a significantly high odds of having reproductive tract infection symptoms(aOR 3.71,95%CI 1.59-8.62;P<0.01).Less frequent change in absorbent during menstruation was also reported to have a higher rate of symptoms.The majority of those who took treatment sought it from government or employees state insurance dispensary.2%also went to faith healers.Conclusions:Nearly half of the study population have reproductive tract infection symptom.Abortions and non-usage of condom increase the risk of reproductive tract infection.Menstrual hygiene and condom usage are the significant interventions,which may reduce the prevalence of these symptoms.

Impact of community strategy package on uptake of reproductive tract infections health services among young street females in the municipality of Eldoret,Kenya

Background:Despite the intervention of free medical care services for street children by a dedicated clinic in Eldoret municipality,health care service of young street females(YSFs)is still deficient.The present study aimed to evaluate the impact of the community strategy package on the uptake of reproductive tract infections(RTI)health services among the target population.Materials and methods:A pre-test-post-test quasi-experimental with a qualitative and quantitative approach was applied among the YSFs aged 10-24 years.The study used structured questionnaires and key informant interviews to collect data from the respondents.Results:The study enrolled a total of 77 young street females in Eldoret municipality.A significantly higher proportion of respondents reportedly first sought treatment for RTI at a health facility after the implementation of the community strategy package(97.1%)when compared to the proportion of respondents who first sought treatment at a health facility in the pre-intervention phase(51.0%)(p<0.001).Early seeking of treatment improved significantly after the introduction of the intervention;72.0%and 94.1%of the respondents sought treatment early during the pre-intervention and post-intervention phase,respectively(p<0.011).Conclusion:The study recommends the adoption of the community strategy as an intervention to increase the uptake of RTIs health services and promotion of the reproductive health of young street females.

Innate and adaptive immune responses in male and female reproductive tracts in homeostasis and following HIV infection

The male and female reproductive tracts are complex microenvironments that have diverse functional demands. The immune system in the reproductive tract has the demanding task of providing a protective environment for a fetal allograft while simultaneously conferring protection against potential pathogens. As such, it has evolved a unique set of adaptations, primarily under the influence of sex hormones, which make it distinct from other mucosal sites. Here, we discuss the various components of the immune system that are present in both the male and female reproductive tracts, including innate soluble factors and cells and humoral and cell-mediated adaptive immunity under homeostatic conditions. We review the evidence showing unique phenotypic and functional characteristics of immune cells and responses in the male and female reproductive tracts that exhibit compartmentalization from systemic immunity and discuss how these features are influenced by sex hormones. We also examine the interactions among the reproductive tract, sex hormones and immune responses following HIV-1 infection. An improved understanding of the unique characteristics of the male and female reproductive tracts will provide insights into improving clinical treatments of the immunological causes of infertility and the design of prophylactic interventions for the prevention of sexually transmitted infections.

Intimate hygiene practices and reproductive tract infections: A systematic review

Introduction:Worldwide,women perform a variety of vaginal practices to enhance their intimate hygiene and sexual health.Objective:To conduct a systematic review to assess the different kinds of intimate hygiene practices and their association with reproductive tract infections and complications.Methods:PubMed,Medline and The Cochrane Library were used.Both observational and interventional studies targeting the urogenital infections and their association with hygiene practices were included.Exclusion criteria included studies that assessed the knowledge and attitudes towards intimate hygiene practices rather than their relation to infections.The design of this systematic review complied with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis(PRISMA).Results:Fifteen articles were included.Intravaginal practices were found to be associated with reproductive tract infections.Reusable absorbent material used during menstruation increased the risk of Candida infection with an adjusted proportional reported ratio(aPRR)of 1.54(95%CI 1.2–2.0),but no association with bacterial vaginosis or trichomonas vaginalis infection was noted.Bathing or vaginal washing during menstruation with water only showed a higher association with symptoms of urogenital infections when compared with washing with both soap and water during menstruation.Drying reusable pads inside the house and storing them inside the toilet was found to be associated with a higher candida infection prevalence.Moreover,bathing in sitting position during menstruation,not drying the genital area or using cloth for drying it,and not paying attention to hand washing,were all associated with a higher risk of genital infections.Finally,postpartum use of native homemade vaginal preparations might be a risk factor for ascending vaginal infections,and the use of inappropriate material for menstrual blood absorption was associated with secondary infertility.Conclusion:Several hygiene practices put women at higher risk for reproductive tract infections.We should continue to increase awareness to counter the misinformation resulting from marketing campaigns and common misconceptions.

Human ribonuclease 9,a member of ribonuclease A superfamily,specifically expressed in epididymis,is a novel sperm-binding protein

To explore the functions of human ribonuclease 9(RNase 9),we constructed a mammalian fusion expression vector pcDNA-hRNase9,prepared recombinant human RNase 9-His fusion protein from HEK293T cells and determined its N-terminal amino acid sequences.According to the determined mature protein,recombinant human RNase 9 was prepared in E.coli.Ribonucleolytic activity and antibacterial activity of recombinant human RNase 9 were detected,and the distribution of human RNase 9 on tissues and ejaculated spermatozoa and in vitro capacitated spermatozoa were analyzed via indirect immunofluorescence assay.The results showed that recombinant human RNase 9 did not exhibit detectable ribonucleolytic activity against yeast tRNA,but exhibited antibacterial activity,in a concentration/time dependent manner,against E.coli.Immunofluorescent analyses showed that the predicted human RNase 9 was present throughout the epididymis,but not present in other tissues examined,and human RNase 9 was also present on the entire head and neck regions of human ejaculated spermatozoa and in vitro capacitated spermatozoa.These results suggest that human RNase 9 may play roles in host defense of male reproductive tract.

Current Situations of the Integration of RTIs Prevention and Treatment into Routine FP Program

Objective To understand the current situation of the integration of reproductive tract infections （RTIs） prevention and treatment into routine Family planning （FP） program. Methods Literature review, in depth interview and focus group discussion were employed to collect the related information. Questionnaire survey was conducted in 59 county level FP facilities. Results Both central and local governments provide policy supports to RTIs prevention and treatment. Nearly 98.3% of local FP facilities had integrated this work into their routine FP program. A comprehensive network system of family planning has been established in China and there were plenty of FP human resources. The existing FP resource should be effectively used, which could produce great social benefit if RTIs prevention and treatment be integrated into routine FP program. However, some problems still need to be solved in the integrated program, such as insufficient finance support, low quality of service, lack of co-operations between different sectors, etc. Conclusion It is possible and feasible to develop RTIs controlling projects in the family planning system. However, intensive training and close cooperation need to be applied respectively into FP staffs and relative departments.

Analysis of Vagina Microecology and Investigation of Common Infection in Border Area of Chongzuo City

Objective: To investigate the microecology and common infection of the female vagina in border area of Chongzuo City. Methods: Female patients in the outpatient department and inpatient department of gynecology of our hospital from April 1, 2018 to August 23, 2021 were selected as the research objects. The reproductive tract secretions of all patients were examined by microecological examination, morphological examination, chemical analysis and microscopic examination, and the results of various indicators were statistically analyzed to draw relevant conclusions. Results: Among the 1498 women with vaginal micro- ecological imbalances, cleanliness was determined to be 534 cases of degree II, 868 cases of degree III, and 96 cases of degree IV;Nugent scores were 9 - 10 in 9 cases, 8 in 122 cases, 7 in 30 cases, 6 in 18 cases, 5 in 8 cases, 4 in 717 cases, 3 in 248 cases, 2 in 209 cases, 1 in 118 cases, and 0 in 19 cases. AV scores were 8 in 1 case, 7 in 1 case, 6 in 2 cases, 5 in 9 cases, 4 in 84 cases, 3 in 207 cases, 2 in 850 cases, 1 in 284 cases, and 0 in 60 cases. Among the pathogen infections, 99 cases were mycoplasma, 361 cases were candida, 199 cases were bacterial and 8 cases were trichomonas;In chemical analysis, there were 138 cases with pH 5.1, 326 cases with pH 4.8, 775 cases with pH 4.6, 217 cases with pH 4.4, and 42 cases with pH 4.1;meanwhile, 1390 cases were positive for hydrogen peroxide, 505 cases were positive for glucosidase, 487 cases were positive for acetylglucosaminidase, 184 cases were positive for sialidase, 290 cases were positive for proline amino-peptidase, 501 cases were positive for coagulase, and 1064 cases were positive for leukocyte esterase. Conclusion: Female reproductive tract microecology is more complex, and the pathogens of infection are also diverse. A systematic examination can clarify the occurrence and development of the disease, and then provide reliable laboratory data for clinical treatment and guide clinical medication.

Socio-Demographic, Clinical, and Hygiene Profile of Syndromically Managed Sexually Transmitted Diseases: A Cross Sectional Study in a Tertiary Care Center in India

Background: Sexually transmitted diseases are one of the several major public health concerns, the burden of which is borne by low- and middle-income countries like India. Purpose: The purpose is to evaluate the relationship between menstrual and sanitary hygiene and sexually transmitted diseases (STD) based on syndromic diagnosis Methods: An out-patient department (OPD) based cross sectional survey to determine these associations, if any exist, which would help critically analyze syndromic management. STD was reported by the presence of vaginal/cervical/urethral discharge with or without irritation and itching, lower abdominal pain and ulcer. Results: The prevalence of STD was 66.84% with the most commonly reported symptoms being discharged (31.18%), followed by abdominal pain (17.92%) and itching/irritation (12.90%), with ulcer (4.83%) being the least reported symptom. Perimenopausal age ((AOR: 0.420 [CI: 0.189 - 0.915];p = 0.030), higher grades of education ((AOR: 0.228 [CI: 0.119 - 0.424];p < 0.001) for secondary), urban residency (AOR: 0.435 [CI: 0.686 - 2.733];p < 0.001), and contraception use (AOR: 0.531 [CI: 0.308 - 0.887];p = 0.018) were associated with lesser odds of presenting with an STD symptom. Belonging to a minority religious community (AOR: 7.20 [CI: 1.866 - 48.251];p < 0.012) or backward castes (AOR: 3.753 [CI: 1.587 - 10.144];p < 0.001), having similar illness (AOR: 4.205 [CI: 2.795 - 6.439];p < 0.001) or having an invasive gynecological procedure done in the past one year (AOR: 1.953 [CI: 1.184 - 3.295];p = 0.010) and washing the reusable sanitary material only with water (AOR: 4.900 [CI: 2.701 - 9.116];p < 0.001) as compared to washing it with water and soap, had a higher association with presenting with STD symptoms. Stratified analysis also showed that women presenting discharge (AOR: 2.049 [CI: 1.343 - 3.146] for vaginal and cervical;AOR: 1.426 [CI: 0.826 - 2.482] for urethral) were more likely to not have a toilet facility in an accessible condition. Women with sanitary napkin use had lesser odds (AOR: 0.780 [CI: 0.516 - 1.180];p = 0.293) of presentation for STD in OPD than women who used other material. Conclusion: To better manage the group of diseases that may present with symptoms of STD under syndromic approach, we propose interventions such as menstrual hygiene education and promotion of the use of sanitary napkins among women especially those belonging to lower socio-economic sections of the society.

Importance of sperm morphology during sperm transport and fertilization in mammals

After natural or artificial insemination, the spermatozoon starts a journey from the site of deposition to the place of fertilization. However, only a small subset of the spermatozoa deposited achieves their goal： to reach and fertilize the egg. Factors involved in controlling sperm transport and fertilization include the female reproductive tract environment, cell-cell interactions, gene expression, and phenotypic sperm traits. Some of the significant determinants of fertilization are known （i.e., motility or DNA status）, but many sperm traits are still indecipherable. One example is the influence of sperm dimensions and shape upon transport within the female genital tract towards the oocyte. Biophysical associations between sperm size and motility may influence the progression of spermatozoa through the female reproductive tract, but uncertainties remain concerning how sperm morphology influences the fertilization process, and whether only the sperm dimensions per se are involved. Moreover, such explanations do not allow the possibility that the female tract is capable of distinguishing fertile spermatozoa on the basis of their morphology, as seems to be the case with biochemical, molecular, and genetic properties. This review focuses on the influence of sperm size and shape in evolution and their putative role in sperm transport and selection within the uterus and the ability to fertilize the oocyte.