Risk Prediction Model for Surgical Treatment of Ruptured Corpus Luteum in the Ovary

Objective: To explore the related factors of surgical treatment of patients with corpus luteum rupture and establish a risk prediction model of surgical treatment of corpus luteum rupture. Methods: 222 patients with corpus luteum rupture treated in Jingzhou First People’s Hospital from January 2015 to March 2022 were analyzed retrospectively, including 45 cases of surgery and 177 cases of conservative treatment. The training set and validation set were randomly assigned according to 7:3. We collected the basic information, laboratory and ultrasonic examination data of 222 patients. Logistic regression analysis was used to determine the independent risk factors and combined predictors of surgical treatment of corpus luteum rupture. The risk prediction model was established and the nomogram was drawn. The discrimination and calibration of the prediction model were verified and evaluated by receiver operating characteristic (ROC) curve, calibration curve and Hosmer-Lemeshow goodness of fit test;Decision curve analysis (DCA) was used to evaluate the clinical effectiveness of the prediction model. Results: Univariate logistic regression showed that whole abdominal pain (OR: 2.314, 95% CI: 1.090 - 4.912), abdominal muscle tension (OR: 2.379, 95% CI: 1.112 - 5.089), adnexal mass ≥ 4 cm (OR: 3.926, 95% CI: 1.771 - 8.266), hemoglobin Conclusion: The nomogram prediction model containing three predictive variables (hemoglobin, depth of pelvic effusion under ultrasound and cervical lifting pain) can be used to predict the risk of surgical treatment in patients with corpus luteum rupture.

Observations on the Diagnostic Effects of CT Examination(Enhanced Scan)on Hemorrhage Corpus Luteum Cyst

Objective:To investigate the diagnostic effects of enhanced CT scan on hemorrhage corpus luteum cyst(HCLC).Methods:The clinical data of 24 patients with hemorrhage corpus luteum cyst diagnosed by surgery and pathology in our hospital were collected.All patients received enhanced CT scan to evaluate the diagnostic value of CT.Results:The average diameter of the cysts in this group of patients was 5.1cm by CT.Further detection of the ruptured cyst wall showed that there was a liquid lowdensity shadow.Some of the cysts were accompanied by signs of increased density,indicating the presence of blood clots;all patients received surgical treatment.Intraoperative ultrasound examination of the cysts had an average diameter of 5.2cm and a wall of 0.2~0.4mm.Among them,19 cases of cysts contained"coffee-colored"liquid with varying degrees of blood clots,and 5 cases had no blood clots in the cysts but there were a lot of blood clots beside the cysts.Conclusion:The application of enhanced CT scan in patients with hemorrhage corpus luteum cyst is of great value.It can provide accurate data reference for clinical treatment and is worthy of promoting its clinical application.

Ultrasonographic Monitoring of Previous Pregnant Corpus Luteum in Postpartum Cow

Sequential ultrasonograms of both ovaries were taken once a day in six postpartum Jersey cows with B-mode Ultrasound Scanner and the concentrations of progesterone in peripheral circulation of the cows were measured by radioimmunoassay (RIA). The whole texture of the previous pregnant corpus luteum was clearly identified during the process of its regressing. The ppCL could be identified for a mean of 17±12.96 days with a range of 4 to 42 days. There were no significant correlation between the time that the ppCL could be identified and both the times to the first postpartum ovulation and the peripheral progesterone concentration.

Temporal and spatial expression of MMP-2,-9,-14 and their inhibitors TIMP-1,-2,-3 in the corpus luteum of the cycling rhesus monkey

The corpus luteum(CL)is a transient endocrine organ that secretes progesterone to support early pregnancy.If implantation is unsuccessful,luteolysis is initiated.Extensive tissue re-modeling occurs during CL formation and luteolysis.In this study,we have studied the possible in-volvement of MMP-2,-9,-14,and their inhibitors,TIMP-1,-2,-3 in the CL of cycling rhesus monkey at various stages by in situ hybridization,immunohistochemistry and microscopic assessment.The re-sults showed that the MMP-2 mRNA and protein were mainly expressed in the endothelial cells at the early and middle stages of the CL development,while their expressions were observed in the luteal cells at the late stage during luteal regression.MMP-9 protein was detected in the CL at the early and middle stages,and obviously increased at the late stage.The expressions of MMP-14 and TIMP-1 mRNA were high at the early and late stages,and low at the middle stage.TIMP-2 mRNA was high throughout all the stages,the highest level could be observed at the late stage.The TIMP-3 produc-tion was detected throughout all the stages,but obviously declined during CL regression.MMP-9,-14 and TIMP-1,-2,-3 were mainly localized in the cytoplasm of the steroidogenic cells.The results suggest that the MMP/TIMP system is involved in regulation of CL development in the primate,and the coordinated expression of MMP-2,-14 and TIMP-1,-3 may have a potential role in the CL forma-tion and the functional maintaining,while the interaction of MMP-2,-9,-14 and TIMP-1,-2,-3 might also play a role in CL regression at the late stage of CL development in the primate.

Expression of Cystic Fibrosis Transmembrane Conductance Regulator in Rat Ovary

The protein expression of cystic fibrosis transmembrane conductance regulator （CFTR）, a cAMP-activated Cl- channel, in ovarian stimulated premature female rat ovary during a cycle of follicle development and corpus luteum formation was investigated. Animals were injected with 10 U pregnant Mare＇s serum gonadotropin （PMSG） and subsequently 10 U hCG 48 h later. Time-dependent immunohistochemistry and Western blotting experiments were performed before and 24, 48, 72 h after hCG treatment. The immunohistochemistry revealed that administration of PMSG stimulated the CFTR expression in thecal cell layer and granulosa cell layer of mature follicles 48 h post injection, coincident with the PMSG-induced peak in follicular estradiol. However, the expression of CFTR in the granulose lutein cell layer and thecal lutein cell layer was time-dependently reduced following hCG injection, in accordance with the gradually increased progestogen level during luteum corpus formation. Western blotting analysis demonstrated that rat ovarian tissue expressed the special CFTR band at 170 kD. It is concluded that cAMP-dependent Cl- channels are involved in regulation of follicle development and luteum formation.

Exacerbated conceptus signaling does not favor establishment of pregnancy in beef cattle

Background: Insufficient production of anti-luteolytic signals by the pre-attachment embryo is considered a major cause of pregnancy failure in cattle.We tested the hypothesis that transfer of multiple blastocysts(n = 5/recipient) and progesterone(P4) supplementation amplify anti-luteolytic signaling and reduce embryonic losses in beef cattle.Cows detected in estrus(D0; n = 104) were assigned randomly to receive 150 mg of injectable long-acting P4(iP4) or vehicle(non-iP4) on D4 and transcervical transfer of none or five,grade 1,not-frozen,in vitro-produced blastocysts,on D7.Luteal development and time of structural luteolysis were monitored by ultrasonography.Plasma P4 concentrations were determined on D4,D5 and D7,and daily between D14 and D20.Conceptus signaling was monitored by transcript abundance of interferon-stimulated gene 15(ISG15) in peripheral blood mononuclear cells isolated on D14,D16,D18 and D20.Early embryonic mortality(EEM) was defined as the absence of ISG15 m RNA upregulation over time and/or luteal regression up to D20.Late embryonic mortality(LEM) was defined as the absence of a conceptus with a heartbeat on pregnancy diagnosis at D30(PD30) after observing upregulation of ISG15 mRNA and extension of luteal lifespan.Pregnant cows presented conceptuses with heartbeat at PD30.Results: On D5,iP4-treated cows had P4 concentrations 2.07-fold greater than non-iP4 treated(P < 0.001).On D7,P4 concentrations were similar.Pregnant and LEM animals showed a progressive increase in the abundance of ISG15 from D14 to D20.iP4-treated cows detected pregnant at PD30 had 1.53-fold greater abundance of ISG15 mRNA between D14 and D20 than non-iP4 treated cows(P = 0.05).iP4 doubled the frequency of EEM while it did not affect LEM.At PD30,embryonic survival was 37.0% vs.55.6% for iP4-treated vs.control cows.Majority of pregnant cows(71%)presented only a single viable embryo.Conclusions: A substantial proportion of cows had EEM(31%) and LEM(20%) even after transferring multiple blastocysts.This argues that mortality was due to poor uterine receptivity that could not be reversed by supplemental P4 or overcome by transferring multiple blastocysts.Further,a given uterine environment was not necessarily adequate to all embryos.

Open Cows in a Beef Cattle Enterprise Managed in a Seasonal Breeding Program? An Appraisal of Their Reproductive Performance Based on Body Fat Reserves

A comparison between two distinct levels of back fat thickness in open cows, females not becoming pregnant during the previous breeding season, was carried out in order to evaluate their reproductive performance prior to the next natural mating in a seasonal breeding program. Thirty open cows from the previous breeding season were divided evenly by age and back fat thickness (BFT) in two groups. HBFT (high back fat thickness ≥ 70 mm) and LBFT (low back fat thickness ≤ 70 mm), values statistically different between groups (P < 0.05). The study was divided into three phases in which the formation of CL and follicular dynamics were recorded by ultrasound and progesterone. Also, serial monitoring of glucose, urea and triglycerides and back fat thickness were studied. A fertile bull previously approved from a breeding soundness evaluation was introduced after the third phase and remained with the herd for 90 days. No differences were found in the follicular dynamics;the number of animals cycling in the two groups and fertility were also similar (80%). Differences in urea and triglycerides were found in cows with high scores of BFT. In conclusion, the decision of keeping open cows to the next breeding season must be based on an economical advantage to the farmer.

Effect of Forskolin on Progesterone and Plasminogen Activator Secretion by Perfused Rat Corpora Lutea during Pseudopregnancy

Effects of forskolin on progesterone and plasminogen activator production in pseudopregnant ratcorpora lutea was investigated using isolated in vitro perfused ovaries.Progesterone andplasminogen activator production were measured on day 1,8 and 18 of hCG-inducedpseudopregnancy.The results indicated:different concentrations of forskolin(100,200,400 and800 μg)administered to ovaries on the 8th day of pseudopregnancy caused elevation of progesteronesecretion in a dose-dependent manner.After 8 hours of perfusion,PA contents increasedsignificantly in ovaries treated with forskolin.With exogenous PA-urokinase(800 U)added to theperfusion solution,progesterone secretion increased significantly as compared to control group andremained on high level throughout the perfusion period.Though exerting no apparent effects in lowdosage(5 mM),AMCHA,a PA inhibitor,administered in higher dosage(10 and 15 mM)led tomarked reduction in PA activity and progesterone secretion as compared to control group.Thusforskolin causes significant elevation of level of progesterone secretion and PA activity inpseudopregnant rat ovary perfused in vitro.And PA seems to regulate progesterone secretion in theperfused rat corpora luteum.

The Resumption of Ovarian Activity in Postpartum of Chinese-Holstein Cows

Ovarian activitly in 10 postpartum Chinese-Holstein cows was monitored by ultrasonography every other day, stared from day 3 postpartum and finished by the end of a normal ovarian cycle. Meanwhile, the concentrations of progesterone and 17β-oestradiol in peripheral plasma of the cows were measured by radioimmunoassay (RIA). The resutis showed that the first postpartum ovulation was found in 67% of the cows on the ovary opposed to the gravid horn. The first dominant foillicles ovulated for the six of ten cows. The time intervals from calving to the first ovulation were significantly associated with the number of follicular waves (r=0.83, P<0.01). No difference between the diameters of the first and the second ovulated follicles was found in the study, however, the growth rates of the first and the second ovulated follicles were significantly different (P<0.05), and the concentrations of 17β-oestradiol prior to the first ovulation were significantly lower than that before the second ovulation.

Dietary energy intake affects fetal survival and development during early and middle pregnancy in Large White and Meishan gilts

This experiment was designed to determine the effects of variations in dietary energy intake on reproductive performance and gene expression of luteal and endometrium tissues in Large White(LW)and Meishan(MS) gilts during early and middle pregnancy. After insemination, 32 LW gilts were assigned to high and low(HE_Land LE_L, 14.23 and 12.56 MJ DE/kg, respectively) diet treatment groups,while 32 MS gilts were allocated to HE_M and LE_M(12.56 and 10.88 MJ DE/kg) groups. Gilts were slaughtered on days 35, 55 and 90 of gestation. The fetal survival and luteal progesterone(P_4) concentration in the HE_Lgroup were higher on day 35 but lower on day 90 of gestation compared with the LE_L group(P < 0.05) for LW gilts. However, fetal survival and luteal P_4 concentration on day 35 of gestation were greater(P < 0.05) in the LE_M group than in the HE_M group for MS gilts, but no significant difference in mid-gestation was showed. The fetal weights of both breeds were higher for the high energy diets compared with the respective control group on day 90 of gestation(P < 0.05). In addition,the m RNA levels of P_4 synthesis-related proteins had correlated with luteal P_4 concentration in both breeds. Further, endometrial levels of uteroferrin(ACP5), retinol-binding protein 4(RBP_4) and secreted phosphoprotein 1(SPP1) m RNA were upregulated in the HE_Lgroup on day 35 of gestation but ACP5 and SPP1 were downregulated on day 55 of gestation compared with the LE_Lgroup(P < 0.05) for LW gilts. In MS gilts, diet only affected the expression of SPP1(P < 0.05). Our results revealed the differential sensitivity of LW and MS breeds to variations in dietary energy intake. For LW gilts, the HE_Lgroup improved fetal survival on day 35 but a sustained high energy diet decreased fetal survival on day 90 of gestation. The differences in dietary energy intake did not influence fetal survival on day 90 of gestation but the higher energy diet did increase fetal weight in the MS breed compared with the lower energy intake diet. These results may be due to differential luteal secretion activity and endometrium gene expression in these two breeds.

Effect of Acupuncture on Infertility Due to Luteal Phase Defect

Objective：To observe the effect of acupuncture for infertility due to luteal phase defect （LPD）.Method：Fifty cases were randomized into an acupuncture group （30 cases） and a medication （Clomiphene） group （20 cases）.High phase score （HPS） was adopted to evaluate the luteal function before and after treatments,coupled with observation on the changes of E 2,progesterone （P）,follicles and endometrium.Results：The total effective rate in the acupuncture group was 93.4%,versus 70.0% in the medication group,showing a significant difference （P〈0.05）.Conclusion：Both acupuncture and Clomiphene can substantially improve the luteal function;however,acupuncture can get a better effect in improving the endometrium and a lower miscarriage rate than Clomiphene.