Effect of Yangjing Zhongyu Decoction (养精种玉汤) on MatrixMetalloproteinase-9 Expression in Endometrium and SexHormone Regulation in Women with Cryptogenic Infertility

Objective: To investigate the effect of Yangjing Zhongyu decoction (YZD, 养精种玉汤) on metalloproteinase-9 (MMP-9) and its inhibitor-1 (TIMP-1) expression and sex hormone regulation in mid-luteal phase endometrium of women with cryptogenic infertility. Methods: Twenty-two infertile women were treated with YZD for 30 days successively. During the mid-luteal phase, in situ hybridization and reverse transcription-polymerase chain reaction method was used to detect MMP-9 and TIMP-1 mRNA, and radioimmunoassay was used to determine levels of serum estradiol (E2) and progesterone (P) synchronously. Results: After treatment, the mid-luteal serum E2 and P level were 451. 501 ± 226. 342 pmol/L and 46. 502 ± 19. 948 nmol/L respectively, significantly higher than that before treatment (304.656 ± 135.853 pmol/L and 33. 782 ± 15. 459 nmol/L respectively) , the difference was significant ( P < 0. 01). Staining of MMP-9 mRNA positive granules in cytoplasm and nuclei of adeno-epithelial cell in mid-luteal phase endometrium deepened significantly, but the change in mesenchym was insignificant. The MMP-9 mRNA expression after treatment was 0.617 ± 0.186 (grey level), significantly higher than the level before treatment (0.490 ± 0. 370), comparison between them showed significant difference ( P < 0. 05 ) . Change of TIMP-1 mRNA expression in adeno-epithelial and mesenchym before and after treatment was insignificant (0. 588 ± 0. 191 vs 0. 621 ± 0. 146,P>0. 05). Correlation analysis showed that the quantitative difference of P level before and after treatment was positively correlated with the difference of MMP-9 mRNA before and after treatment (r=0. 682, P< 0.01). Conclusion: YZD could soothen Gan(肝) and nourish Shen(肾) , raise the level of mid-luteal phase serum P, and further promote MMP-9 gene expression in endometrium to benefit the degradation of extracellular matrix of endometrium, and facilitate for blastocyst implantation.Original article on CJITWM (Chin) 2004 ;24 (4): 294

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.

A Randomized Trial of Chinese Medicine Lirukang Granule(利乳康颗粒)Combined with Psychological Intervention for Cyclomastopathy and Menoxenia

ABSTRACT Objective： To observe the influence of therapy with Chinese medicine Lirukang Granule （利乳康颗粒 LRKG） combined with psychological intervention on anxiety states and sex hormones in patients with cyclomastopathy and menoxenia. Methods： A total of 470 subjects were randomly assigned to three groups by the net-central randomization system, the treatment group （161 patients, treated with LRKG and psychological intervention）, the Chinese medicine group （157 patients, treated with LRKG）, and the psychological intervention group （152 patients, treated with psychological intervention）. The dose of LRKG was 12 g three times per day; psychological intervention included establishing relations, cognitive intervention and psychological persuasion, 30-40 min per session, once a week. The therapy duration for all groups was three months. The efficacy was compared and anxiety state/State-Trait Anxiety Invertory （STAI） scoring was measured before and after treatment. The serum estradiol （E2）, progesterone （P）, prolactin （PRL） and follicle stimulating hormone （FSH） levels of 60 patients selected randomly from each group during the luteal phase were measured before and after treatment, and a group of 20 healthy women were evaluated for comparison. A follow-up was arranged for one year after treatment. Results： Thirty subjects were lost to follow-up. （1） Comparison of efficacy： the markedly effective rate and the total effective rate of the treatment group were 86.67% （131/150） and 98.00% （147/150）, respectively; of the Chinese medicine group, 64.58% （93/144） and 90.27% （130/144）, respectively; and of the psychological intervention group, 0% （0/146） and 3.42% （5/146）, respectively. The markedly effective rate and the total effective rate in the treatment group were significantly higher than those in the Chinese medicine and psychological intervention groups （P〈0.05）. （2） Comparison of STAI scoring： STAI scoring was decreased dramatically in the treatment group after treatment compared with that of the Chinese medicine group （P〈0.01）, but there was no significant difference compared with the psychological intervention group. （3） Comparison of levels of sex hormones： E2, P, PRL and FSH of the three patient groups were disordered before treatment, and significantly different from healthy women （/：＇〈0.01）. After treatment, the levels of P and FSH of the treatment group were significantly increased （P〈0.01）, E2 and PRL were significantly reduced, which were also significantly decreased compared with the psychological intervention groups （P〈0.01）. （4） Follow-up： the markedly effective rate and the total effective rate of the treatment group remained higher than those of the other two groups after one year of treatment （P〈0.05）. （5） Adverse reactions： no obvious adverse reactions were found among the three groups. Conclusions： Therapy with Chinese medicine combined with psychological intervention was effective for short-term and long-term treatment of cyclomastopathy and menoxenia. The mechanism might be