Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological...Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological diseases have been widely explored.The glymphatic system is a fluid drainage and waste clearance pathway that utilizes perivascular space and aquaporin-4 protein located in the astrocyte endfeet to provide a space for exchange of cerebrospinal fluid and interstitial fluid.The intramural periarterial drainage pathway drives the flow of interstitial fluid through the capillary basement membrane and the arterial tunica media.Meningeal lymphatic vessels within the dura mater are involved in the removal of cerebral macromolecules and immune responses.After ischemic stroke,impairment of these systems could lead to cerebral edema,accumulation of toxic factors,and activation of neuroinflammation,while restoration of their normal functions can improve neurological outcomes.In this review,we summarize the basic concepts of these drainage systems,including drainage routes,physiological functions,regulatory mechanisms,and detection technologies.We also focus on the roles of lymphatic drainage systems in brain injury after ischemic stroke,as well as recent advances in therapeutic strategies targeting these drainage systems.These findings provide information for potential novel strategies for treatment of stroke.展开更多
Objective:Although consensus on the optimal endometrial preparation protocol for frozen-thawed embryo transfer(FET)is lacking,this is particularly true for patients with infertility and a history of endometrial polyps...Objective:Although consensus on the optimal endometrial preparation protocol for frozen-thawed embryo transfer(FET)is lacking,this is particularly true for patients with infertility and a history of endometrial polyps(EPs).In this study,we aimed to investigate whether a gonadotropin-releasing hormone agonist combined with hormone replacement therapy(GnRHa-HRT)could improve pregnancy outcomes in single euploid FET for patients with a history of EPs.Methods:In this retrospective cohort study,395 women who underwent their first single euploid FET cycle were divided into groups according to endometrial preparation protocols as follows:natural cycle(NC)(n=220),hormone replacement therapy(HRT)(n=122),and GnRHa-HRT groups(n=53).Subsequently,the FET cycles in the three groups were subdivided according to maternal age.All patients underwent hysteroscopic polypectomy before FET,and their EPs were confirmed by pathology.Results:No statistically significant differences were observed in live birth rates among the three groups(58.64%vs.58.20%vs.56.60%,P=0.964).Furthermore,the rates of miscarriage,ectopic pregnancy,premature live birth,and pregnancy complications were comparable among the three groups(P>0.05).After adjusting for potential confounding factors,no significant differences in pregnancy outcomes were reported between the groups(adjusted odds ratios[OR]and 95%credible intervals[CI]for live birth rate,HRTvs.NC:1.119,0.660–1.896,P=0.677;GnRHa-HRTvs.NC:1.165,0.610–2.226,P=0.643).Additionally,the pregnancy outcomes of the FET cycle were not influenced by the endometrial preparation protocols in the subgroups when stratified by maternal age(P>0.05).Conclusion:GnRHa-HRT did not improve the pregnancy outcomes of the single euploid FET in patients with a history of EPs.展开更多
Infertility seriously endangers the reproductive health of women at childbearing age.It is defined as the failure to achieve successful pregnancy after 1 year or more of regular unprotected intercourse.Broadly defined...Infertility seriously endangers the reproductive health of women at childbearing age.It is defined as the failure to achieve successful pregnancy after 1 year or more of regular unprotected intercourse.Broadly defined,infertility includes two aspects-failure to conceive or have a live birth.This guideline only addressed content relevant to the former.It was proposed by the gynecological endocrine group of the Chinese Society of Obstetrics and Gynecology,Chinese Medical Association,based on relevant guidelines of the World Health Organization,the American Society for Reproductive Medicine,the National Institute for Health and Clinical Excellence,as well as the clinical practice in China.The guideline was reviewed by experts and doctors from medical institutions at all levels,which is applicable to the diagnosis of infertility by physicians in obstetrics,gynecology,and andrology at various medical institutions nationwide.展开更多
Dear Editor, Klinefelter syndrome （KS） is the most frequent genetic cause of infertility in men. Paternity can be achieved through intracytoplasmic sperm injection （ICSI） with spermatozoa recovered from ejaculated...Dear Editor, Klinefelter syndrome （KS） is the most frequent genetic cause of infertility in men. Paternity can be achieved through intracytoplasmic sperm injection （ICSI） with spermatozoa recovered from ejaculated semen if exist, or testes with testicular sperm extraction （TESE）.展开更多
基金supported by the Natural Science Foundation of Beijing(Key Program)No.Z200025(to JHY)+1 种基金the National Natural Science Foundation of China,No.81873818(to LHQ)Supporting Platform Construction Project of Peking University Health Science Center,No.BMU2021ZC011(to JHY).
文摘Recent studies have proposed three lymphatic drainage systems in the brain,that is,the glymphatic system,the intramural periarterial drainage pathway,and meningeal lymphatic vessels,whose roles in various neurological diseases have been widely explored.The glymphatic system is a fluid drainage and waste clearance pathway that utilizes perivascular space and aquaporin-4 protein located in the astrocyte endfeet to provide a space for exchange of cerebrospinal fluid and interstitial fluid.The intramural periarterial drainage pathway drives the flow of interstitial fluid through the capillary basement membrane and the arterial tunica media.Meningeal lymphatic vessels within the dura mater are involved in the removal of cerebral macromolecules and immune responses.After ischemic stroke,impairment of these systems could lead to cerebral edema,accumulation of toxic factors,and activation of neuroinflammation,while restoration of their normal functions can improve neurological outcomes.In this review,we summarize the basic concepts of these drainage systems,including drainage routes,physiological functions,regulatory mechanisms,and detection technologies.We also focus on the roles of lymphatic drainage systems in brain injury after ischemic stroke,as well as recent advances in therapeutic strategies targeting these drainage systems.These findings provide information for potential novel strategies for treatment of stroke.
基金This study was funded by Key R&D Program of Shandong Province(2021LCZX02)National Key Research and Development Program(2021YFC2700604,2022YFC2703202)+4 种基金General Program of National Natural Science Foundation of China(82171648)Taishan Scholars Program for Young Experts of Shandong Province(tsqn201812154)Youth Program of National Natural Science Foundation of China(82101752)Youth Program of Shandong Provincial Natural Science Foundation of China(ZR2021QH075)General Program of Shandong Provincial Natural Science Foundation of China(ZR2022MH087) for data fee(scientific research informed consent,etc.),paper modification,and publication fee,etc.
文摘Objective:Although consensus on the optimal endometrial preparation protocol for frozen-thawed embryo transfer(FET)is lacking,this is particularly true for patients with infertility and a history of endometrial polyps(EPs).In this study,we aimed to investigate whether a gonadotropin-releasing hormone agonist combined with hormone replacement therapy(GnRHa-HRT)could improve pregnancy outcomes in single euploid FET for patients with a history of EPs.Methods:In this retrospective cohort study,395 women who underwent their first single euploid FET cycle were divided into groups according to endometrial preparation protocols as follows:natural cycle(NC)(n=220),hormone replacement therapy(HRT)(n=122),and GnRHa-HRT groups(n=53).Subsequently,the FET cycles in the three groups were subdivided according to maternal age.All patients underwent hysteroscopic polypectomy before FET,and their EPs were confirmed by pathology.Results:No statistically significant differences were observed in live birth rates among the three groups(58.64%vs.58.20%vs.56.60%,P=0.964).Furthermore,the rates of miscarriage,ectopic pregnancy,premature live birth,and pregnancy complications were comparable among the three groups(P>0.05).After adjusting for potential confounding factors,no significant differences in pregnancy outcomes were reported between the groups(adjusted odds ratios[OR]and 95%credible intervals[CI]for live birth rate,HRTvs.NC:1.119,0.660–1.896,P=0.677;GnRHa-HRTvs.NC:1.165,0.610–2.226,P=0.643).Additionally,the pregnancy outcomes of the FET cycle were not influenced by the endometrial preparation protocols in the subgroups when stratified by maternal age(P>0.05).Conclusion:GnRHa-HRT did not improve the pregnancy outcomes of the single euploid FET in patients with a history of EPs.
文摘Infertility seriously endangers the reproductive health of women at childbearing age.It is defined as the failure to achieve successful pregnancy after 1 year or more of regular unprotected intercourse.Broadly defined,infertility includes two aspects-failure to conceive or have a live birth.This guideline only addressed content relevant to the former.It was proposed by the gynecological endocrine group of the Chinese Society of Obstetrics and Gynecology,Chinese Medical Association,based on relevant guidelines of the World Health Organization,the American Society for Reproductive Medicine,the National Institute for Health and Clinical Excellence,as well as the clinical practice in China.The guideline was reviewed by experts and doctors from medical institutions at all levels,which is applicable to the diagnosis of infertility by physicians in obstetrics,gynecology,and andrology at various medical institutions nationwide.
文摘Dear Editor, Klinefelter syndrome （KS） is the most frequent genetic cause of infertility in men. Paternity can be achieved through intracytoplasmic sperm injection （ICSI） with spermatozoa recovered from ejaculated semen if exist, or testes with testicular sperm extraction （TESE）.
