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Chen S, Lu Y, Chen Y, Xu J, Chen L, Zhao W, Wang T, Wang H, Wang P. The effect of Bu Shen Huo Xue Tang on autoimmune premature ovarian insufficiency via Modulation of the Nrf2/Keap1 signaling pathway in mice. JOURNAL OF ETHNOPHARMACOLOGY 2021; 273:113996. [PMID: 33684516 DOI: 10.1016/j.jep.2021.113996] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/25/2021] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Bu Shen Huo Xue Tang (BSHXT) is a traditional Chinese medicine formula that is clinically used in the treatment of premature ovarian insufficiency (POI). However, its therapeutic mechanism remains unclear. AIM OF THE STUDY This study aimed to investigate the underlying molecular mechanism of pharmacological activity of BSHXT, via the Nrf2/Keap1 signaling pathway, in the treatment of autoimmune POI. MATERIALS AND METHODS The chemical composition of BSHXT was analyzed using ultra-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry. The autoimmune POI mouse model was induced by immunizing mice twice, with zona pellucida (ZP) glycoprotein 3 antigen. The autoimmune POI mice were continuously administered BSHXT for 28 days. Body weight and organ indices were recorded. The pathological morphology of the ovaries was observed. The estrous cycle of each mouse was recorded. Immunofluorescence assay was used to detect the levels of ZP antibodies in the mouse ovaries. The levels of ZP antibodies, follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), estradiol (E2), luteinizing hormone (LH), superoxide dismutase (SOD), and malondialdehyde (MDA) were measured. The expression of genes and proteins involved in the Nrf2/Keap1 signaling pathway were measured by Q-PCR and IHC, respectively. RESULTS Twenty-one compounds were identified in the BSHXT water extract. BSHXT was found to increase the body weight and ovarian index, improve ovarian function, and reduce disorders in the estrus cycle. It also reduced the expression of ZP antibodies in the ovaries and serum of POI mice. BSHXT significantly increased E2 and AMH levels and decreased FSH and LH levels. It also increased the levels of SOD, and reduced MDA levels. The levels of Nrf2 and Keap1 were also increased, and the expression of Nrf2, HO-1 and NQO1 genes was upregulated. CONCLUSIONS BSHXT has a therapeutic effect on autoimmune POI in mice, which may be a result of the enhanced antioxidant capacity and activation of the Nrf2/Keap1 signaling pathway. BSHXT is a good drug candidate for use as a protective agent for POI and may be used in clinical practice.
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Affiliation(s)
- Si Chen
- Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China; Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China.
| | - Yan Lu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China
| | - Yue Chen
- Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China; Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China
| | - Jindi Xu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China
| | - Lulu Chen
- Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China
| | - Weibo Zhao
- Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China
| | - Tingting Wang
- Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China
| | - Hui Wang
- Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China
| | - Peijuan Wang
- Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China; Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China.
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Yin XD, Xue XO, Wang JS, Yang W, He JQ. Effect of Bushen Huoxue recipe on women with thin endometrial ovulation disorder and a rat model of thin endometrium resulted from kidney deficiency-related blood stasis. Gynecol Endocrinol 2021; 37:433-437. [PMID: 32584196 DOI: 10.1080/09513590.2020.1781079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 02/15/2020] [Accepted: 06/08/2020] [Indexed: 10/24/2022] Open
Abstract
To examine the therapeutic effect of Bushen Huoxue recipe (BHR) on women with thin endometrial ovulation disorder and on a rat model of kidney deficiency-related blood stasis. A total of 60 women with thin endometrial ovulation disorder was enrolled. The primary outcome of the study was the pregnancy rate three menstrual cycles after treatment. The study also examined the changes in the type and thickness of uterine artery, uterine artery pulsatility index (PI) and endometrial resistance index (RI). To establish kidney deficiency-related blood stasis in Sprague Dawley (SD) rats, an intragastric administration of hydroxyurea and a tail vein injection of Dextran were given, following with a flashing of the uterine cavity with 95% anhydrous ethanol. A combined regimen of BHR and estradiol valerate significantly increased the rate of pregnancy in women with thin endometrial ovulation disorder. The treatment was accompanied by a significant increase in endometrial thickness and decreases in uterine artery PI and endometrial RI. In rats, kidney deficiency-related blood stasis caused severe loss in endometrial architecture, thickness, and numbers of gland and blood vessel compared to the healthy SD rats. Treatment with BHR could ameliorate the endometrial damages associated with kidney deficiency-related blood stasis.
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Affiliation(s)
- Xiao-Dan Yin
- Department of TCM, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Xiao-Ou Xue
- Department of Gynecology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jing-Shang Wang
- Department of TCM, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Wei Yang
- Department of TCM, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jun-Qin He
- Department of TCM, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
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BuShen HuoXue Decoction Promotes Decidual Stromal Cell Proliferation via the PI3K/AKT Pathway in Unexplained Recurrent Spontaneous Abortion. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:6868470. [PMID: 33082827 PMCID: PMC7556073 DOI: 10.1155/2020/6868470] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/08/2020] [Indexed: 01/16/2023]
Abstract
BuShen HuoXue decoction (BSHXD) has been used to treat patients with unexplained recurrent spontaneous abortion (URSA). However, the chemical compounds and mechanism by which BSHXD exerts its therapeutic and systemic effects to promote the proliferation of decidual stromal cells (DSCs) has not been elucidated. This work sought to elucidate the cellular and molecular mechanism of BSHXD in terms of inflammatory factors IL-17A in DSCs in vitro because of the critical roles of inflammation, apoptosis, and immunity in the development and progression of pregnancy loss. Twelve migratory chemical compounds from BSHXD extract were qualitatively analyzed by high-performance liquid chromatography (HPLC). DSCs were collected from normal early pregnancy (NEP) and URSA to determine whether BSHXD affects IL-17A/IL17RA via the PI3K/AKT pathway. Abnormal apoptosis and activated p-AKT were observed in URSA DSCs. RhIL-17 A, LY294002 (a PI3K pathway inhibitor), and BSHXD were individually or simultaneously administered in NEP DSCs, suggesting that BSHXD restored cell proliferation without excessive stimulation and IL-17A promotes proliferation via the PI3K/AKT pathway. Using the same intervention in URSA DSCs, qRT-PCR measured the upregulated mRNA levels of IL-17 A/IL-17RA, PI3K, AKT, p-AKT, PTEN, Bcl-2, and Bcl-xL and downregulated mRNA levels of BAD and ACT1 after treatment with BSHXD. We demonstrated that BSHXD affected IL-17A/IL-17R via PI3K/AKT pathway to promote the proliferative activity of DSCs in URSA. These results provide a new insight to further clarify the relationship between inflammation and apoptosis and the mechanism of imbalance in the dynamic equilibrium between Th17/Treg immune cells at the maternal-fetal interface.
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Guo F, Xia T, Zhang Y, Ma X, Yan Z, Hao S, Han Y, Ma R, Zhou Y, Du X. Menstrual blood derived mesenchymal stem cells combined with Bushen Tiaochong recipe improved chemotherapy-induced premature ovarian failure in mice by inhibiting GADD45b expression in the cell cycle pathway. Reprod Biol Endocrinol 2019; 17:56. [PMID: 31311554 PMCID: PMC6636150 DOI: 10.1186/s12958-019-0499-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/06/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To investigate the therapeutic effects of menstrual blood derived mesenchymal stem cells (MB-MSCs) combined with Bushen Tiaochong recipe (BSTCR) on epirubicin induced premature ovarian failure (POF) in mice. METHODS Twenty-four female C57BL/6 mice of 6-8 weeks were intraperitoneally injected with epirubicin to induce POF, and then they were randomized into 4 groups of 6 mice each and treated with PBS, MB-MSCs, BSTCR, and MB-MSCs combined with BSTCR, respectively. Six mice of the same age were used as controls. Vaginal smear, TUNEL and hematoxylin-eosin staining were to observe estrous cycles, ovarian cell apoptosis and follicles. Enzyme-linked immunosorbent analysis determined serum estradiol, follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH) levels. RT-qPCR and Western Blot analysis were to determine GADD45b, CyclinB1, CDC2 and pCDC2 expressions. RESULTS Epirubicin treatment resulted in a decrease in the number of primordial, primary, secondary and antral follicles, an increase in the number of atretic follicles and ovarian cell apoptosis, a decrease in estradiol and AMH levels, an increase in FSH levels, and estrous cycle arrest. However, MB-MSCs combined with BSTCR rescued epirubicin induced POF through down-regulating GADD45b and pCDC2 expressions, and up-regulating CyclinB1 and CDC2 expressions. The combined treatment showed better therapeutic efficacy than BSTCR or MB-MSCs alone. CONCLUSIONS MB-MSCs combined with BSTCR improved the ovarian function of epirubicin induced POF mice, which might be related to the inhibition of GADD45b expression and the promotion of CyclinB1 and CDC2 expressions. The combined treatment had better therapeutic efficacy than BSTCR or MB-MSCs alone.
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Affiliation(s)
- Fengyi Guo
- 0000 0000 9792 1228grid.265021.2Department of Obstetrics & Gynecology, General Hospital, Tianjin Medical University, NO.154, Anshan Road, Heping District, Tianjin, 300052 People’s Republic of China
| | - Tian Xia
- 0000 0004 1799 2712grid.412635.7Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88 Chang Ling Street, Xi Qing district, Tianjin, 300112 China
| | - Yedan Zhang
- 0000 0000 9792 1228grid.265021.2Department of Obstetrics & Gynecology, General Hospital, Tianjin Medical University, NO.154, Anshan Road, Heping District, Tianjin, 300052 People’s Republic of China
| | - Xiaotong Ma
- 0000 0000 9792 1228grid.265021.2Department of Obstetrics & Gynecology, General Hospital, Tianjin Medical University, NO.154, Anshan Road, Heping District, Tianjin, 300052 People’s Republic of China
| | - Zhongrui Yan
- 0000 0000 9792 1228grid.265021.2Department of Obstetrics & Gynecology, General Hospital, Tianjin Medical University, NO.154, Anshan Road, Heping District, Tianjin, 300052 People’s Republic of China
| | - Shaohua Hao
- 0000 0000 9792 1228grid.265021.2Department of Obstetrics & Gynecology, General Hospital, Tianjin Medical University, NO.154, Anshan Road, Heping District, Tianjin, 300052 People’s Republic of China
| | - Yali Han
- 0000 0000 9792 1228grid.265021.2Department of Obstetrics & Gynecology, General Hospital, Tianjin Medical University, NO.154, Anshan Road, Heping District, Tianjin, 300052 People’s Republic of China
| | - Ruihong Ma
- 0000 0004 1799 2712grid.412635.7Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88 Chang Ling Street, Xi Qing district, Tianjin, 300112 China
| | - Yuan Zhou
- grid.461843.cState Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, 300020 China
| | - Xue Du
- 0000 0000 9792 1228grid.265021.2Department of Obstetrics & Gynecology, General Hospital, Tianjin Medical University, NO.154, Anshan Road, Heping District, Tianjin, 300052 People’s Republic of China
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Wang P, Lu Y, Chen S, Chen Y, Hu C, Zuo Y. Protective function of Bu Shen Huo Xue formula on the immunity of B6AF1 mice with experimental autoimmune premature ovarian failure. Exp Ther Med 2018; 15:3302-3310. [PMID: 29545848 PMCID: PMC5840928 DOI: 10.3892/etm.2018.5804] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 07/27/2017] [Indexed: 01/09/2023] Open
Abstract
Autoimmune abnormality is one of the main causes of premature ovarian failure (POF). Bu Shen Huo Xue formula (BSHXF), a traditional Chinese medicine formula, has been clinically used for the treatment of patients with POF in China. Regulatory T cells (Tregs) are important in the pathogenesis of autoimmune POF. The aim of the present study was to evaluate the immunoprotective effects of BSHXF on POF and the underlying mechanisms. An experimental autoimmune POF model was induced in B6AF1 mice with zona pellucida 3 (ZP3) fragments. Following modeling, BSHXF (31.53 g/kg/day) was orally administered for 4 weeks. CD4+ T lymphocytes, Tregs, anti-zona pellucida (anti-ZP) antibodies and cytokines were detected using flow cytometry, enzyme-linked immunosorbent assays, reverse transcription-quantitative polymerase chain reaction and immunohistochemistry. The results revealed that BSHXF exhibited an immunoprotective function and reduced inflammatory cell infiltration and damage to the ovary. BSHXF upregulated the percentage of CD4+ CD25+ forkhead box P3+ T cells in the spleen, effectively inhibiting the activation of CD4+ T lymphocytes. The proliferation of Tregs was increased in serum obtained from mice in the BSHXF group in vitro. Anti-ZP antibodies and interleukin-10 and interferon-γ levels were decreased in the serum in the BSHXF-treated group. The present study demonstrated that BSHXF had an immunoprotective effect on POF model mice. Additionally, it indicated that the protective mechanisms of BSHXF may be associated with an increase in Treg cells.
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Affiliation(s)
- Peijuan Wang
- Department of Obstetrics and Gynecology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210028, P.R. China
- Department of Obstetrics and Gynecology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu 210028, P.R. China
| | - Yan Lu
- Department of Obstetrics and Gynecology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210028, P.R. China
- Department of Obstetrics and Gynecology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu 210028, P.R. China
| | - Si Chen
- Department of Obstetrics and Gynecology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210028, P.R. China
- Department of Obstetrics and Gynecology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu 210028, P.R. China
| | - Yue Chen
- Department of Obstetrics and Gynecology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210028, P.R. China
- Department of Obstetrics and Gynecology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu 210028, P.R. China
| | - Chunping Hu
- Department of Obstetrics and Gynecology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210028, P.R. China
- Department of Obstetrics and Gynecology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu 210028, P.R. China
| | - Yawei Zuo
- Infirmary, 8724 Forces Health Teams, Wuxi, Jiangsu 214000, P.R. China
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Guilin F, Meijiao L, Xiaolin Z, Lihong Z, Jing L, Jingfeng O. Efficacy of Bushenjianpi prescription on autoimmune premature ovarian failure in mice. J TRADIT CHIN MED 2017. [DOI: 10.1016/s0254-6272(17)30321-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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He X, Wang SY, Yin CH, Wang T, Jia CW, Ma YM. Hydrogen-rich Water Exerting a Protective Effect on Ovarian Reserve Function in a Mouse Model of Immune Premature Ovarian Failure Induced by Zona Pellucida 3. Chin Med J (Engl) 2017; 129:2331-7. [PMID: 27647193 PMCID: PMC5040020 DOI: 10.4103/0366-6999.190668] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Premature ovarian failure (POF) is a disease that affects female fertility but has few effective treatments. Ovarian reserve function plays an important role in female fertility. Recent studies have reported that hydrogen can protect male fertility. Therefore, we explored the potential protective effect of hydrogen-rich water on ovarian reserve function through a mouse immune POF model. Methods: To set up immune POF model, fifty female BALB/c mice were randomly divided into four groups: Control (mice consumed normal water, n = 10), hydrogen (mice consumed hydrogen-rich water, n = 10), model (mice were immunized with zona pellucida glycoprotein 3 [ZP3] and consumed normal water, n = 15), and model-hydrogen (mice were immunized with ZP3 and consumed hydrogen-rich water, n = 15) groups. After 5 weeks, mice were sacrificed. Serum anti-Müllerian hormone (AMH) levels, granulosa cell (GC) apoptotic index (AI), B-cell leukemia/lymphoma 2 (Bcl-2), and BCL2-associated X protein (Bax) expression were examined. Analyses were performed using SPSS 17.0 (SPSS Inc., Chicago, IL, USA) software. Results: Immune POF model, model group exhibited markedly reduced serum AMH levels compared with those of the control group (5.41 ± 0.91 ng/ml vs. 16.23 ± 1.97 ng/ml, P = 0.033) and the hydrogen group (19.65 ± 7.82 ng/ml, P = 0.006). The model-hydrogen group displayed significantly higher AMH concentrations compared with that of the model group (15.03 ± 2.75 ng/ml vs. 5.41 ± 0.91 ng/ml, P = 0.021). The GC AI was significantly higher in the model group (21.30 ± 1.74%) than those in the control (7.06 ± 0.27%), hydrogen (5.17 ± 0.41%), and model-hydrogen groups (11.24 ± 0.58%) (all P < 0.001). The GC AI was significantly higher in the model-hydrogen group compared with that of the hydrogen group (11.24 ± 0.58% vs. 5.17 ± 0.41%, P = 0.021). Compared with those of the model group, ovarian tissue Bcl-2 levels increased (2.18 ± 0.30 vs. 3.01 ± 0.33, P = 0.045) and the Bax/Bcl-2 ratio decreased in the model-hydrogen group. Conclusions: Hydrogen-rich water may improve serum AMH levels and reduce ovarian GC apoptosis in a mouse immune POF model induced by ZP3.
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Affiliation(s)
- Xin He
- Reproductive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Shu-Yu Wang
- Reproductive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Cheng-Hong Yin
- Reproductive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Tong Wang
- Reproductive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Chan-Wei Jia
- Reproductive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Yan-Min Ma
- Reproductive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
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Chen XY, Chen WL, Ma M, Gu C, Xiao XR, Li B. The potential of follicle-stimulating hormone peptide-modified triptolide-loaded nanoparticles to induce a mouse model of premature ovarian insufficiency. Int J Nanomedicine 2015; 10:2765-74. [PMID: 25897221 PMCID: PMC4396643 DOI: 10.2147/ijn.s72593] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The use of triptolide (TP) is limited by its poor water solubility and severe toxicity. In this study, we developed an active drug delivery system (TP-loaded nanoparticles) that could help improve the water solubility of TP and decrease its toxicity. Then, we investigated whether TP-loaded nanoparticles could be used to establish a novel premature ovarian insufficiency mouse model. The mice treated with TP-loaded nanoparticles for 35 days displayed normal growth, decreased serum antimullerian hormone, prominent ovarian fibrosis and vacuolar changes, fewer follicles and corpus lutea, increased collapsed oocytes and follicle apoptosis, and sterility. In conclusion, this model appears to show the reproductive characteristics associated with premature ovarian insufficiency in women and will allow us to study the mechanism of the effects of traditional Chinese medicine on gonadal toxicity.
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Affiliation(s)
- Xiu-Ying Chen
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China ; Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai, People's Republic of China ; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, People's Republic of China
| | - Wu-Lian Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, People's Republic of China
| | - Min Ma
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China ; Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai, People's Republic of China ; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Fudan University, Shanghai, People's Republic of China
| | - Chao Gu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China ; Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Xi-Rong Xiao
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China ; Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Bin Li
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China ; Department of Obstetrics and Gynecology of Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
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