Clinical observation of fallopian tube obstruction recanalization by ozone

The Treatment of Tubal Inflammatory Infertility using Yinjia Tablets through EGFR/MEK/ERK Signaling Pathway based on Network Pharmacology

Background: Salpingitis obstructive infertility (SOI) refers to infertility caused by abnormal conditions such as tubal adhesion and blockage caused by acute and chronic salpingitis. SOI has a serious impact on women's physical and mental health and family harmony, and it is a clinical problem that needs to be solved urgently.

Objective: The purpose of the present study was to explore the potential pharmacological mechanisms of the Yinjia tablets (Yin Jia Pian, YJP) on tubal inflammation.

Methods: Networks of YJP-associated targets and tubal inflammation-related genes were constructed through the STRING database. Potential targets and pathway enrichment analysis related to the therapeutic efficacy of YJP were identified using Cytoscape and Database for Annotation, Visualization, and Integrated Discovery (metascape). E. coli was used to establish a rat model of tubal inflammation and to validate the predictions of network pharmacology and the therapeutic efficacy of YJP. H&E staining was used to observe the pathological changes in fallopian tubes. TEM observation of the ultrastructure of the fallopian tubes. ELISA was used to detect the changes of IL-6 and TNF-α in fallopian tubes. Immunohistochemistry was used to detect the expression of ESR1. The changes of Bcl-2, ERK1/2, p-ERK1/2, MEK, p-MEK, EGFR, and p-EGFR were detected by western blot.

Results: Through database analysis, it was found that YJP shared 105 identical targets with the disease. Network pharmacology analysis showed that IL-6, TNF, and EGFR belong to the top 5 core proteins associated with salpingitis, and EGFR/MEK/ERK may be the main pathway involved. The E. coli-induced disease rat model of fallopian tube tissue showed damage, mitochondrial disruption, and increased levels of the inflammatory factors IL-6 and TNF-α. Tubal inflammatory infertility rats have increased expression of Bcl-2, p-ERK1/2, p-MEK, and p-EGFR, and decreased expression of ESR1. In vivo, experiments showed that YJP improved damage of tissue, inhibited shedding of tubal cilia, and suppressed the inflammatory response of the body. Furthermore, YJP inhibited EGFR/MEK/ERK signaling, inhibited the apoptotic protein Bcl-2, and upregulated ESR1.

Conclusion: This study revealed that YJP Reducing tubal inflammation and promoting tissue repair may be associated with inhibition of the EGFR/MEK/ERK signaling pathway.

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The diagnostic value of hysterosalpingo-contrast sonography in female infertility of the fallopian tube

Objective

To explore the clinical diagnostic value of hysterosalpingo-contrast sonograghy (HyCoSy) in female infertility of the fallopian tube.

Methods

One hundred nineteen female infertility patients who underwent laparoscopy in Shenzhen Hospital of Beijing University of Chinese medicine (Longgang) and Longgang District People's Hospital of Shenzhen City from June 2019 to December 2021. Patients diagnosed with fallopian tube obstruction; 119 patients included 233 fallopian tubes (five patients had the affected fallopian tubes removed due to ectopic pregnancy) were selected for HyCoSy, and then the results of laparoscopic examination were taken as the gold standard for diagnosis. The authenticity of the diagnostic test was evaluated using four grid table data, and the consistency of the two diagnostic methods of hysterosalpingography and laparoscopy was compared by Kappa test.

Results

Of the 233 fallopian tubes assessed, 139 were unobstructed, 50 were blocked at the proximal end and 44 were blocked at the distal end by laparoscopy. The results of HyCoSy showed that 115 were unobstructed, seventy three was considered proximal obstruction and 45 were distal obstruction. When compared to laparoscopy, the accuracy of HyCoSy in the diagnosis of tubal patency, proximal obstruction and distal obstruction was 74.2%, 78.1% and 80.7%, respectively. Two methods had good consistency in the diagnosis of tubal patency (Kappa=0.486) and proximal tubal obstruction (Kappa=0.444), and poor consistency in the diagnosis of distal tubal obstruction (Kappa=0.375).

Conclusion

Laparoscopy and HyCoSy are both useful in the diagnosis and etiological analysis of female infertility. HyCoSy can be the first choice, those who have doubts about the screening results can actively carry out laparoscopy to further improve the accuracy of diagnosis and etiological analysis of this disease.

Dose-Effect Relationship of Chitosan and Danshen Combined Injection for Fallopian Tube Recanalization

Objectives: This study examined the dose-effect relationship of chitosan and danshen combined injections on the long-term prevention of fallopian tube re-obstructions, with increased pregnancy rates in infertile women.

Methods: High-performance liquid chromatography was used to determine the content changes of combined chitosan and danshen injection. Two hundred and eighty patients with fallopian tube obstructions were randomly assigned to four groups. Group A (control group, saline), Group B (2 ml chitosan, 4 ml danshen), Group C (2 ml chitosan, 10 ml danshen), and Group D (1 ml chitosan, 10 ml danshen). Injections were administered after tubal recanalization.

Results: The effective constituent of chitosan and danshen injection was stable. Tubal patency rate was 94.2% and 87.3% in Group C after 1 and 3 years, respectively, which was significantly higher than Groups A (38.6%, 31.5%), B (73.5%, 64.1%), and D (68.5%, 50.7%). Intrauterine pregnancy rates were 61.8% and 79.4% in Group C after 1 and 3 years, respectively, and were significantly higher than Groups A (31.8%, 34.8%), B (40.1%, 62.5%), and D (38.5%, 58.5%) (p < 0.05).

Conclusion: Combined Chitosan and danshen injections prevented tubal obstruction and increased pregnancy rates for long periods using an optimal ratio of 1 part chitosan and 5 parts danshen.

Successful pregnancy in a woman with bilateral fallopian tube obstruction and diminished ovarian reserve treated with electroacupuncture: A case report

RATIONALE

Fallopian tube obstruction and diminished ovarian reserve (DOR) are main factors including female infertility. Acupuncture might be effective in the treatment of the disease.

PATIENT CONCERNS

A 39-year-old woman diagnosed with fallopian tube obstruction and DOR has been unable to conceive in the past 5 years, despite of receiving various treatments and 3-time in vitro fertilization (IVF) in different countries.

DIAGNOSES

Under comprehensive consideration of clinical manifestations and hysterosalpingography examinations results, the patient was diagnosed as female infertility due to fallopian tube obstruction and DOR.

INTERVENTION

Electroacupuncture treatment was performed 3 times per week for about 3 months.

OUTCOMES

After 2-months of electroacupuncture treatment, the patient's menstrual cycle was back to normal, and she conceived after 3-month treatment and gave birth to a healthy baby boy finally.

LESSONS

Electroacupuncture might be a complementary or alternative treatment for female infertility, particularly for women with fallopian tube obstruction and DOR.