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Bicarbonate (HCO3(-)) is essential for preimplantation embryo development. However, the mechanism underlying the HCO3(-) transport into the embryo remains elusive. In the present study, we examined the possible involvement of Cl(-)/HCO3(-) exchanger in mediating HCO3(-) transport into the embryo. Our results showed that depletion of extracellular Cl(-), even in the presence of HCO3(-), suppressed embryo cleavage in a concentration-dependent manner. Cleavage-associated HCO3(-)-dependent events, including increase of intracellular pH, upregulation of miR-125b and downregulation of p53, also required Cl(-). We further showed that Cl(-)/HCO3(-) exchanger solute carrier family 26 (SLC26) A3 and A6 were expressed at 2-cell through blastocyst stage. Blocking individual exchanger's activity by inhibitors or gene knockdown differentially decreased embryo cleavage and inhibited HCO3(-)-dependent events, while inhibiting/knocking down both produced an additive effect to an extent similar to that observed when CFTR was inhibited. These results indicate the involvement of SLC26A3 and A6 in transporting HCO3(-) essential for embryo cleavage, possibly working in concert with CFTR through a Cl(-) recycling pathway. The present study sheds light into our understanding of molecular mechanisms regulating embryo cleavage by the female reproductive tract.

Objective: To investigate the association of menopausal specific fat distribution with metabolic risk factors., Methods: Two hundred Chinese women including 110 premenopausal women aged 39.7±9.2 y and 90 postmenopausal women aged 55.4±4.6 years were enrolled. Total and regional fat depots including android fat and gynoid fat were measured by dual-energy X-ray absorptiometry. The differences of regional fat depot between pre-and post menopausal women were compared by covariate analysis. The association of regional fat changes with metabolic risk factors were analyzed by logistic models., Results: Gynoid fat was significantly decreased in postmenopausal women after accounting for total fat changes. After adjusting covariates (including age, BMI, and %BF), the inverse associations of gynoid fat with metabolic risk factors still remained (OR=1.8-3.7,P<0.05). Furthermore, the interaction between menopause and gynoid fat was significantly in all logistic models (P<0.05)., Conclusion: Android fat was increased whereas gynoid fat was decreased after menopause. Opposite to the detrimental effects of android fat, gynoid fat was inversely associated with metabolic risk factors, especially in postmenopausal women.

Objective: To investigate safety and efficacy of hysteroscopy in treatment of cesarean scar pregnancy (CSP)., Methods: From Aug. 2003 to Dec. 2011, 33 cases with CSP treated by hysteroscopy guided by transabdominal ultrasound or laparoscopy were studied retrospectively in Women's Hospital, School of Medicine, Zhejiang University. The clinical characteristics including gestational age, myometrial thickness anterior to the CSP, β-hCG level before treatment, success rate, cure rate, operative time, blood loss, time of serum β-hCG resolution and CSP mass clearance, and complication were collected and analyzed., Results: Median gestational age was 54 days (range, 37 - 140 days). Median level of β-hCG before treatment was 15 000 U/L (range, 3.3 - 151 747 U/L). Mean thickness of anterior myometrium was 3.3 mm. Twenty-nine cases underwent uterine artery embolism (UAE) before hysteroscopy. Pouch in the anterior uterine isthmus with gestation masses implanted were observed in 30 cases (91%, 30/33). CSP masses progressed toward the pouch or uterine cavity in all cases was removed by cutting wire loop electrode combined with curettage. The mean operative time was (34 ± 10) minutes. Both success rate and cure rate were 94% (31/33). Salvage methotrexate (MTX) therapy was administrated in one case. Complication occurred in three cases (9%, 3/33). Both massive hemorrhage rate and hysterectomy rate were performed in two cases (6%, 2/33). No uterine perforation occurred. The mean time of hCG resolution was (22 ± 10) days. The mean time of CSP mass clearance was (21 ± 12) days. Four pregnancies were achieved in four cases: one term pregnancy and three abortions. No recurrent CSP occurred., Conclusion: Management of CSP by hysteroscopy combined with UAE is safe and effective.

Objective: To explore the clinical efficacy of Gengxueting (GXT) in treating hysteromyoma and its effects on estrogen receptor (ER) and progesterone receptor (PR)., Methods: Sixty-four hysteromyoma patients with surgical indication were equally assigned to the treated group and the control group. Patients in the treated group were treated with GXT one capsule every day for 90 consecutive days before surgical operation, while those in the control group were treated with surgery alone. Serum levels of reproductive hormones were determined in the follicular phase before medication and one day before operation by RIA, and colored Doppler ultrasound examination was conducted for measuring the size of uterus and myoma. Moreover the protein expressions of ER and PR in tumor and uterine muscular tissues were detected by immunohistochemistry assay with streptomycin avidin-biotin peroxidase complex method., Results: In the treated group after medication, the serum level of estradiol was (167.0 +/- 85.9) pmol/L, progesterone (1.9 +/- 1.0) nmol/L, follicle-stimulating hormone (10.4 +/- 2.1) IU/L, and luteinizing (12.0 +/- 9. 8) IU/L, all reached the levels of early follicular phase, with the maximal size of myoma significantly decreased from (380.4 +/- 21.0) cm3 to (162.3 +/- 14. 8) cm3 (P < 0.01); and the ER and PR expressions in tumor tissue were significantly lower than those in the control group respectively (P < 0.01)., Conclusion: Expressions of ER and PR in hysteromyoma tissue could be significantly reduced by medication of GXT, which leads to significant shrinkage of tumor size and improvement of clinical symptoms.

Objective: To investigate the role of interleukine-16 (IL-16) in the pathogenesis of endometriosis., Methods: Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of IL-16 in peritoneal fluid and serum specimens of 22 women with different stage endometriosis and 22 controls., Results: The median levels of IL-16 in peritoneal fluid and serum were 290.5 pg/ml and 539.4 pg/ml in women with endometriosis, and 296.6 pg/ml and 778.1 pg/ml in controls, respectively; there was no significant difference between two groups (P>0.05). However, the IL-16 levels in peritoneal fluid and serum of patients with minimal/mild stage endometriosis and controls were all significantly higher than those of patients with moderate/severe endometriosis (P<0.01, <0.05). In addition, there was no statistical correlation of peritoneal IL-16 levels with those in serum (P>0.05)., Conclusion: Reduced levels of IL-16 in peritoneal fluid and serum of women with advanced stage endometriosis may imply a role of IL-16 in the development and progression of endometriosis.