| Objective:To study the infection of Ureaplasma urealyticum(uu) and other pathogenic microorganism of cervical discharge in patients with pelvic inflammatory disease (PID) and tubal factor infertility (TFI) in order to instruct the diagnose and treatment. To study the effects of Modified Sini San decoction on histopathology changes of the genital organism, cytokines of spleen organism and cytokines and T lymph cells of blood in the Balb/C mice with pelvic inflammatory disease infected by ureaplasma urealyticum or colibacillus. To study the characteristics of two PID mice model infected by ureaplasma urealyticum or colibacillus.Method:Clinical research:from the inpatients of our department in China-Japan Friendship Hospital, PID and TFI cases were investigated by different pathogens: uu, Mycoplasma huminis(Mh), Chlamydia trachomatis (CT), and common bateriacs. A retrospective analysis of resistance to antibiotic drugs of these pathogens also was done. Experimtantal studies:The first mice model of PID was infected one of uterine by colibacillus. Chinese herbals were intragastuic administrated for 3 weeks as treated group and antibiotics Levofloxacin was administrated for 2 weeks as one of controlled group.Mice blood cytokines, the index of thymus gland and spleen were calculated and analyzed. The second mice model of PID was Oestradiaol-treated female BALB/c mice, which were inoculated intravaginally by serotype 8 of ureaplasma urealyticum. Chinese herbals were intragastric administrated for 3 weeks as treated group and Azithromycin as one of controlled groups. T lymphocyte subgroup of peripheral blood were analyzed by flow cytometry, cytokines of IFN-γ,TNF-α,IL-4 of mice spleen by ELISA, T-bet/GATA3 mRNA by real-time PCR.Result:Clinical research:In PID cases, the positive rates for uu tests, Mh tests, CT tests and common bactials tests were 33.87%(42/124),0.81%(1/124), 0.81%(1/136),16.94%(21/124). In bacterial culture, mainly candida, followed by colibacillus. In TFI cases, the positive rates for uu tests, Mh tests, CT tests and common bactials tests were 39.13%(36/92),2.17%(2/92); 0%(0/92); 6.52%(6/92). Exper imtantal studies:The PID mice modal infected by colibacillus showed infiltration of neutrophil in vagina, cervix, uterine, fallopian tube. After treatment of Chinese herbal compound FukeyihaoFang, the inflammatory pathological changes of PID mice improved well. But either the blood cytokines IL-2, IL-6, IL-10 and TNF-αof different groups or index of spleen and thymus gland showed no statistical significance. In the PID mice modal inoculated by uu, the vulvae turned red, the vaginal secretions became profuse, and uterines and oviducts even showed edema. Ureaplasmas can be sought in all model mice group. There were obvious infiltrations of neutrophil in 4 positions. And Chinese herbal compound FukeyihaoFang showed the same good improvement about it. The ratio of CD4+ and CD8+ of mice model were found to decline. The ratio of CD4+ and CD8+ and inflammatory cytokines in Chinese herbal group and Azithromicin group increased compared with model group, but the difference is not statistically significant. In addition, the T-bet/GATA3 mRNA of spleen in different groups showed no statistical significance.Conclusion:The pathogen of PID are mainly uu. Colibacillus is the most common pathogen for bacterial infection. Resistance for quinolone drugs is most serious. Intravaginal inoculation with ureaplasma urealyticum serotype 8 can induce pelvic inflammatory disease of mice; result in decreasing of immune function and genital tract acute inflammation. Chinese herbal compound FukeyihaoFang can improve the inflammatory pathological changes of PID mice model infected by either Escherichia coli or uu, although these two pathological models have different characteristics and formation mechanisms respectively. The mechanisms of Chinese herbals relieving inflammatory pathological changes on immunological network regulation need more experimental proof. |
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