| Objective By detecting the expression of mmp-9 and DDR2 in the endometrium of patients with mild or moderate intrauterine adhesions,the mechanism of intrauterine adhesions(IUA)was discussed.On the basis of the successful establishment of the IUA model of rats,it was observed that whether the Zuogui pills can improve the uterine fibrosis of rats,and The role of MMP-9 and DDR2 in the mechanism of uterine fibrosis was further discussed.Methods The first part was clinical study,30 patients who had been diagnosed with mild and moderate intrauterine adhesion were selected as the intrauterine adhesion group,and 30 patients who with secondary infertility to undergo hysteroscopy which examining normal hysteroscopy and normal endometrium in the same period were treated as normal control group.All patients underwent hysteroscopy in the third to 7th day after menstruation,and A small amount of endometrial tissue was taken from the adhesion group of the uterine cavity,and a small amount of normal intimal tissue was taken from the normal control group.All of the endometrial tissuesare immunohistochemical after the paraffin embedding.The second part was animal experiment,and 20 SD rats were randomly divided into two groups,group a and group b,each group of 10.The left uterine of two groups rats were processed with thermal damage 10 s,the right uterus has not been processed.After the establishment of the IUA model of rats,the group a was given saline irrigation,while group b was injected of Chinese traditional medicine Zuogui pills into the stomach.After 28 days of gavage,the two sides of the uterus were divided into 4 groups.The right uterus was the control group(group A),and the left uterus of group a was the model group(group B).The right uterus was the traditional Chinese medicine group(group C),and the left uterus of group b was the traditional Chinese medicine + model group(group D).HE staining observed changes in endometrial morphology and the number of endometrial glands in rats.Masson staining observed the interstitial fibrosis of rats in each group and analyzed the area ratio of endometrial fibrosis in each group using IPP image analysis software.The expression levels of mmp-9 and DDR2 in endometrium were detected by immunohistochemistry.The expression levels of mmp-9 and DDR2 protein in endometrial tissues were detected by Western blot.Results The first part of the clinical study,compared with the control group,the mmp-9 and DDR2 in the endometrium of the uterine adhesion group showed a low expression,and the difference was statistically significant(P < 0.05).In the second part of the animal experiment,the morphological observation was observed.Compared with the control group,the intimal damage of the model group was thinner and the glands weresignificantly reduced,and the uterine cavity lost the star structure,accompanied by a certain degree of reduction.The uterine cavity of Chinese medicine group increased obviously,and the number of glands did not change significantly.There was no significant change in endometrial thickness and glands in the TCM+ model group.Compared with the model group,the uterine cavity morphology of traditional Chinese medicine + model group had different degrees of recovery,the intima thickened,the number of glands increased,and the area of fibrosis decreased.The positive color of MMP-9 and DDR2 detected by immunohistochemistry are tan.As to control group,traditional Chinese medicine and traditional Chinese medicine(TCM)+ model group,there are no statistical difference of MMP-9 and DDR2 in three groups to compare the average optical density(P > 0.05).But the expression of MMP-9 and DDR2 in model group was obviously lower than the above three groups(P< 0.05),the difference is statistically significant.Comparing protein bands relative grey value of MMP-9 and DDR2 in the control group,Chinese medicine and traditional Chinese medicine(TCM)+model group,there is no statistical difference(P > 0.05),while expression protein bands of MMP-9 and DDR2 in the significantly lower than the above three groups(P < 0.05),the difference is statistically significant.Conclusions The MMP-9 and DDR2 in the endometrium of the patients were low expression.The low expression of MMP-9 and DDR2 may be involved in the pathogenesis of intrauterine adhesions.Zuogui pills can effectively improve the degree of adhesion in rats and prevent the formation of uterine adhesion after endometrial damage.It is possible to improve the mechanism of MMP-9 activation to inhibit uterine adhesion fibrosis by improving the expression of DDR2. |
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