Correlation Analysis Between TCM Syndrome And RAFS Endometriosis Classification,Ovarian EMS And Autophagy

Objective1.Analysising the distribution of TCM syndromes and rAFS staging.With a view to further clinical guidance on the prevention and treatment of EMS.2.To further explore the pathogenesis of EMS by studying the correlation between ovarian EMS and autophagy.Methods1.Clinical studies were included in patients admitted to First Affiliated Hospital of Guangzhou University of Chinese Medicine.A total of 72 cases of intraoperative or postoperative pathology were identified as EMS.The patient's general condition,clinical data,surgical records,and four Chinese medical consultations were collected and questionnaires were filled out.The study determined the patient's TCM syndrome type,and further explored the distribution pattern of TCM syndrome type and the correlation with rAFS stage.2.The study aims to collecting tissue samples of patients diagnosed with ovarian EMS or tubal obstruction infertility by laparoscopic or open surgery in First Affiliated Hospital of Guangzhou University of Chinese Medicine.The expression of LC3B,Beclin-1,p62 and protein mRNA in eutopic,ectopic endometrium of patients with ovarian EMS as well as tubal infertility patients'endometrium were detected by Q-PCR and Western blotting respectively.Results1.The 72 patients in this study all lived in Guangdong Province for a period of 24 to 39 years old,accounting for 66.8%.Among those with fertility requirements,infertility patients accounted for 35%.Of all patients who underwent CA125 examination,66.7%had abnormal results.Of these,67%of patients increased significantly.2.The survey found that EMS patients were mainly qi stagnation blood stasis syndrome and kidney deficiency blood stasis syndrome,accounting for 33%and 32%respectively,followed by qi deficiency and blood stasis syndrome,accounting for 17%of the total.Then,the syndrome of cold coagulation and blood stasis accounting for 10%,the least is damp-heat blood stasis,about 8%.3.47.2%of patients in the rAFS stage IV were included in this study.There was no correlation between TCM syndrome distribution and rAFS staging(P>0.05).5.Western blotting results showed that LC3B protein expression in tubal infertility patients' endometrium and eutopic,ectopic endometrium of patients with ovarian EMS was not significantly different(p>0.05).The expression of Beclin-1 and p62 protein in ectopic endometrium of ovarian EMS patients was higher than that of endometrium and tubal obstructive infertility patients.The difference was statistically significant(P<0.05).5.Q-PCR results showed that the expression of LC3B,Beclin-1 and p62 mRNA had no significant difference in tubal infertility patients' endometrium and eutopic,ectopic endometrium of patients with ovarian EMS(P>0.05).Conclusion1.EMS occurs in the 24 to 39-year-old age of childbearing.35%of patients with infertility,66.7%of patients with elevated CA125,in addition to this,of those patients,67%of them increased significantly.However,the increased value was not significantly related to the severity of EMS.2.EMS patients are characterized by Qi-stagnation blood stasis syndrome and kidney-deficiency blood stasis syndrome,followed by Qi-deficiency and blood-stasis syndrome,cold coagulation and blood stasis syndrome,and damp-heat and blood stasis syndrome.After statistical analysis,there is no correlation between the distribution of TCM syndrome types and rAFS stage.3.Abnormalities of autophagy exist in ectopic endometrium of ovarian EMS patients,which may be one of the important mechanisms of EMS development.