Effects of Bushen Huoxue Formula on endometrial receptivity,Wnt/β-catenin signaling pathway and endometrial stem cell markers in severe intrauterine adhesions
Objective:To explore the effect of Bushen Huoxue Formula on endometrial receptivity,Wnt/β-catenin signaling pathway and endometrial stem cell markers in patients with severe intrauterine adhesions(IUA)after separation.Methods:From July 2021 to December 2021,70 patients with severe IUA were randomly divided into control group and treatment group,35 patients in each group.The control group was treated with oral estradiol valerate,which started on the fifth day of menstrual cycle(or withdrawal bleeding)and continued for 21 days.The treatment group was treated with Bushen Huoxue Formula on the basis of the control group's treatment measures,and took drugs and stopped taking drugs at the same time as western medicine.After three menstrual cycles of treatment,hysteroscopy was reexamined in both groups.Uterine cavity volume was measured by four-dimensional ultrasound,endometrial thickness,stroma,glands,inflammation and fibrosis were observed by HE and Masson staining,endometrial thickness was measured by Leica qwin plus image processing software,the expression of CD34/CD117 and β-catenin protein were detected by immunohistochemistry,Oct-4 mRNA was detected by RT-PCR,and the expression of ABCG2 protein was detected by Western Blot.Results:In the control group,the endometrial structure was complete,most glandular epithelial and luminal epithelial cells were cubic,the number of glands and blood vessels was basically normal,and lymphocyte infiltration and interstitial fibers were less.In the treatment group,the endometrial structure was complete,continuous and wavy,the glandular epithelium and luminal epithelial cells were complete,single-layer cubic and orderly arranged,the number of glands and capillaries was normal,and lymphocyte infiltration and interstitial fibers were few.The endometrial thickness and uterine cavity volume in the treatment group were significantly improved compared with those in the control group(P＜0.05).The expression of CD34,CD117,ABCG2 protein and Oct-4 mRNA in endometrial tissue was positive in both groups.The expressions of CD34,CD117,β-catenin and ABCG2 in the treatment group were significantly higher than those in the control group(P＜0.05).The relative expression of Oct-4 mRNA in the treatment group was significantly higher than that in the control group(P＜0.05).And the adverse reaction rate in the treatment group was significantly lower than that in the control group(P＜0.05).Conclusion:Bushen Huoxue Formula can increase endometrial receptivity,promote endometrial and interstitial growth,inhibit inflammatory reaction and fibrosis,positively promote the activation of Wnt/β-catenin signaling pathway,and increase the expression of CD34,CD117,Oct-4 mRNA and ABCG2 protein in endometrial stem cells.
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