Chronic Pelvic Inflammation Research Articles

Exploration into the Mechanism of Yiyi Baijiang Decoction Attenuating Chronic Pelvic Inflammation Based on Network Pharmacology and Experimental Verification

Exploration into the Mechanism of Yiyi Baijiang Decoction Attenuating Chronic Pelvic Inflammation Based on Network Pharmacology and Experimental Verification

Retracted: Analysis of Infertility Factors Caused by Gynecological Chronic Pelvic Inflammation Disease Based on Multivariate Regression Analysis of Logistic.

[This retracts the article DOI: 10.1155/2022/7531190.].

Application of Bioinformatics Technology to Analyse the Mechanism of Guizhi Fuling Capsule in Treating Chronic Pelvic Inflammation

Application of Bioinformatics Technology to Analyse the Mechanism of Guizhi Fuling Capsule in Treating Chronic Pelvic Inflammation

Re-evaluation of mouse models of endometriosis for pathological and immunological research.

Endometriosis is an estrogen-dependent gynecological disease with chronic pelvic inflammation. In order to study the pathophysiology of endometriosis and examine the therapeutic effects of new pharmaceuticals for endometriosis treatment, different animal models had been developed in the last two decades, especially mouse models. However, no study evaluated the effects of various modeling approaches on pathology and immunology in endometriosis. This study aimed to compare endometriotic lesion development and immune profiles under different methods of establishing endometriosis models in mice, including estrus synchronization (ovariectomy with estrogen supplement versus male urine-soaked transfer bedding), endometrium preparations (whole uterus including endometrium and myometrium fragments versus solely endometrium fragments), and surgical transplantation (subcutaneous transplantation versus intraperitoneal injection). Our results showed that lesion growth under estrus synchronization by ovariectomy with estrogen supplement had a higher success rate and more proliferative endometrium, apart from higher body weight gain. Immune responses in peripheral blood were similar in the whole uterus and solely endometrium fragments and in intraperitoneal injection and subcutaneous transplantation, but a more innate immune response in the peritoneal microenvironment was found in solely endometrium fragments and intraperitoneal injection than counterparts. In conclusion, different endometriosis modeling methods result in different pathological and immunological features. Ovariectomy with estrogen supplement, solely endometrium fragments, and intraperitoneal injection are more suitable for both pathological and immunological studies of endometriosis in mice, which are important for mechanistic studies and immunotherapy development.

PEG2-Induced Pyroptosis Regulates the Expression of HMGB1 and Promotes hEM15A Migration in Endometriosis.

Endometriosis (EMS) is a common gynecological disease. Prostaglandin E2 (PGE2), which induces chronic pelvic inflammation and cell pyroptosis, a form of programmed cell death based on inflammasome activation, are involved in EMS, but the extent of their involvement and roles remain unclear. The present study aimed to evaluate PGE2-induced pyroptosis in EMS and the influence of PGE2 in EMS progression. Using western blotting, it was found that the expressions of PGE2 and pyroptosis-related proteins (NLRP3, cleaved caspase-1, interleukin (IL)-1β and IL-18) were higher in EMS tissues than in normal endometrial tissues. The levels of PGE2, IL-1β, and IL-18 in the serum of patients with EMS and cell culture fluids were also detected. Using the transwell assay, we verified that PGE2 promoted hEM15A migration via the NLRP3/caspase-1 pyroptotic pathway, and PGE2-induced pyroptosis upregulated the expressions of high mobility group box 1 (HMGB1), E-cadherin, and vimentin. Immunohistochemistry analysis confirmed that PGE2-induced pyroptosis contributed to EMS invasion. These results suggest that PGE2-induced pyroptosis affects the progression of EMS by changing the migration ability of pyroptotic cells and upregulating the expression of HMGB1, E-cadherin, and vimentin. Our findings provide crucial evidence for new treatment pathways and use of anti-inflammatory drugs in EMS.

Analysis of Infertility Factors Caused by Gynecological Chronic Pelvic Inflammation Disease Based on Multivariate Regression Analysis of Logistic.

In order to solve the complex and recurrent problem of chronic pelvic inflammation disease (CPID) in the process of the clinical treatment, a method of understanding the influencing factors of CPID by investigating the actual situation of clinical cases and using logistics regression analysis was proposed in this study. A total of 204 outpatients were selected from a certain hospital. The ratio of the cases in the experimental group to those in the control group stands at 1 : 1. The results were obtained as follows. According to the data of CPID patients collected in the paper, the majority of patients had a high school education background or below technical secondary school education background, accounting for 66.7%. And the majority of patients were manual workers, accounting for 69.1%. All the exp (B) values of the frequency of sex life per month ≥ 9 times, frequent sex life during menstruation, IUD contraception, no contraception, abortion ≥ 3 times, vaginal irrigation per week ≥ 1 time, and intrauterine surgery ≥ 3 times were more than 1. These seven factors were the risk factors for chronic pelvic inflammation. Oral contraceptives were a weak protective factor of chronic pelvic inflammation. These factors including early drug withdrawal (53.1%), without understanding the condition of the disease (35.7%), no time to review the disease (24.5%), and irregular medication (21.4%) accounted for a large proportion. They were associated with the recurrence of CPID. This method is aimed at providing some foundations for establishing effective prevention and control measures for chronic pelvic inflammation and providing a recognized clinical diagnosis and efficacy evaluation criteria for the treatment of chronic pelvic inflammation.

Effect Observation of Continuous Care for Patients with Chronic Pelvic Inflammation

Effect Observation of Continuous Care for Patients with Chronic Pelvic Inflammation

Observation of the Effect of Levofloxacin and Metronidazole Combined with Gynecological Therapeutic Apparatus in Treating Chronic Pelvic Inflammation

Observation of the Effect of Levofloxacin and Metronidazole Combined with Gynecological Therapeutic Apparatus in Treating Chronic Pelvic Inflammation

Research Progress of Chinese Medicine Reserved Enema in the Treatment of Chronic Pelvic Inflammation

Research Progress of Chinese Medicine Reserved Enema in the Treatment of Chronic Pelvic Inflammation

Mathematical Analysis of Efficacy of Condom as a Contraceptive on the Transmission of Chlamydia Disease

Chlamydia disease caused by the Chlamydia trachomatis is one of the major sexually transmitted infectious diseases globally. The progression of this disease has deadly effects cumulating into millions of death. Chlamydia causes numerous complications such as infertility in female, chronic pelvic pain and inflammation. Previous studies did not consider the effects of undetected infected individuals on the dynamic spread of the disease. Hence, this work investigated the effects of undetected infected individuals and efficacy of condom as a contraceptive in the dynamic spread of the disease. A six compartmental model to study the dynamic spread of chlamydia disease was developed using system of ordinary differential equation. The population was divided into susceptible, exposed, infected undetected symptomatic, infected detected symptomatic, infected asymptomatic and recovered individuals. The well-posedness of the model was investigated by the positivity of solution technique. Basic reproduction number (R0) was computed using Next Generation Matrix Method. The endemic equilibrium was investigated by the use of Lyapunov function. The results showed that the disease free equilibrium was stable whenever the basic reproduction number is less than unity (R0<1). The endemic equilibrium was found to be stable as a results of constructed Lyapunov function being negative definite. Numerical analysis showed that increasing in the undetected infected individuals enhanced the spread of the disease. Findings showed that undetected infected individuals played a vital role in the spread of Chlamydia disease. Moreover, using condom as a contraceptive reduced the spread of the disease.

Diagnostic Value and Clinical Application of Diffusion-Weighted Magnetic Resonance Imaging for Female Pelvic Lesions.

Pelvic inflammatory disease refers to a group of infectious diseases of the female upper genital tract, often caused by ascending infection of vaginitis and cervicitis, causing endometritis, salpingitis, tubo-ovarian abscess, pelvic connective tissue inflammation, and/or pelvic peritonitis. PID is the most common and important infectious disease in nonpregnant women of childbearing age, and inflammation in multiple parts often coexists and affects each other. The functional MRI techniques currently used in pelvic floor muscle injury are magnetic resonance diffusion tensor imaging, T2 mapping, and magnetic resonance elastography. Diffusion tensor imaging is a new imaging and postprocessing technology developed on the basis of magnetic resonance diffusion-weighted imaging. Due to the lack of specificity of clinical symptoms, many subclinical patients are often not detected and diagnosed in time, so it is very difficult to accurately estimate the incidence of PID. This article retrospectively analyzed 72 patients with pelvic inflammatory disease confirmed by surgical pathology from February 2020 to 2022, who had undergone pelvic MRI examination before surgery, including 25 patients with chronic pelvic inflammation (hydrosalpinx), 25 patients with acute pelvic inflammation, and 47 cases (including 21 cases of hydrosalpinx, 19 cases of tubo-ovarian abscess, and 7 cases of pelvic abscess). The age range was 13 to 59 years old. The clinical data and MRI findings were analyzed, the ADC value of the cystic part of the lesion was measured, and the differences in age, maximum diameter of the lesion, thickness of the vessel wall/separation, and the ADC value of the cystic part of chronic and acute pelvic inflammation were compared. In this part of the cases, there were 25 cases of chronic pelvic inflammation and 47 cases of acute pelvic inflammation. The average ADC value of the cystic component of chronic inflammation was significantly higher than that of acute inflammation, which were (2.86 ± 0.20) × 10−3 mm2/s and (1.07 ± 0.38) ×10−3 mm2/s, respectively, P value <0.001.

Clinical Effect Analysis of Acupuncture Combined with Cupping Exercise in The Treatment of Chronic Pelvic Inflammatory Disease

Objective: To explore the clinical efficacy of acupuncture combined with cupping exercise in the treatment of chronic pelvic inflammation. Methods: The subjects of this study were all patients with chronic pelvic inflammation who visited our hospital from November 2018 to November 2019, a total of 90 cases. The patients were divided into control group and research group according to the single and double numbers of the beds, 45 cases in each group. The patients in the control group were treated with conventional Western medicine, while the patients in the study group were treated with acupuncture and cupping exercise, and the clinical effects of the two treatment methods were compared. Results: The total effective rate was 95.56% in the study group and 84.44% in the control group, which was significantly higher in the study group than in the control group. The data between the two groups were statistically significant (P&lt;0.05). The scores of menstrual disorder, abdominal distension, abnormal leucorrhea and lumbosacral pain in the two groups were significantly lower than those before treatment (P&lt;0.05), and the corresponding scores of syndromes in the study group after treatment were (1.05+0.40), (0.73+0.38), (0.74+0.24) and (0.53+0.16), which were significantly lower than those in the control group (P&lt;0.05). The plasma viscosity and hematocrit in both groups were significantly lower than those before treatment (P&lt;0.05). The plasma viscosity and hematocrit in the study group after treatment were (1.14+0.32) mPa * s and (0.41+0.06) %, respectively, which were significantly lower than those in the control group (P&lt;0.05). There was no significant difference in the levels of inflammatory factors between the two groups before treatment (P&gt;0.05). The level of inflammatory factors in the study group after treatment was (5.74 + 2.35) mg/L, which was significantly lower than that in the control group after treatment, and the difference between tne groups was statistically significant (P &lt; 0.05). Conclusion: Acupuncture combined with cupping exercise has a very significant clinical effect in the treatment of chronic pelvic inflammatory disease, can effectively improve the TCM syndrome score of patients, and improve the hemorheology and inflammation level of patients, so it can be widely used in clinical practice.

Deciphering the molecular interplay between pelvic inflammatory disease (PID) and ovarian cancer (OC)—A network biology approach

Endometriosis is a condition that is associated with viable endometrial tissue external to the uterus that may lead on to Endometriosis-Associated Ovarian Carcinoma (EAOC). The primary risk factor is chronic pelvic inflammation involving malignant transformation of epithelial cells or the transformation of premalignant lesions in the fallopian tubes leading to ovarian cancer. Differential gene expression analysis of EAOC and pelvic inflammatory Disease (PID) gene expression profiles revealed that 134 overlapping up-regulated genes. Protein-protein interaction (PPI) networks, gene ontology and pathway-based functional enrichment analysis revealed pathways of the hub genes namely CDK1, CDC20, BRCA1, FEN1, RAD51, BUB1, AURKA, CDC28A and their ontology (GO). Up-regulated genes were enriched with GO terms Progesterone-mediated oocyte maturation, mitotic cell cycle, p53 signalling pathway, Double Strand Break Repair, etc. The identified DEGs and hub genes may hold promise of deciphering the underlying molecular mechanism of tumour progression in endometriosis-associated ovarian cancer and associated tissues.

Implementation of comprehensive service in nursing care of patients with chronic pelvic inflammation and evaluation of its effect on quality of life.

article: Implementation of comprehensive service in nursing care of patients with chronic pelvic inflammation and evaluation of its effect on quality of life - Minerva Surgery 2021 Sep 29 - Minerva Medica - Journals

Peritoneal Fluid from Patients with Ovarian Endometriosis Displays Immunosuppressive Potential and Stimulates Th2 Response.

Endometriosis is a common gynaecological disorder characterized by the ectopic growth of endometrial tissue outside the uterine cavity. It is associated with chronic pelvic inflammation and autoimmune reactivity manifesting by autoantibody production and abrogated cellular immune responses. Endometriotic peritoneal fluid contains various infiltrating leucocyte populations and a bulk of proinflammatory and immunoregulatory cytokines. However, the nature and significance of the peritoneal milieu in women with endometriosis still remains obscure. Therefore, the aim of the present study was to investigate the immunoregulatory activity of the peritoneal fluid (PF) from women with endometriosis. The peritoneal fluid samples were collected during laparoscopic surgery from 30 women with and without endometriosis. Immunoregulatory cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-γ and TNF) and chemokines (CCL2, CCL5, CXCL8 and CXCL9) were evaluated in PF and culture supernatants generated by unstimulated and CD3/CD28/IL-2-stimulated CD4+ T cells cultured in the presence of PF. The effect of PF on the generation of Treg and Th17 cells in CD4+ T cell cultures, as well as the natural cytotoxic activity of peripheral blood mononuclear cells, was also investigated. Concentrations of IL-6, IL-10, CCL2, CXCL8 and CXCL9 were significantly upregulated in the PF from women with endometriosis when compared to control women, whereas concentrations of other cytokines and chemokines were unaffected. The culturing of unstimulated and CD3/CD28/IL-2-stimulated CD4+ T cells in the presence of endometriotic PF resulted in the downregulation of their IL-2, IFN-γ, IL-17A and TNF production as compared to culture medium alone. On the other side, endometriotic PF significantly stimulated the production of IL-4 and IL-10. Endometriotic PF also stimulated the release of CCL2 and CXCL8, whereas the production of CCL5 and CXCL9 was downregulated. Endometriotic PF stimulated the generation of Treg cells and had an inhibitory effect on the generation of Th17 cells in cultures of CD4+ T cells. It also inhibited the NK cell cytotoxic activity of the peripheral blood lymphocytes. These results strongly imply that the PF from patients with endometriosis has immunoregulatory/immunosuppressive activity and shifts the Th1/Th2 cytokine balance toward the Th2 response, which may account for deviation of local and systemic immune responses. However, a similar trend, albeit not a statistically significant one, was also observed in case of PF from women without endometriosis, thus suggesting that peritoneal milieu may in general display some immunoregulatory/immunosuppressive properties. It should be stressed, however, that our present observations were made on a relatively small number of PF samples and further studies are needed to reveal possible mechanism(s) responsible for this phenomenon.

A comparative study of prevalence of Chlamydia trachomatis infection among infertile and fertile women at a tertiary care center

Background and Aim: Chlamydia trachomatis is an obligate intracellular Gram-negative bacterium causing sexually transmitted infection leading to urogenital infections which are asymptomatic. If untreated, leads to complications such as chronic pelvic pain, inflammation, and occlusion of the fallopian tubes, resulting in infertility and ectopic pregnancy. The association is found between C. trachomatis infection and female infertility with a prevalence rate of 15%–30%. The aim was to determine the prevalence of C. trachomatis infection in women with infertility. Materials and Methods: This was a hospital-based cross-sectional study of patients presenting with or without infertility. Group A (75 cases) cases with infertility with or without symptoms of pelvic inflammatory disease. Group B (75 cases) with no infertility matching age, symptoms with Group A. After history, physical examination cervical swab for chlamydial antigen and serology sample was taken and processed. Positive cases were followed by hysterosalpingography (HSG) and laparoscopy. Results: Out of 150 patients, 14 were positive for chlamydia in cases and 4 in the control group. Chlamydial prevalence was four times more in cases as compared to the control group, which is significant. The mean age was 27.97 + 4.520 years. Out of 14 positive cases, 8 (57.14%) had symptoms, whereas 6 (42.85%) were asymptomatic; in controls, 2 were symptomatic, whereas 2 were asymptomatic. HSG and laparoscopy were positive in chlamydia positive cases. Conclusion: It can be presumed that there is a significant role of C. trachomatis in infertility and also there is an association between chlamydia antigen detection and tubal factor infertility.

Guizhi Fuling wan for chronic pelvic inflammatory disease protocol: A protocol for systematic review and meta analysis.

Background:Chronic pelvic inflammatory disease (CPID) is one of common diseases of department of gynaecology, point to female inside genital and circumferential organization to suffer from infection of all sorts of pathogenic bacteria and cause chronic inflammation sex disease, also cause one of main factors of infertile of female of childbearing age period. Due to its insidious onset, it is not easy to find out in the early stage. Therefore, it is difficult to obtain satisfactory curative effect by taking routine treatment with antibiotics. In recent years, TCM has made great strides in the treatment of chronic pelvic inflammation, a number of clinical studies have shown that Guizhi Fuling wan combined with antibiotics can significantly improve the clinical symptoms and enhance the therapeutic effect. Therefore, we intend to conduct a system review and meta-analysis to further clarify the effectiveness and safety of GZFLW for CPID.Methods:We will search each database from the built-in until September2020.The English literature mainly searches Cochrane Library, PubMed, EMBASE, and Web of Science, while the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Simultaneously we will retrieval clinical registration tests and grey literatures. This study only screens the clinical randomized controlled trials (RCTs) about GZFLW for CPID to assess its efficacy and safety. The 2 researchers worked independently on literature selection, data extraction, and quality assessment. The dichotomous data is represented by relative risk (RR), and the continuous is expressed by mean difference (MD) or standard mean difference (SMD), eventually the data is synthesized using a fixed effect model (FEM) or a random effect model (REM) depending on whether or not heterogeneity exists. The clinical efficacy, pelvic effusion and mass were evaluated as the main outcomes. The serum interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor (TNF)-α, erythrocyte sedimentation rate (ESR), erythrocyte specific volume was secondary outcomes. Finally, meta-analysis was conducted by RevMan software version 5.3.Results:This study will provide high-quality evidence for treatment of CPID with GZFLW in terms of effectiveness and safety.Conclusion:This systematic review aims to provide new options for GZFLW treatment of CPID in terms of its efficacy and safety.Ethics and dissemination:This study does not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal.OSF registration number:DOI 10.17605 / OSF.IO / R9NVT.

Patients with chronic prostatitis/chronic pelvic pain syndrome show T helper type 1 (Th1) and Th17 self-reactive immune responses specific to prostate and seminal antigens and diminished semen quality.

To assess the presence of self-reactive immune responses to seminal and prostate antigens (PAg), biomarkers of inflammation of the male genital tract, and semen quality parameters in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Peripheral blood and semen samples were collected from patients with CP/CPPS and age-matched healthy control volunteers. We analysed the lymphoproliferative responses of peripheral blood mononuclear cells (PBMC) to different seminal plasma (SP)-derived and purified PAg, serum autoantibodies specific to PAg, leucocyte subpopulations, and inflammatory cytokines in semen, sperm apoptosis/necrosis, and semen quality parameters. Significantly greater PBMC proliferative responses specific to PAg, with elevated secretion of interferon (IFN)γ and interleukin (IL)-17, were detected in the patients with CP/CPPS vs the controls. Moreover, the patients with CP/CPPS had significantly greater serum immunoglobulin G immune reactivity to SP proteins, such as prostate-specific antigen and prostatic acid phosphatase, than the controls. Inflammation of the male genital tract was exemplified by high levels of IFNγ, IL-17, IL-1β and IL-8, as well as higher counts of leukocytes, mainly CD4 T lymphocytes and macrophages, in the semen. In addition, this local inflammation was associated with an overall diminished semen quality, i.e., reduced sperm concentration, motility and viability; and higher levels of sperm apoptosis/necrosis in patients with CP/CPPS vs controls. Patients with CP/CPPS show T helper type 1 (Th1) and Th17 immune responses specific to PAg associated with chronic inflammation of the male genital tract and reduced semen quality. These immune responses may underlie the induction and development of chronic pelvic pain and inflammation of the male genital tract, which in turn could alter normal prostate functioning and impair semen quality.

Research on the mechanism of Chinese herbal medicine Radix Paeoniae Rubra in improving chronic pelvic inflammation disease by regulating PTGS2 in the arachidonic acid pathway

Radix Paeoniae Rubra (RPR) is a traditional Chinese medicine with anti-inflammatory effects that has been used in chronic pelvic inflammation disease (CPID) therapy. However, research on the mechanism of RPR in CPID therapy is lacking. Here, we used a network pharmacology method to screen targets and found that the PTGS2 target in the arachidonic acid (AA) pathway was significantly related to CPID. Then, regarding the molecular mechanism, it was further confirmed that RPR may reduce the development of CPID by regulating the PTGS2 target. The CPID rat model was established by mixed bacterial infection. We verified the expression of PTGS2 by immunohistochemical analysis, western blotting assays to detect the expression of PTGS2 protein, and polymerase chain reaction detection of PTGS2 mRNA expression. It was observed that the PTGS2 target decreased significantly after RPR administration at different doses. It is suggested that RPR can reverse the abnormal expression of PTGS2 in CPID rats. We believe that RPR is effective in the treatment of CPID, and RPR can reduce the inflammatory symptoms of CPID by regulating the level of PTGS2 in the AA pathway.

Different Expression Pattern of TIM-3 and Galectin-9 Molecules by Peripheral and Peritoneal Lymphocytes in Women with and without Endometriosis.

Endometriosis is a gynecological condition that is associated with chronic pelvic inflammation, pain, and infertility. Although substantial evidence supports that immunological alterations contribute to its pathogenesis and we previously posed a pivotal role of Galectin-9 (Gal-9) in this disorder, the involvement of the TIM-3/Gal-9 pathway in the development of endometriosis-associated immunological abnormalities is not yet known. In the present study, multicolor flow cytometry was used to compare the immunophenotype and cell surface expression of TIM-3 and Gal-9 molecules on peripheral blood (PB) and peritoneal fluid (PF) lymphocytes of women with and without endometriosis. We found an altered distribution of different lymphocyte subpopulations, a markedly decreased TIM-3 labeling on all T and NK subsets and a significantly increased Gal-9 positivity on peripheral CD4+ T and Treg cells of the affected cohort. Furthermore, a significantly increased TIM-3 expression on CD4+T-cells and elevated Gal-9 labeling on all T and NK subsets was also revealed in the PF of the examined patients. In conclusion, our results suggest a persistent activation and disturbed TIM-3/Gal-9-dependent regulatory function in endometriosis, which may be involved in the impaired immune surveillance mechanisms, promotes the survival of ectopic lesions, and aids the evolution of reproductive failures in endometriosis.