Background
The oocyte development ability of prepubertal animals is significantly lower than that of adult animals. Granulosa cells (GCs) have an important function on regulation of follicular and oocyte development. Therefore, analysis of GCs characteristics can be used to explore the developmental mechanism of follicles and oocytes.
Results
In order to understand the possible reasons for the differences in follicles and oocytes development between lambs and adult sheep, we utilized high-throughput sequencing technique to analyze the transcriptome of GCs from follicle-stimulating hormone (FSH) superstimulated adult ewes and prepubertal lambs. Adult ewes were stimulated with FSH for 3 days (group A) and lambs were FSH-stimulated for 2 days (group B) or 3 days (group C). Transcriptome analysis of GCs showed that there were 405 and 159 differentially expressed genes from A vs. B and A vs. C, respectively. The results indicated that prolonging the FSH-stimulation of lambs made the GC state of lambs more similar to the adult sheep, but there were still a large number of differentially expressed genes between adult sheep and lambs. Further analysis showed that many differently expressed genes were implicated in cell proliferation and apoptosis, oocyte development and follicular ovulation. Cellular examination demonstrated that fatty acid binding protein 4 (FABP4), which was highly expressed in lamb GCs, had a potential of promoting cell apoptosis. Cytoplasmic phospholipase A2 (PLA2G4A), which was expressed lowly in lamb GCs, may be responsible for reduced synthesis of prostaglandins in cells and impaired follicle/oocyte development. In contrast, glutathione S-transferase β-1 (GSTT2B) and forkhead boxO6 (FOXO6) had no apparent effect on the proliferation and apoptosis of GCs.
Rationale:IgA nephropathy is one of the most common causes of renal hypertension. The clinical management of IgA renal patients during pregnancy is challenging, as complex pathophysiological changes may occur that affect both the patient's prognosis and the outcome of the pregnancy.Patient concerns:A 36-year-old woman with a family history of hypertension and at least one year of untreated mild high blood pressure was admitted to our hospital in the 28th week of pregnancy. She suffered from hypertensive disorder complicating pregnancy (HDCP) with renal insufficiency and stillbirth. Treatment with duplex antihypertensive drugs did not improve her blood pressure and she presented with abnormal renal function.Diagnoses:A renal biopsy led to the diagnosis of a grade IV IgA nephropathy (Lee's grading system) with renal hypertension.Interventions:The prescribed treatment regimen consisted of low dose cyclophosphamide 0.2 g per day for two days, followed by daily oral administration of 30 mg prednisone, 30 mg Nifedipine extended-release tablets and 80 mg Telmisartan to regulate the blood pressure.Outcomes:The medication with a combination of antihypertensive and immunosuppressive drugs led to a clinical improvement with a nearly normal renal function and a stable blood pressure during the one-year follow-up.Lessons:This case underlines that 1) the pregnancy outcomes of patients with IgA nephropathy are variable and depend on the renal function, blood pressure, status of urine proteins and the renal histological grade, and 2) especially female patients of childbearing age with hypertension need to be carefully examined to determine the cause of hypertension to avoid damage to target organs and complications during pregnancy.
Objective: To explore the impact of different educational models on disease recognition and compliance in patients with type 2 diabetes. Methods: For 100 patients with type 2 diabetes who were filed at the Changyanbao Community Health Service Center and the Electronic City Community Health Service Center from January 2017 to January 2018, the patients with diabetes were divided into 50 patients in the patient education group (group I) and 50 patients in the comprehensive education group (group II) according to the order of establishment. Observe the effects of different educational models on disease recognition and compliance in patients with type 2 diabetes. Results: After the relevant education, the effects of disease recognition and compliance were significantly higher in both groups (P<0.05), but the disease recognition and compliance of the patients in group II were significantly better than patients in group I (P<0.05). Conclusion: Through a variety of diabetes education models, and the network medical platform, patients can effectively improve disease awareness and compliance, thereby further control blood sugar, and improve patient quality of life.
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