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Background: Polycystic ovary syndrome (PCOS) is a common heterogeneous disorder linked with endocrine and metabolic disturbances. The underlying mechanism of PCOS, especially its effect on oocyte competence, remains unclear. The study aimed to identify abnormal follicular metabolic changes using a multi-omics approach in follicular fluid from PCOS patients and to determine their effects on oocyte competence., Methods: A total of 36 women with PCOS and 35 women without PCOS who underwent in vitro fertilization and embryo transfer were included in the study. Cumulus cells and follicular fluid samples were collected. Follicular fluid samples underwent metabolomic analysis, while cumulus cell clusters from the same patients were assessed using transcriptomic analysis. Clinical information of patients and assisted reproductive technology (ART) results were recorded. Transcriptomics and metabolomics were integrated to identify disrupted pathways, and receiver operation characteristics (ROC) analysis was conducted to identify potential diagnostic biomarkers for PCOS. Pearson correlation analysis was conducted to assess the relationship between metabolites in follicular fluid and oocyte competence (fertilization and early embryo development potential)., Results: Through multi-omics analysis, we identified aberrantly expressed pathways at both transcriptional and metabolic levels, such as the citrate cycle (TCA cycle), oxidative phosphorylation, the cAMP signaling pathway, the mTOR signaling pathway, and steroid hormone biosynthesis. Ten candidate metabolites were identified based on metabolic profiling data from these altered pathways. Phytic acid, succinic acid, 2'-deoxyinosine triphosphate, and 4-trimethylammoniobutanoic acid in the follicular fluid exhibited high specificity and sensitivity in distinguishing PCOS. Among these metabolites, L-arginine showed a negative correlation with the 2PN fertilization rate and cleavage rate, while estrone sulfate showed a negative correlation with the high-quality embryo rate in the in-vitro fertilization (IVF) cycle., Conclusions: We have conducted a preliminary study of a novel metabolic signature in women with PCOS using a multi-omics approach. The alterations in key metabolic pathways may enhance our understanding of the pathogenesis of PCOS., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Xie, Wu, Deng, Tang, Guan, Ye, He and Li.)

Objective: The present study aimed to investigate the clinical efficacy of endometrial ablation with high-intensity focused ultrasound (HIFU) for symptom relief in women with adenomyosis., Methods: Between July 2014 and July 2020, 167 patients with adenomyosis treated at the Zhongshan City People's Hospital were enrolled in this study. Patients were divided into two groups according to patient aspirations: the control group, including patients who only underwent ablation of adenomyosis lesions (group A) and the treatment group, including patients who underwent removal of adenomyosis lesions and endometrial ablation (group B)., Results: The reduced dysmenorrhea scores (visual analog scale) and menstrual volume scores (pictorial blood assessment chart) were measured before and after treatment. The scores were obtained by subtracting the postoperative scores from the preoperative scores and were compared to determine whether the symptoms had alleviated. Compared with the menstrual volume of group A, that in group B showed significant improvements. The average relief rates of dysmenorrhea in the two groups also showed significant improvement. However, the scores in group B showed a more significant improvement than those in group A., Conclusion: Therefore, our findings suggest that endometrial ablation using HIFU may be superior to conventional therapy with regard to alleviating the symptoms of increased menstruation in women with adenomyosis., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wu, Liu, Liu and Han.)

Aim: The aim of the study was to analyse the correlation between maternally expressed gene 3 (MEG3) expression and heart rate variability (HRV) in heart failure patients with ventricular arrhythmia (VA)., Methods: A total of 130 heart failure patients, treated from July 2018 to March 2021, were prospectively selected and divided into a non-VA group ( n = 85) and a VA group ( n = 45) according to the presence or absence of VA. The correlations of serum MEG3 expression and HRV with cardiac function indicators were investigated by Pearson correlation analysis. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of MEG3, HRV and their combination for the occurrence of heart failure complicated with VA., Results: The VA group had a higher left atrial diameter (LAD) and left ventricular end-diastolic diameter (LVEDD) but lower left ventricular ejection fraction (LVEF) and ratio of mitral early diastolic peak velocity (E) to late peak atrial filling velocity (A) (E/A) than the non-VA group ( p < 0.05). The serum MEG3 expression was negatively correlated with: standard deviation of the average RR intervals calculated over five-minute segments in the 24-hour record (SDANN), SDANN index, standard deviation of normal-to-normal RR interval (SDNN) index, percentage of differences between adjacent normal RR intervals exceeding 50 ms (PNN50), root mean square of successive difference (RMSSD), low frequency (LF), high frequency (HF), very low frequency (VLF), LVEF and E/A ( r < 0, p < 0.05). The serum MEG3 expression was positively correlated with LAD and LVEDD ( r > 0, p < 0.05). The areas under the ROC curves of MEG3, SDANN, SDANN index, SDNN index, PNN50, RMSSD, LF, HF, VLF and their combination for the prediction of the occurrence of heart failure complicated with VA were 0.812, 0.731, 0.737, 0.689, 0.860, 0.783, 0.791, 0.856, 0.769 and 0.966, respectively., Conclusion: MEG3 combined with HRV can effectively predict the occurrence of heart failure complicated with VA.