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               ·1628 ·                           南 京    医 科 大 学 学         报                        2024年12月


              明显降低。这提示 CTX 可能对二细胞发育至囊胚                               te[J]. Jnt J Wonen’s Health,2014,20(6):235-243
              阶段所需的关键储备产生了重大影响,而人类胚胎                            [8] MULDER R L,FONT⁃GONZALEZ A,HUDSON M M,
              基因组中的可访问区域的数量在二细胞到囊胚阶                                  et al. Fertility preservation for female patients with child⁃
              段之间逐渐增加        [26] 。相关文献表明,人类染色质可                     hood,adolescent,and young adult cancer:recommenda⁃
                                                                     tions from the PanCareLIFE consortium and the interna⁃
              及性变化最大的区域是低甲基化区域                  [27] ,这表明低
                                                                     tional late effects of childhood cancer guideline harmoni⁃
              水平甲基化可能支持染色质可及性的可变性,低甲
                                                                     zation group[J]. Lancet Oncol,2021,22(2):e45-e56
              基化可能构成一种允许其他因子结合的状态,使得
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              早期胚胎细胞具有可塑性。而本研究提示 CTX 可
                                                                     #ESHREjc report:is OTO⁃IVM the future fertility preser⁃
              能通过上调卵母细胞及早期胚胎中 DNMT3A 的表                              vation alternative for urgent cancer patients?[J]. Hum
              达,使细胞内整体甲基化水平升高,从而降低早期                                 Reprod,2021,36(9):2631-2633
              胚胎细胞的可塑性,造成其发育阻滞。                                 [10] VUONG L N,PHAM T D,HO T M,et al. Outcomes of
                  综上,本研究表明,4⁃HC 可引发卵母细胞氧化                            clinical in vitro maturation programs for treating infertility
              应激,降低卵母细胞胚胎发育潜能并影响其表观遗                                 in hyper responders:a systematic review[J]. Fertil Steril,

              传。本研究首次关注到4⁃HC对卵母细胞内DNMT3A                             2023,119(4):540-549
              表达情况的影响。然而,尽管4⁃HC作用下卵母细胞                          [11]刘    力. 儿童狼疮性肾炎治疗中环磷酰胺药物代谢的
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              内DNMT3A表达上升,但仍无法确定其酶活性是否
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              也会发生相应改变。后续仍需观察卵母细胞整体
                                                                     mitochondrial function/dysfunction on IVF and new treat⁃
              甲基化水平,进一步验证CTX对卵母细胞各发育时
                                                                     ment possibilities for infertility[J]. Reprod Biol Endocrinol,
              期甲基化水平的具体影响。
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