Pioglitazone Metformin Complex Improves Polycystic Ovary Syndrome Comorbid Psychological Distress via Inhibiting NLRP3 Inflammasome Activation: A Prospective Clinical Study.

OBJECTIVE: This study aimed at investigating the therapeutic effect and mechanism of pioglitazone metformin complex preparation (PM) in polycystic ovary syndrome (PCOS) comorbid psychological distress. METHODS: Seventy-five patients with PCOS comorbid psychological distress were randomly allocated into the PM, metformin, and placebo groups. The primary efficacy measure was the change from baseline to week 12 on the Symptom Checklist 90-R (SCL-90-R) scores. NLRP3 inflammasome, IL-1ß, IL-6, TNF-α, and biochemical parameters were determined at baseline and at week 12. The participants were required to meet the criteria for PCOS (Rotterdam, NIH) and psychological distress (any factor scores of SCL - 90 - R > 2). RESULTS: The participants had significantly high scores on the SCL-90-R scales of anxiety and depression. PM significantly decreased anxiety and depression symptom severity (from 2.31 ± 0.75 to 1.65 ± 0.38, p < 0.001, and from 2.08 ± 0.74 to 1.61 ± 0.46, p = 0.010, at week 12, respectively). PM significantly decreased the expression of NRPL3 and caspase-1. Patients in the PM group experienced a significant reduction in IL-1ß (from 98.42 ± 14.38 to 71.76 ± 13.66, p = 0.02), IL-6 (from 87.51 ± 8.74 to 71.98 ± 15.87, p = 0.02), and TNF-α (from 395.33 ± 88.55 to 281.98 ± 85.69, p = 0.04). PM was superior to metformin in reducing total testosterone (2.24 ± 0.74 versus 3.06 ± 0.83, p = 0.024, at week 12). CONCLUSIONS: This study is the first to reveal that PM alleviates psychological distress via inhibiting NLRP3 inflammasome and improves several markers, including total testosterone.

Knowledge about, attitudes toward and acceptance and predictors of intention to receive the mpox vaccine among cancer patients in China: A cross-sectional survey.

This study aimed to investigate the knowledge about, attitudes toward, and acceptance and predictors of receiving the mpox vaccine among Chinese cancer patients. Patients were selected using a convenience sampling method. A web-based self-report questionnaire was developed to assess cancer patients' knowledge, attitudes, and acceptance regarding the mpox vaccine. Multivariate logistic regression analysis was used to determine predictors of acceptance of the mpox vaccine. A total of 805 cancer patients were included in this study, with a vaccine hesitancy rate of 27.08%. Approximately 66% of the patients' information about mpox and the vaccine came from the mass media, and there was a significant bias in the hesitant group's knowledge about mpox and the vaccine. Multivariable logistic regression analysis suggested that retirement; chemotherapy; the belief that the mpox vaccine could prevent disease, that vaccination should be compulsory when appropriate and that the mpox vaccine prevents mpox and reduces complications; the willingness to pay for the mpox vaccine; the willingness to recommend that friends and family receive the mpox vaccine; and the belief that the mpox vaccine should be distributed fairly and equitably were factors that promoted vaccination. The belief that mpox worsens tumor prognosis was a driving factor for vaccine hesitancy. This study investigated the knowledge of cancer patients about mpox and the vaccine, evaluated the acceptance and hesitancy rates of the mpox vaccine and examined the predictors of vaccination intention. We suggest that the government scientifically promote the vaccine and develop policies such as free vaccination and personalized vaccination to increase the awareness and acceptance rate of the mpox vaccine.

[Effects of Chinese herbal medicine Neiyi Recipe-medicated serum on angiopoiesis of endometriosis in the chick chorioallantoic membrane model].

OBJECTIVE: To compare angiopoiesis ability of eutopic and ectopic endometrial tissue isolated from women with endometriosis and endometrium isolated from women without endometriosis (control), and to explore the inhibitory effects of medicated serum of Neiyi Recipe, a compound traditional Chinese herbal medicine. METHODS: Chick chorioallantoic membrane (CAM) model of endometriosis was established by transplanting endometrium onto CAM. The CAMs were then hatched with blank serum or medicated serum of danazol or Neiyi Recipe, which were prepared in rats by orally administering. The sizes of the transplanted tissue and new vessels around the transplanted tissue were measured. Expression of vascular endothelial growth factor (VEGF) was detected by immunohistochemical method. RESULTS: There was no difference in the sizes of transplanted tissue among CAM models of ectopic and eutopic endometrial tissue isolated from women with endometriosis or control (P>0.05), and more new vessels were found around the ectopic and eutopic endometrial tissue than the endometrial tissue of control (P<0.05). Compared with the controls, the size of the transplanted tissue and positive area of new vessels were significantly inhibited by Neiyi Recipe-medicated serum (P<0.01, P<0.05), and similar changes happened in the danazol groups, except for the size of transplanted tissue from ectopic endometrial tissue (P>0.05). Expression of VEGF was significantly higher in eutopic and ectopic endometrial tissue than in the control (P<0.01); the level of VEGF obviously reduced in the Neiyi Recipe and danazol groups (P<0.01), but no significant difference was detected between them. CONCLUSION: Endometrium from women with endometriosis stimulates the formation of new vessels by increase the expression of VEGF. Neiyi Recipe-medicated serum significantly decreases the expression of VEGF in eutopic and ectopic endometrial tissues and thus restrains the formation of new vessels, reduces the blood supply and inhibits growth of ectopic endometrial tissue, which are similar to danazol, but has greater efficacy in suppressing the expression of VEGF.

Impact of Maternal Age on Singleton Birthweight in Frozen Embryo Transfer Cycles.

Background: Previous studies have investigated the effect of maternal age on assisted reproductive technology success rates. However, little is known about the relationship between maternal age and neonatal birthweight in frozen embryo transfer (FET) cycles. Whether maternal age influences singleton birthweight in FET cycles remains to be elucidated. Methods: This study was conducted at a tertiary care center, involving singleton live births born to women undergoing frozen-thawed embryo transfer during the period from January 2010 to December 2017. A total of 12,565 women who fulfilled the inclusion criteria were enrolled and grouped into four groups according to the maternal age: <30, 30-34, 35-39, and ≥40 years old. A multivariable linear regression analysis was conducted to reveal the relationship between maternal age and neonatal birthweight with controlling for a number of potential confounders. Results: The highest proportions of low birthweight (LBW, 4.1%), high birthweight (1.2%), preterm birth (PTB, 5.9%), and very PTB (0.9%) were found in the group over 40 years old, but no significant difference was observed among the four groups. Additionally, the 35-39-year-old group had the highest rate of very LBW (0.6%), whereas the 30-34-year-old group had the lowest rate of small for gestational age (SGA, 2.7%). However, multivariate analyses revealed that neonatal outcomes including PTB, LBW, and SGA were similar between the different maternal age groups. Conclusion: Grouping with different maternal age was not associated with mean birthweight and Z-scores of singletons resulting from FET.

[Effects of Chinese herbal medicine Bushen Shugan Recipe in regulating the hypothalamus-pituitary-ovarian axis in a rat model of stress-induced anorexia].

OBJECTIVE: To investigate the effects of Bushen Shugan Recipe (BSSGR), a compound traditional Chinese herbal medicine, in regulating the hypothalamus-pituitary-ovarian axis (HPOA) in a rat model of stress-induced anorexia. METHODS: Anorexia was induced in rats by the methods of separation, diet restriction and constraint. Rats were divided into 4 groups randomly: control group, untreated group, sham-operated group and BSSGR group. After the experiments, body weights and oestrous cycles of the 4 groups were compared. The levels of serum estradiol (E(2)), hypophysis luteotrophic hormone (LH), hypophysis follicle stimulating hormone (FSH) and hypothalamus ß-endorphin (ß-EP) were detected by radioimmunoassay. The level of serum corticosterone (CORT) was detected by enzyme-linked immunosorbent assay. RESULTS: Body weight of BSSGR group was significantly increased in comparison with sham-operated group(P<0.01); the oestrous cycle disordering rate was higher than those of the untreated group and sham-operated group; hypophysis LH and serum E(2) were obviously increased in comparison with untreated group (P<0.05); hypothalamus ß-EP was obviously decreased in comparison with sham-operated group (P<0.05); serum CORT was obviously decreased in comparison with untreated group (P<0.05), and significantly decreased in comparison with sham-operated group (P<0.01). CONCLUSION: BSSGR increased hypophysis LH and serum E(2), and decreased serum CORT and hypothalamus ß-EP in rats with stress-induced anorexia.

Xiaotan Jieyu Prescription Alleviates Breast Precancerous Lesions through PI3K/Akt Signaling Pathway.

METHODS: The successfully established breast precancerous lesion rat model and normal healthy rats were randomly assigned into the blank (BLA), model (MOD), XTJY-low (LD), XTJY-medium (MD), XTJY-high (HD), and tamoxifen (TAM) groups. Different concentrations of XTJY and saline were supplied by intragastric administration for 4 consecutive weeks to assess the protective effect of XTJY on the progress of the breast precancerous lesion in rats involving the phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. RESULTS: In this study, it determined that 10 mg/each rat DMBA-combined estrogen and progesterone induction for 10 weeks was the optimal condition for the establishment of the breast precancerous lesion rat model. In vivo administration of XTJY or TAM was found to inhibit the development of the breast precancerous lesion, and the occurrence rate of breast invasive carcinomas was decreased by about 50%. Furthermore, XTJY or TAM markedly reduced protein expressions of PI3K and p-Akt and increased protein expressions of PTEN. CONCLUSION: These data indicated that XTJY can significantly alleviate the development of breast precancerous lesions by inhibiting the activation of the PI3K/Akt signaling pathway. XTJY may be a promising drug for the treatment of precancerous lesions in breast cancer.

[Inhibitory effects of puerarin on invasion and metastasis of oophoroma cells HO-8910].

OBJECTIVE: To investigate the inhibitory effect of puerarin on invasive and metastatic abilities of tumor cells, and its possible mechanism through observing its impacts on the migratory, adhesive and invasive capacities of human oophoroma cells HO-8910 to the artificial recombined basement membrane. METHODS: Expression of estrogen receptor (ER) in HO-8910 cells was detected using PCR assay. Effects of puerarin on HO-8910 proliferation was detected with MTT assay; on its adhesion potential was tested with cell-matrigel adhesion assay, and on invasive and migratory capacities were measured with Transwell matrigel invasion assay and Transwell motility assay respectively. RESULTS: ER was positively expressed in HO-8910 cells. After being treated with 20 micromol/L puerarin for 12 h, the adhesive test showed that OD value in the tested group was significantly lower than that in the control (P < 0.01), the inhibiting rate reached 50.63%; and the Transwell assay showed a significant lowering of penetrated cells (P < 0.01), the inhibition rate for invasion was 38.59% and that for motility migration 40.63%. The number of penetrated cells was lower in the group intervened with combination of Puerarin and estrogen than in the group intervened with estrogen alone, 33.40 +/- 3.30 vs 48.05 +/- 3. 56 for invasion and 35.35 +/- 3.03 vs 52.45 +/- 1.04 for motility (all P < 0.01). CONCLUSION: Puerarin can inhibit the adhesion, invasion and migration of HO-8910 cells, plays an antagonist effect against the stimulation of estrogen on the malignant behavior of tumor cells.

[Regulatory mechanism of malignant behavior of endometriosis mediated by puerarin].

OBJECTIVE: To observe the inhibitory effects of puerarin on angiopoiesis of endometriotic tissue, and to explore the regulatory effects of puerarin on tumor-related gene expression of endometriosis. METHODS: The regulatory effects of puerarin on endometriotic angiopoiesis and tumor-related gene expression were observed by using a chicken chorioallantoic membrane model and gene array method. RESULTS: Chicken chorioallantoic membrane experiment indicated that puerarin obviously inhibited endometriotic vesiculation and angiopoiesis. The area of blood vessels was significantly reduced as compared with the untreated group (P<0.05). The expressions of oncogenes and genes related to adhesion, invasion, and apoptosis, including ERBB2, ETS2, FOS, S100A4, TEK, TERT, NFKBIA, CDH1, CD44, ITGA6, NCAM1, MMP1, FLT1, AKT1, BCL2L and BIRC5 genes, were obviously higher, while the expressions of the anti-oncogenes, anti-apoptosis genes and anti-invasion genes, including KAI1, KISS1, SERPINB5, TNFRSF25, TNFRSF1A, TNFRSF6 and SERPINB2, were significantly lower in eutopic endometrial tissue from patients with endometriosis than those from endometriosis-free women. The expressions of oncogenes (ERBB2, ETS2, FOS), apoptosis gene (BCL2L1), cyclin-dependent kinases (CDK4, CDC25A), and growth factor and receptors (HGF, FGFR2, TGFBR) were significantly enhanced, while the expressions of the anti-oncogenes (KAI1, SERPINB5), apoptosis genes (BAD and TNF) and cyclin-dependent kinase inhibiting factor (CDKN2A) were obviously reduced in ectopic tissue as compared with those in eutopic tissue from patients with endometriosis. Puerarin significantly enhanced the gene expressions in endometriotic stromal cells, including BAD, BAX, CASP8, CASP9, TNFRSF6, CDKN1B, CDKN2A, IFNA1 and IFNB1, and reduced the gene expressions of FOS, CHEK2, SRC, ITGB5, MMP9, PDGFA and NFKBIA. CONCLUSIONS: The tumor-related gene expression has significant differences in eutopic endometrial tissue between patients with endometriosis and endometriosis-free women, and between ectopic and eutopic tissues from patients with endometriosis. Puerarin can reduce angiopoiesis, regulate tumor-related gene expression and facilitate apoptosis in endometriotic tissue.

[Epidemiological investigation of perimenopausal women in Shanghai].

OBJECTIVE: To explore the cognitive level and the mental status of the patients suffering from perimenopausal syndrome in Shanghai, and to identify the traditional Chinese medicine syndrome distribution feature of perimenopausal syndrome. METHODS: The cognitive level of the perimenopausal women was evaluated by using general living problem questionnaire. The mental status of the perimenopausal women was evaluated by using self-rating depressive scale. The traditional Chinese medicine syndrome distribution feature of perimenopausal syndrome was identified by using traditional Chinese medical symptoms questionnaire. RESULTS: A total of 634 perimenopausal women finished the investigation. There were 74.76% (474/634) patients who knew little about the perimenopausal syndrome; 77.29% (490/634) patients had a depressive tendency; 8.36% (53/634) patients had depressive disorder. There were 72.40% (459/634) patients who had the symptoms such as susceptibility to anger and restlessness, restless sleep at night, thirst with dry throat and bitter taste, and all these symptoms could be classified into hyperactivity of heart and liver fire syndrome. CONCLUSION: Patients suffering from perimenopausal syndrome know little about this disease and mostly have depressive tendency, and the major traditional Chinese medicine syndrome pattern is hyperactivity of heart and liver fire based on the chief clinical manifestations of the patients.

[Effects of Bushen Huayu Qutan Recipe on local ovarian factors in androgen-sterilized rats].

OBJECTIVE: To explore the effects of Bushen Huayu Qutan Recipe (BHQR), a compound traditional Chinese herbal medicine, on local ovarian factors in androgen-sterilized rats (ASR). METHODS: One hundred and five 9-day-old SD rats were randomly divided into normal control group (15 rats) and ASR group (90 rats). ASR was induced by subcutaneous injection of testosterone propionate, and the rat model of ASR was established successfully in 30 rats in the ASR group. Thirty ASR rats were randomly divided into untreated group and BHQR-treated group. There were 15 rats in each group. The rats in BHQR-treated group were intragastrically administered with BHQR. The rats in the normal control and untreated groups were intragastrically administered with distilled water. They were all treated for 30 days. The levels of serum testosterone and insulin (INS) were measured by radioimmunoassay. The inhibin (INH) level, and the expressions of insulin-like growth factor-I(IGF-I) and vascular endothelial growth factor (VEGF) in ovary were determined by immunohistochemical method. RESULTS: None of the ASR ovulated and all the rats in the normal control group ovulated. The rate of ovulation in BHQR-treated group was 66.67%. The serum concentrations of testosterone and INS in the untreated group were significantly higher than those in the normal control group (P<0.05), and the serum concentrations of testosterone and INS in BHQR-treated group were decreased as compared with the untreated group (P<0.05). The levels of ovarian INH, IGF-I and VEGF in the untreated group were significantly higher than those in the normal control group (P<0.01), and the levels of ovarian INH, IGF-I and VEGF in BHQR-treated group were decreased as compared with the untreated group (P<0.01). CONCLUSION: BHQR is an effective recipe in promoting ovulation, and the effects of BHQR on balancing the internal environment of ovary may be due to the reduction of serum INS level and decrease in the expressions of ovarian INH, IGF-I and VEGF.

[Bushen Huoxue Huayu Recipe up-regulates expression of insulin receptor substrate-1 and phosphorylation of tyrosine in adipose tissue in androgen sterilized rats].

OBJECTIVE: To investigate the expression of insulin receptor substrate-1 (IRS-1) and phosphorylation of tyrosine in androgen sterilized rats (ASRs) and the effects of Bushen Huoxue Huayu Recipe (BHHR), a compound Chinese herbal medicine for tonifying kidney and activating blood, on the ASRs, and to analyze the possible mechanism. METHODS: ASR models were established by means of testosterone injected subcutaneously at the age of 9 days. The model rats were randomly divided into BHHR group (n=15) and untreated group (n=15); the rats in normal group (n=15) were injected with oil. The rats in the BHHR group were treated with BHHR for 30 days, and the rats in model group and normal group were treated with distilled water for 30 days. Body weight and area under the curve (AUC) of insulin were measured after treatment. Expression of IRS-1 and phosphorylation of tyrosine in adipose tissue in ASRs were analysed by immunohistochemical method. RESULTS: The body weight and insulin AUC in the untreated group were increased and more than those in the BHHR group and the normal control group (P<0.05). Expression of IRS-1 and phosphorylation of tyrosine in normal group were significantly higher than those in the untreated group (P<0.05), and those in BHHR group were improved and significantly different from those in the untreated group (P<0.05). CONCLUSION: BHHR can increase the expression of IRS-1 and phosphorylation of tyrosine in adipose tissue in IR rats, which may be one of its mechanisms in improving insulin sensitivity of the target tissues.

Regulation of aromatase P450 expression by puerarin in endometrial cell line RL95-2.

OBJECTIVE: To study the effects of puerarin on the aromatase P450 (P450(arom)) mRNA expression and the effects of low-dose puerarin on transcription factors of the P450(arom) gene (P II) 5'-flanking region. METHODS: The effects of puerarin on the P450(arom) mRNA expression were determined by real-time polymerase chain reaction (RT-PCR). The 5'-flanking region was amplified by PCR using human genomic cDNA as a template. By means of the restriction sites and sequence confirmation, the PCR product was cloned into reporter vector. Series of sequential deletion reporter constructs were transiently transfected into RL95-2 cells which were treated with or without puerarin. Luciferase activity was measured by Dual-Luciferase Reporter Assay System and Luminoskan Ascent luminometer. Furthermore, by using web-based search program, the most possible cis-acting elements and transcription factors were evaluated. RESULTS: The data demonstrated that low-dose puerarin treatment could decrease P450(arom) expression at mRNA level compared to dimethyl sulphoxide (DMSO) treatment (P<0.01), and puerarin (10(-7)mol/L) had a time-course effect on P450(arom) mRNA expression, which reached the bottom at 12h (P<0.01). Cells transfected with the -763/+8 bp constructs showed decrease in relative luciferase activity after puerarin (10(-7)mol/L) treatment compared to DMSO treatment (P<0.05), indicating an essential regulatory site between -763 bp and -543 bp responsible for the transcription suppression by puerarin. Furthermore, the most possible transcription factors, which turned out to be AP-1(c-jun/c-fos) at -410/-401 bp were also evaluated. The activity of exogenous AP-1 was reduced after 12 hours of puerarin treatment (P<0.05). The inhibition of c-jun mRNA also showed a time-course effect, which bottomed out at 12h in parallel with that of P450(arom) (P<0.01). The protein level of c-jun was also down-regulated by puerarin (10(-7)mol/L) treatment at 12h. CONCLUSION: The suppression of P450(arom) expression and activity may be associated with the down-regulation of transcription factor AP-1/c-jun. This partially explains the mechanisms whereby puerarin treats endometriosis.

[Clinical study on effect of Bushen Huayu Qutan Recipe in treating polycystic ovarian syndrome].

OBJECTIVE: To investigate the therapeutic effect and the possible mechanism of Bushen Huayu Qutan Recipe (BHQR, a Chinese recipe formulated according to the therapeutic principle of nourishing Shen, resolving stasis and dispelling phlegm) on polycystic ovarian syndrome (PCOS). METHODS: BHQR was used, both internally and externally, to treat 46 patients with PCOS, and combined with diformin if necessary. Six successive months treatment was regarded as one course. The clinical symptoms and signs, including obesity, polytrichia, acne and acanthosis, were observed and scored before and after treatment; and serum levels of hormones and insulin were measured as well. RESULTS: After treatment, the scores of symptoms and signs of patients were significantly lowered (P<0.05 for obesity and P <0.01 for others), significant lowering was also found in serum level of testosterone (P<0.05), fasting serum insulin (P<0.01) and the values of insulin and insulin area under curve (P<0.05) 30 min and 60 min after glucose load. CONCLUSION: BHQR could not only significantly relieve the symptoms and signs of patients with PCOS, but also regulate well the ovarian function.

[Construction of a therapeutic effect evaluation system for patients with primary liver cancer based on syndrome differentiation in traditional Chinese medicine].

OBJECTIVE: To construct a system of therapeutic effect evaluation for patients with primary liver cancer according to the theory of syndrome differentiation in traditional Chinese medicine (TCM), and to examine its reliability. METHODS: Analytic hierarchy process and 100 mm surveyor's rod method were applied to obtain bottom layer and top level syndromes, which were used to construct the method of therapeutic effect evaluation, and its reliability was verified in clinical practice by comparing with some evaluation criteria in Western medicine, such as cancer severity scale; Karnofsky performance scale; Child-Pugh classification, cancer staging classification, and quality of life scale, etc. RESULTS: A system of therapeutic effect evaluation was constructed, and it could reflect the progress of tumor, changes of hepatic function and constitution. The evaluation scores acquired from the system were highly associated with the quality of life of the patients. CONCLUSION: The system of therapeutic effect evaluation can reflect the severity of disease and the characteristics of TCM treatment.

Consensus on the integrated traditional Chinese and Western medicine criteria of diagnostic classification in polycystic ovary syndrome (draft).

Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder of women, with complex pathogenesis and heterogeneous manifestations. Professor Jin Yu recently wrote an article entitled "Proposal of Diagnosis and Diagnostic Classification of PCOS in Integrated Traditional Chinese and Western Medicine."From this, the Obstetrics and Gynecology branches of the Chinese Association of Integrative Medicine and the China Association of Chinese Medicine collaborated with the Gynecology branch of the Chinese Association for Research and Advancement of Chinese Medicine to draft a report on the consensus of criteria for the diagnosis and classification of PCOS in integrated traditional Chinese and Western medicine. The diagnosis for PCOS includes all three features: (1) oligo-ovulation or anovulation; (2) clinical and/or laboratory evidence of hyperandrogenism;(3) PCOS is classified into four types: types Ia,Ib, IIa, and IIb. Syndrome differentiation types for PCOS in traditional Chinese medicine are as follows: Kidney deficiency with phlegm blockage syndrome, Kidney Yin deficiency with phlegm blockage and blood stasis syndrome, and Kidney deficiency with Liver Qi stagnation syndrome.

Meta-Analysis of Chinese Traditional Medicine Bushen Huoxue Prescription for Endometriosis Treatment.

OBJECTIVES: To evaluate the efficacy and safety of Bushen Huoxue prescription (BSHXP) for endometriosis. METHODS: A meta-analysis was performed, and studies were searched from the seven databases from the date of database establishment to April 30, 2017. Randomized controlled trials (RCTs) that explored the efficacy and safety of BSHXP for patients with endometriosis were included. Two assessors independently reviewed each trial. The Cochrane Risk of Bias assessment tool was used for quality assessment. RESULTS: In the 13 included studies, the total effectiveness rates of BSHXP were higher than those of Western medicine (RR, 1.55; 95% CI, 1.03-2.32; P = 0.04), but the dysmenorrhea alleviation rates of the two treatments did not significantly differ (RR, 1.28; 95% CI, 0.70-2.34; P = 0.42). The pregnancy rates of BSHXP were also higher than those of hormone therapy (RR, 1.99; 95% CI, 1.17-3.39; P = 0.01). However, whether BSHXP is more effective than Western medicine in diminishing endometriotic cyst remains unknown. CONCLUSIONS: Our study provides evidence that BSHXP is effective and safe for endometriosis, but this evidence is inconclusive because of the low methodological quality of the included RCTs. Our findings suggest that BSHXP is an alternative drug for endometriosis, but it should be further examined in future clinical research.

[Primary culture and morphologic observation of eutopic and ectopic endometrial cells from patients with endometriosis].

OBJECTIVE: To explore the method of primary culture for endometriotic cells and to find out the differences in morphological manifestations among endometriotic cells and eutopic endometrial cells sampled from patients with endometriosis and endometriosis-free women. METHODS: Endometriotic and eutopic endometrial cells were cultured by modified method of primary culture. The endometriotic cell types were observed and differentiated under optical and electron microscopes. RESULTS: The success rates for culture of eutopic endometrial cells from endometriosis-free women and patients with endometriosis were 91.67% and 93.75% respectively. The success rate for culture of endometriotic cells was 75.00%. The size of endometriotic glandular cells was similar to those of eutopic endometrial glandular cells from endometriosis-free women and patients with endometriosis. The chromatin was manifold and the nucleus was augmented in the endometriotic glandular cells. The endometriotic stromal cells were smaller than the eutopic endometrial stromal cells from endometriosis-free women and patients with endometriosis. Many tiny villi and protuberances on plasma membrane could be seen in the endometriotic stromal cells. CONCLUSION: The success rate for culture of endometriotic cells can be elevated through improving the method of primary culture. The ultrastructures of endometriotic glandular and stromal cells are obviously different from those of eutopic endometrial glandular and stromal cells from endometriosis-free women and patients with endometriosis.

[Ginsenosides combined with dexamethasone in preventing and treating postembolization syndrome following transcatheter arterial chemoembolization: a randomized, controlled and double-blinded prospective trial].

OBJECTIVE: To observe the effect of ginsenosides (GS) and low dose glucocorticoid in preventing and treating the postembolization syndrome following transcatheter arterial chemoembolization (TACE). METHODS: Eighty patients with primary liver carcinoma were randomly divided into 4 double-blinded groups, with 20 patients in each group. Patients in groups A, B, C, D were treated with placebo, dexamethasone (Dex), GS, Dex and GS, respectively. The changes of clinical symptoms and laboratory tests after TACE were observed. RESULTS: Dex combined with GS markedly decreased the occurrence ratio and lasting time of the symptoms such as nausea, vomiting, fever and pain, and protected the function of liver as compared with the placebo (P<0.05). Single use of Dex or GS improved some symptoms as compared with the placebo, but it was not as good as the combination of Dex and GS. CONCLUSION: Dex combined with GS can effectively prevent and treat the postembolization syndrome following TACE.

[Study of a qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer].

OBJECTIVE: To work out a qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer. METHODS: Based on the collection and analysis of related medical literature, clinical investigation, and experts' discussion, a preliminary qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer was formulated. Then it was used in clinic to be verified and revised repeatedly till it was improved to be a satisfied formal criterion. RESULTS: The basic syndromes listed in the qualitative diagnostic criterion for basic syndromes in patients with primary liver cancer consisted of two parts: excessive syndromes, including the syndromes of stagnation of qi, blood stasis, excess-heat and dampness, and deficient syndromes, including the syndromes of deficiency of qi, deficiency of blood, deficiency of yin and deficiency of yang. Each of the above syndromes could be diagnosed according to specific combination of its corresponding symptoms or signs. The clinical verification results showed that the total matching ratio was 73.92% between the diagnoses made according to the criterion and the diagnoses acquired from the experts' experience. CONCLUSIONS: The qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer is coincident with the experts' clinical practice. However, it needs to be further studied.

Wrist-ankle acupuncture and ginger moxibustion for preventing gastrointestinal reactions to chemotherapy: A randomized controlled trial.

OBJECTIVE: To evaluate the effects of wrist-ankle acupuncture combined with ginger moxibustion against gastrointestinal tract reactions (nausea, vomiting, and constipation) to chemotherapy in cancer patients. METHODS: A total of 60 patients with gynecological tumors treated by chemotherapy were randomly divided into two groups. The treatment group (30 cases) underwent wrist-ankle acupuncture and ginger moxibustion, whereas tropisetron hydrochloride and dexamethasone were intravenously administered to the control group (30 cases) during chemotherapy. RESULTS: The frequency of nausea in the treatment group was significantly less than that of the control group from the 2nd to the 5th day of chemotherapy (P<0.01). The anti-emetic effect in the treatment group was significantly better than that in the control group on the 3rd day of therapy (P<0.05). The incidence rate of constipation was significantly lower in the treatment group than that in the control group (P<0.01). Furthermore, the cost of therapy for the treatment group was significantly lower than that of the control group (P<0.01). Only 1 patient manifested a post-acupuncture side effect in the form of subcutaneous blood stasis. CONCLUSION: Wrist-ankle acupuncture combined with ginger moxibustion could prevent gastrointestinal tract reactions to chemotherapy in cancer patients. In addition, the proposed method had fewer side effects, lower cost, and less risk.