Effect of danefukang on symptoms and biomarkers in women with endometriosis.

OBJECTIVE: The purpose of this study was to observe the efficacy of Danefukang (DEFK) soft extract for the treatment of symptoms associated with endometriosis, and its effect on quality of life, the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores, and on levels of carbohydrate antigen (CA)-125, tumor necrosis factor (TNF)-α, and interleukin (IL)-6. MATERIALS AND METHODS: A total of 174 patients with endometriosis treated from January 2010 to December 2013 were randomly divided into a control group treated with mifepristone (n = 87) or DEFK (n = 87). Both groups were treated for 3 months. Symptoms, quality of life, SAS, SD scores, and levels of CA-125, TNF-α, and IL-6 were evaluated before and after treatment. RESULTS: The effectiveness rate was 93.10% in the DEFK group and 81.61% in the mifepristone control group (χ2 = 4.215, P < 0.05). Treatment with DEFK resulted in a greater improvement in quality of life, SDS, and SAS scores compared with mifepristone (all, P < 0.05). DEFK treatment also resulted in a greater decrease of CA-125, TNF-α, and IL-6 levels compared with mifepristone (all, P < 0.05). CONCLUSION: Based on the current results - improved symptoms, attenuated depression and anxiety, and reduced the levels of pro-inflammatory cytokines and CA-125 -treatment with DEFK is a meaningful option for patients with endometriosis. DEFK fills an unmet need in the pharmacologic treatment of endometriosis.

Randomized comparison of long and short vascular sheaths in reduction of the operator radiation exposure during uterine artery embolization.

OBJECTIVE: To introduce a method in which a long sheath is used instead of the traditional short sheath, to reduce the radiation exposure of operators in uterine artery embolization (UAE). METHODS: 52 patients undergoing UAE were randomly divided into two groups before the procedure: an 11-cm short sheath was used in Group A (n = 25), and a 45-cm-long sheath was used in Group B (n = 27); the 45-cm-long sheath was only partly inserted such that the hub of the sheath was approximately 34 cm caudal to the groin puncture site. All the procedures were standard bilateral UAE operations through unilateral approach. The other parameters of the two groups were kept the same, including the fluoroscopy conditions and the pelvic radiation field size. The thermoluminescent personal dosemeters were attached to the left wrist and left outer side of the thyroid collar of the operator during each operation. The radiation exposure of the operator, procedure duration and fluoroscopy time of each procedure were recorded. Statistical analysis was performed using independent samples t-test. RESULTS: The radiation exposure of both the left hand and thyroid of the operator was significantly reduced with the long sheath compared with the short sheath (89.5 ± 7.2 µGy vs 186.7 ± 12.6 µGy, p < 0.001, and 54.1 ± 5.5 µGy vs 63.9 ± 7.4 µGy, p < 0.001, respectively). No significant differences were found in the procedure duration and fluoroscopy time between the two groups (p > 0.1). CONCLUSION: Using a long sheath in UAE could significantly reduce the radiation exposure to the interventionists without extending the procedure duration or fluoroscopy time. ADVANCES IN KNOWLEDGE: For the first time, we introduce a simple and convenient method to reduce the radiation exposure of the operator in the UAE procedure.

Entropy of T2-weighted imaging combined with apparent diffusion coefficient in prediction of uterine leiomyoma volume response after uterine artery embolization.

RATIONALE AND OBJECTIVES: To determine the potential value of entropy of T2-weighted imaging combined with apparent diffusion coefficient (ADC) before uterine artery embolization (UAE) for prediction of uterine leiomyoma volume reduction (VR) after UAE. MATERIALS AND METHODS: In this prospective study, 11 patients with uterine leiomyomas who underwent pelvic magnetic resonance imaging including diffusion-weighted imaging before and 6 months after UAE were included. A total number of 16 leiomyomas larger than 2 cm in diameter were evaluated. The volume of each leiomyoma before and after UAE was determined, and the percentage change in volume was calculated. Entropy of T2-weighted imaging and ADC before UAE were assessed. Pearson correction coefficients were calculated between leiomyoma VR after UAE and age, leiomyoma volume, ADC, and entropy, respectively. Multiple regression analysis was performed to investigate the parameters that determine the VR after UAE. Receiver operating characteristic curve analysis was used to determine the sensitivity and specificity of ADC, entropy and the combination of ADC and entropy for predicting volume response. RESULTS: The mean leiomyoma VR was 58.9% (range 25.8%-95.0%) in the 6-month follow-up. The mean ADC of leiomyomas was 1.37 × 10(-3) mm(2)/s (range 1.05 × 10(-3)-2.32 × 10(-3) mm(2)/s) and the mean entropy of T2-weighted imaging was 5.36 (range 4.62-5.91) before UAE. ADC and entropy were significantly correlated with leiomyoma VR, respectively (r = 0.61, P = .012; r = 0.73, P = .001). On multiple regression analysis, a combination of ADC and entropy constituted the best model for determining leiomyoma VR using Akaike information criterion. For predicting ≥50% VR, the optimal cutoff value of ADC was 1.39 × 10(-3) mm(2)/s (sensitivity 45.5%, specificity 80.0%) and the optimal cutoff value of entropy was 5.15 (sensitivity 90.9%, specificity 60.0%). The combination of ADC and entropy (area under the curve [AUC] 0.86) provided better classification accuracy than ADC or entropy alone (AUC 0.69 and 0.82, respectively). CONCLUSIONS: Pre-UAE entropy of T2-weighted imaging and ADC of leiomyomas were significantly correlated with the leiomyoma VR 6 months after embolization. Higher entropy and higher ADC may be related to greater leiomyoma VR after UAE. A combination of entropy and ADC may have predictive value for leiomyoma VR after UAE.

Thrombin promotes epithelial ovarian cancer cell invasion by inducing epithelial-mesenchymal transition.

OBJECTIVE: Over-expression of thrombin in ovarian cancer cells is associated with poor prognosis. In this study, we investigated the role of thrombin in inducing epithelial-mesenchymal transition (EMT) in SKOV3 epithelial ovarian cancer cells. METHODS: After thrombin treatment SKOV3 cells were subjected to western blots, reverse-transcription PCR, and enzyme-linked immunosorbent assay to quantify EMT-related proteins, mRNA expression of SMAD2, DKK1, and sFRP1, and the secretion of matrix metalloproteinases (MMPs) and cytokines. Meanwhile, invasion ability was evaluated using transwell assays. RESULTS: The results indicated a dose- and time-dependent down-regulation of E-cadherin and upregulation of N-cadherin and vimentin in thrombin-treated SKOV3 cells, compared with the thrombin-free control group (p<0.05). There was a dose- and time-dependent increase in the levels of SMAD2 and DKK1 mRNAs and a decrease in the levels of sFRP1 mRNA in thrombin-treated SKOV3 cells compared to control cells (p<0.05). Thrombin-treated SKOV3 cells exhibited increased secretion of MMP-9, MMP-2, interleukin (IL)-8, and IL-6 and increased invasion compared to untreated cells (p<0.05). Thrombin altered the morphology of SKOV3 cells to a spindle-like phenotype. Addition of hirudin to thrombin-treated cells reversed the effects of thrombin. CONCLUSION: Thrombin induced EMT and promoted the invasion of SKOV3 cells, possibly via distinct signaling pathways. Hirudin inhibited the effects of thrombin, suggesting that anticoagulant therapy could be a novel therapeutic strategy for ovarian carcinoma.