Comparison between direct use and PLGA nanocapsules containing drug of traditional Chinese medicine, Tiaojing Zhixue, in treatment of dysfunctional uterine bleeding

Dysfunctional uterine bleeding is menstrual bleeding in abnormal volume, duration, or time, and it is a common problem in women. A wide range of drug therapies, with varying efficacy, is available for women with dysfunctional uterine bleeding. The use of herbal and traditional medicine is one of the ways to treat this disease, which has fewer side effects than chemical drugs. On the other hand, these medicines have less effect on treatment than chemical drugs. Therefore, increasing their effectiveness in the treatment of diseases has always been important. For this purpose, in this study, a comparison was done between direct use and PLGA nanocapsules containing Tiaojing Zhixue, in the treatment of dysfunctional uterine bleeding. First, PLGA nanocapsules containing Tiaojing Zhixue were synthesized by the electrospray technique. Then 80 women with dysfunctional uterine bleeding were treated with this medicine. These people were divided into two groups of 40 people. The first group was treated with 20mg of Tiaojing Zhixue and the other group was treated with PLGA nanocapsules containing Tiaojing Zhixue for eight months. The duration and frequency of bleeding from one month before the start of treatment and during the eight months after the start of treatment (second, fourth, and eighth month) were assessed in two groups. The two groups were homogeneous in terms of mean frequency of bleeding and mean duration of bleeding before starting treatment. The positive response in the PLGA nanocapsules treatment group (75%) was higher than the direct use drug treatment group (42.5%) (P < 0.01). The rate of side effects was the same in each group. Due to the effectiveness of PLGA nanocapsules in the treatment of dysfunctional uterine bleeding and the lack of side effects, it can be considered as an alternative medicine for the treatment of this disorder.

A Prospective Comparative Study on Cardiac Alterations After Surgery and Drug Treatment of Primary Aldosteronism

BackgroundCurrent guideline recommends both surgery and drug treatment for primary aldosteronism. Treatment effects on the cardiac structure and function remain under investigation.ObjectiveWe performed a prospective study in patients with primary aldosteronism to compare effects of surgery and drug treatment on the cardiac structure and function as assessed by the left ventricular (LV) pressure-strain loop, a novel echocardiographic technique that incorporates myocardial deformation and LV pressure.MethodsOur study included 39 and 28 patients treated with surgery and a mineralocorticoid antagonist, respectively. We performed conventional and speckle tracking echocardiography at baseline and 3 and 6 months of follow-up.ResultsDuring follow-up, both surgery and drug treatment normalized serum potassium concentration and significantly reduced blood pressure. Both treatments significantly and similarly decreased LV mass index and left atrial volume index. However, only in the surgery group did global wasted work significantly decrease (200.8 ± 86.7 at baseline vs. 142.1 ± 58.1 mmHg% at 6 months) and global work efficiency (91.5 ± 3.1 vs. 93.6 ± 2.3%) and global longitudinal strain (−18.3 ± 2.7 vs. −19.2 ± 1.9%) significantly (p &lt; 0.01) increase at 6 months of follow-up. The corresponding differences from the changes in the drug treatment group were 39.5 mmHg% (95% CI, 17.1, 62.0 mmHg%), −1.64% (95% CI, −2.56, −0.71%), and −0.85% (95% CI, −1.51, −0.20%), respectively. In addition, the changes in global wasted work at 6 months of follow-up was significantly correlated with that in 24-h urinary aldosterone excretion in the drug treatment group (r = 0.54) and two groups combined (r = 0.55), but not the surgery group.ConclusionIn spite of similar serum potassium normalization and blood pressure control, surgical removal of an adrenal gland, but not mineralocorticoid receptor antagonism, showed early improvement in cardiac function.

Treatment Experience of 210 Pediatric Patients With Extraordinary Daytime Urinary Frequency: A Prospective Study

Background: Lactulose can be used to manage chronic constipation and children who are withholding their bowel movements, but no studies are available regarding lactulose to treat pediatric extraordinary daytime urinary frequency (PEDUF). To explore the benefits of different therapeutic regimens (non-drug treatment vs. oral lactulose) in patients with PEDUF.Methods: This prospective study included PEDUF patients admitted to the Pediatric Center of Qilu Hospital of Shandong University (Qingdao) from January 2015 to December 2019. The patients randomized received non-drug treatment (counseling), drug treatment (lactulose), or combination therapy. A therapeutic effect was defined by a decrease of&gt;10% of the urination frequency.Results: A total of 210 patients were included. They were 5.9 ± 0.4 years. There were 98 boys and 112 girls. Among the 210 patients, 82.4% (173/210) of their family members reported symptoms of constipation. Among the three groups, the response rate was 61.4% (43/70) in the non-drug treatment group, 90.0% (63/70) in the drug treatment group, and 91.4% (64/70) in the combination therapy group (P &lt; 0.0001).Conclusion: The frequency of constipation in children with PEDUF is high. The use of a laxative, like lactulose, might achieve a high therapeutic response rate in children with PEDUF, higher than counseling alone. That might represent a valuable therapeutic strategy for PEDUF.

Anti-nociceptive effect of gabapentin in mouse models of acute and chronic pain

Purpose: To investigate the anti-nociceptive effect of gabapentin in acute and chronic pain models. Methods: Four mouse models of pain were used in this study. These comprised thermal tests (hot plate and tail immersion tests), and chemical tests (formalin and acetic acid-induced writhing tests). A total of seventy-two (72) albino mice weighing 25 - 40 g (mean weight = 32.5 ± 5.1 g) were used. In each test, the mice were randomly assigned to three sets of 6 mice each: control group, celecoxib group and drug treatment group. Each test was performed at intervals of 30, 60 and 90 min. Results: During the acute phase, there was no significant decrease in foot raising (FR) or licking and biting (L & B) episodes among the groups (p > 0.05). However, these episodes were significantly (p < 0.05) decreased in the second delayed phase, in the celecoxib and drug-treated groups, when compared with normal control group. Gabapentin significantly (p < 0.05) decreased pain response throughout the course of the thermal tests. The number of writhes within 30 min were significantly reduced in celecoxib and gabapentin-treated animals, compared with negative control group (p < 0.05). Gabapentin produced approximately 60 % protection of writhing, similar to that produced by celecoxib, the standard non-steroidal anti-inflammatory drug (NSAID) used (61 %). Conclusion: The results demonstrate that the gabapentin is effective against chronic inflammatory pain in mice and therefore can be potentially developed as an effective anti-inflammatory agent for humans.

Predictive Diagnosis of Neurological Function in Patients with Atherosclerotic Cerebral Arterial Stenosis by Transcranial Doppler Ultrasound Imaging Information Technology

Objective: The purpose of this experiment is to observe the clinical effect of transcranial ultrasound thrombolytic adjuvant therapy, and to provide clinical results for transcranial ultrasound thrombolytic therapy for atherosclerotic cerebral arterial stenosis. in accordance with. Methods: Collected in the Department of Neurology, Brain Hospital of our hospital within 24 hours after the onset from October 2012 to April 2014, DSA and/or MRA, CTA examination confirmed the existence of middle cerebral artery stenosis and evidence of cerebral atherosclerosis, 100 patients with narrow middle cerebral artery as the diagnostic criteria for cerebral infarction. Results: The positive rates of microemboli in the ultrasound thrombolysis group at 7 days and 14 days were 17.00% and 6.00% significantly lower than those in the drug treatment group at 67.00% and 8.30% (P < 0.05); the 7 days and 14 days of ultrasound thrombolysis treatment group Serum high-sensitivity (P < 0.05), and serum C-reactive protein levels in the ultrasound thrombolytic treatment group were significantly lower than those in the drug treatment group (P < 0.05). Conclusion: Transcranial ultrasound thrombolytic adjuvant drug treatment can significantly promote the recovery of neurological function.

Treatment of Uremic Tumoral Calcinosis in Maintenance Hemodialysis Patients

<b><i>Background/Aims:</i></b> Uremic tumoral calcinosis (UTC) is a rare disease with metastatic tissue calcification in maintenance hemodialysis (HD) patients. However, limited data are available on the treatment of UTC in HD patients. This article mainly discusses the diagnostic findings and efficacy of treatment on HD patients with UTC. <b><i>Methods:</i></b> A retrospective analysis was conducted based on the data of 13 cases of UTC, including their clinical features, biochemical indicators, imaging findings, diagnosis, therapeutic methods, and follow-up results. Parathyroidectomy (PTX) or drug treatment was determined based on intact parathyroid hormone (iPTH) levels and clinical symptoms. <b><i>Results:</i></b> All 13 patients were diagnosed as UTC definitely by imaging examination. The predominant areas involved were the buttocks (4 cases, 30.77%), shoulders (4 cases, 30.77%), and elbows (3 cases, 23.08%). Based on the levels of iPTH, cases were categorized into 2 different groups: PTX treatment group was associated with high levels of iPTH, while drug treatment group (lanthanum carbonate or sevelamer with sodium thiosulfate) was associated with lower iPTH levels. After PTX treatment, there was a significant decrease in serum iPTH, calcium (Ca), phosphate (P), and alkaline phosphatase levels (<i>p</i> &#x3c; 0.05). In drug treatment group, the serum <i>p</i> levels were decreased significantly, along with a finding that hemoglobin levels were increased (<i>p</i> &#x3c; 0.05). All the UTC had lessened or even disappeared after 4–6 months treatment. <b><i>Conclusions:</i></b> Although most UTC patients have an increased iPTH, a small number had lower iPTH levels. Based on iPTH levels and clinical symptoms, the patients were treated with PTX or drug therapy. With proper treatment, UTC disappeared without the need for surgery to remove calcinosis tissue.

Exploration of the pathological mechanism of endometriosis in rats using high-throughput sequencing

Background : This study aimed to explore the pathological mechanism of endometriosis (EMs) in rats by high-throughput sequencing. Methods : Rat EMs model, sham operation group and drug treatment group were established. Uterine tissue was collected for construction of sequencing library and high-throughput sequencing. Data quality was examined. KEGG pathway enrichment analysis was carried out. Results : Percentages of both high-quality sequence Reads and high-quality sequence bases accounted for more than 98%, suggesting that the data quality was acceptable. Total sequences mapped to reference genome (Total Mapped) accounted for more than 90% of total sequences used for mapping (Clean Reads), suggesting that the mapping results of the sequencing data were acceptable. There were 440 differentially expressed genes (DEGs) in the drug treatment group compared with the sham operation group, 382 DEGs in the drug treatment group compared with the model group, and 503 DEGs in the sham operation group compared with the model group. We screened genes ENSRNOG00000023079 and ENSRNOG00000012175 related to vascular endothelial growth factor pathway. The DEGs were mainly enriched in the signaling pathways such as phagosome, natural killer cell mediated cytotoxicity, Janus kinase-signal transducers and activators of transcription signaling pathway, hematopoietic cell lineage, cytokine-cytokine receptor interaction, regulation of actin cytoskeleton and extracellular matrix-receptor interaction. Conclusions : EMs might begin with the inflammatory response of the ectopic endometrium. Phagocytes played a key role in this process. The ectopic endometrium adhered to the abdominal wall with the help of the inflammation reaction, generated blood vessels, and finally transformed into growing lesions.

Therapeutic effects of percutaneous coronary intervention on acute myocardial infarction complicated with multiple organ dysfunction syndrome

Objective: To evaluate the clinical efficacy of percutaneous coronary intervention (PCI) on patients with acute myocardial infarction (AMI) complicated with multiple organ dysfunction syndrome (MODS). Methods: A total of 216 patients with AMI complicated with MODS enrolled from January 2016 to March 2018 were divided into a PCI group (n=98) and a drug treatment group (n=118). The baseline clinical data, the incidence of each dysfunction organ, the number of dysfunctional organs and the mortality were compared between the two groups. Results: The number of patients with ST-segment elevation AMI in the PCI group was higher than in the drug treatment group, and the rate of patients with non-ST-segment elevation AMI was lower than in the drug treatment group (P<0.05). The use of temporary pacemakers and IABP was similar between the two groups (P>0.05). The recanalization rate in PCI group was much higher than that in the drug treatment group (P<0.05). The two groups had similar incidence of organ dysfunction in the heart, lungs, kidneys, stomach and intestine, etc. and the PCI group had lower organ dysfunction incidence in the liver, brain and hematological system than the drug treatment group (P<0.05). The dysfunction incidence rate of two organs was higher in PCI group than in drug treatment group (P<0.05), the dysfunction incidence rate of 3 organs was similar between the two groups, and the dysfunction incidence rate of three organs or more was significantly lower in PCI group than in drug treatment group (P<0.05). Conclusion: Despite the high risk and high mortality of patients with AMI plus MODS, clinical improvement can still be achieved when effective PCI is performed. doi: https://doi.org/10.12669/pjms.35.6.1162 How to cite this:Qian D, Zhou D, Liu H, Xu D. Therapeutic effects of percutaneous coronary intervention on acute myocardial infarction complicated with multiple organ dysfunction syndrome. Pak J Med Sci. 2019;35(6):1701-1706. doi: https://doi.org/10.12669/pjms.35.6.1162 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

P2776Radiofrequent pulmonary artery denervation - alternative treatment of residual chronic thromboembolic pulmonary hypertension. Results of a randomized pilot study

Background/Introduction Pulmonary endarterectomy (PEA) is the gold standard of CTEPH treatment. However, residual CTEPH develops in 10–40% of patients after PEA, which leads to progression of right ventricular insufficiency. Currently, the only way to treat residual CTEPH is PAH-specific drug therapy. However, this treatment is not indicated for all patients because of the arterial hypotension and dyspeptic disorders. Purpose To assess the safety and efficacy of radiofrequent pulmonary artery denervation (PADN) in patients with residual CTEPH after PEA. Methods In 2015, a randomized pilot study was conducted to evaluate PADN in patients with residual CTEPH (NCT 02745106). 278 patients with CTEPH after PEA were screened. In 62 of them, according to the echocardiography, residual CTEPH (systolic pulmonary artery pressure (PAP) ≥45 mm Hg) was detected. In 50 patients, residual CTEPH was confirmed during right heart catheterization (RHC): mean PAP ≥25 mmHg and pulmonary vascular resistance (PVR) >400 dyn s cm–5. Patients were randomized into two groups: 25 in PADN group and 25 in drug therapy group with riociguat. Mean age was 39 years [26; 51]. The mean duration after PEA was 4.5 years [1; 8.5]. The primary end point was PVR in the short-term and long-term follow-up. Secondary end points were: mean PAP, cardiac output, 6-minute walk test (6MWD) and NYHA functional class. All patients were followed up for 12 months after discharge. The PADN procedure was performed using electrophysiological catheter Navistar RMT Thermocool, Biosense Webster, Diamond Bar, CA, USA and non-fluroscopic 3D navigation system. Results There was no mortality. In two patients (one in each group) hematoma developed in femoral vein puncture site without any consequences. The mean surgery time was 105 [93; 120] minutes. After 12 months, PVR was significantly lower in the PADN group compared with the drug treatment group (343±149 dyn s cm–5 vs 444±145 dyn s cm–5, respectively; mean difference −101, 95% confidence interval from −193 to −10; p=0.032). The mean PAP was also significantly lower in the PADN group (25.8±7.3 mm Hg vs. 33.8±6.4 mm Hg, p<0.001). We noticed a significant improvement of 6MWD test in PADN group compared with the drug treatment group (470±84 m versus 399±116 m, respectively, p=0.031). In PADN group 1 (4%) patient was hospitalized due to progression of heart failure compared with 7 patients (29%) in the drug treatment group (p=0.049). One patient (4%) in the PADN group and two patients (8%) in the drug treatment group died due to progression of heart failure over the long-term follow-up. Conclusions The PADN technique showed its safety and efficacy in the treatment of patients with residual CTEPH and can be used in clinical practice. The obtained first results showed that the proposed PADN, together with optimal medical therapy, can take a place in the treatment of residual CTEPH after PEA.

The impact of At1r inhibition via losartan on the anti-leukaemic effects of doxorubicin in acute myeloid leukaemia

Introduction: Bone marrow renin–angiotensin system(RAS) modulates acute myeloid leukaemia(AML).The aim of this study is to clarify the relationships between RAS and AML, and to show the effect of losartan and doxorubicin treatment in AML cell lines. Methods: AML cell lines including CESS, HL-60, MO-1, P31/FUJ, GDM-1 and KASUMI-3 were used as models in this study. Results: After treating the six AML cell lines with a combination of losartan and doxorubicin, they were divided into two groups based on their behaviour: one became more sensitive to drug treatment (Group A) and the other had no change observed in behaviour after drug treatment (Group B). In silico analyses showed that Group A is involved in cellular apoptosis, while Group B is involved in tumour angiogenesis further supporting the in vitro results. Conclusion: The combined treatment of the AML cell lines with losartan and doxorubicin resulted in an increase in sensitivity of some of the cell lines. Those leukaemic cells are modulated via the induction of apoptosis, whereas the other cells resistant to the drug treatment are closely related to tumour angiogenesis indicating that RAS-AT1R seems to be differently expressed in different leukaemic blast cells and tumour microenvironments. Pharmaco-biological actions of RAS inhibitors may be different in distinct leukaemic cells based on the pathological behaviour of AML genomic subtypes.