Background:Polycystic ovary syndrome(PCOS)is an endocrine disorder that occurs in women of child-bearing age.Moreover,PCOS patients have decreased pregnancy rates and clomiphene citrate resistance.The traditional Chin...Background:Polycystic ovary syndrome(PCOS)is an endocrine disorder that occurs in women of child-bearing age.Moreover,PCOS patients have decreased pregnancy rates and clomiphene citrate resistance.The traditional Chinese medicine formula Kun-Tai-1S(KT1S),consisting of the seahorse species hippocampus,has been reported to elicit therapeutic effects in patients with PCOS.However,given the limited resources and global demand for wild hippocampus,whether KT1S with or without hippocampus can elicit similar therapeutic effects has not been confirmed.Methods:KT1S and Kun-Tai-1A(KT1A,KT1S without dry hippocampus)were used to treat a letrozole-induced rat model of PCOS with an established disease.The serum levels of testosterone,luteinizing hormone,anti-Müllerian hormone,and estradiol were determined,the luteinizing hormone/follicle-stimulating hormone ratio was determined,and the ovarian pathology was evaluated.Results:Similar to the therapeutic effects of cyproterone acetate,both the KT1S and KT1A treatments reduced the body weight and ovarian and uterine indices in the rats with PCOS.The serum levels of testosterone,anti-Müllerian hormone,and luteinizing hormone and the luteinizing hormone/follicle-stimulating hormone ratio were significantly lower in the KT1S and KT1A treatment groups compared to the model group(P<0.01 and P<0.05,respectively).Moreover,the histopathological assessment results suggested that both the KT1S and KT1A treatments significantly ameliorated the PCOS pathology in the rats with an established disease,with a reduced number of cystic and atretic follicles and an increased number of corpora lutea being observed in the ovaries.Notably,there was no obvious difference in the disease outcomes between the KT1S and KT1A-treated groups.Network pharmacology analysis revealed that 4’,7-dihydroxyflavanone,sinpemine A,quercetin,8-isopentenyl-kaempferol,and luteolin in KT1A may promote estrogen signaling;furthermore,the nitric oxide regulation pathway is also closely involved.Conclusion:KT1A and KT1S treatments both significantly ameliorated the PCOS-related pathology in rats,suggesting that the hippocampus component is dispensable for KT1S-mediated amelioration.Given the limited resources and global demand for wild hippocampus for use in complementary medicines,our findings may help conserve this species.Together,our results suggest that KT1A is a promising approach for treating PCOS.展开更多
Background:Hemorrhoids are one of the most common conditions that lead to surgery,and until now surgical hemorrhoidectomy has been the major effective treatment.Post-operative pain from hemorrhoidectomy has been exper...Background:Hemorrhoids are one of the most common conditions that lead to surgery,and until now surgical hemorrhoidectomy has been the major effective treatment.Post-operative pain from hemorrhoidectomy has been experienced by thousands of patients and remains a major inconvenience of the operation.Objective:This study evaluates the clinical efficacy of the pestle needle therapy,an acupoint stimulation method,for relief of post-hemorrhoidectomy pain.Design,setting,participants and interventions:This was a single-center,patient-assessor-blinded and randomized controlled trial with 154 patients receiving Milligan hemorrhoidectomy surgery.Eligible patients were randomly assigned to either a treatment group or a control group at a ratio of 1:1.The treatment group received the pestle needle therapy,with manual stimulation at Yaoshu(DU2),Mingmen(DU4),Changqiang(DU1),Chengshan(BL57),Erbai(EX-UE2)and the perianal points(1,3,5,7,9,and 11 o’clock around the lesion);while the control group received a sham treatment with very light pressure.Three sessions of treatment were performed at 30 min,4 h and 12 h after the surgery,and each lasted for 15 min.Main outcome measures:The primary outcome was post-operative pain measured with the visual analogue scale(VAS)at 12 h after surgery.The secondary outcomes included the VAS scores measured at0.5,2,4,6,8,24 and 48 h after surgery,the analgesic dose,the time and the VAS score of the patients’first defecation after surgery,as well as the Hamilton Rating Scale for Anxiety(HAMA)evaluated before discharge.Results:The mean pain score of the treatment group was significantly lower than that of the control group(3.10±1.27 vs 4.82±1.29;P<0.001)at 12 h after surgery.Compared with the control group,patients in the treatment group needed a smaller dose of analgesic within the first 24 hours after surgery(P=0.002);and their HAMA scores before discharge were lower(4.07±2.40 vs 5.10±2.45,P=0.009).Compared to the treatment group,patients in the control group had a greater time to the first defecation after surgery([52.34±15.72]h vs[27.08±13.68]h;P<0.001),but there was no difference in their VAS scores at the first defecation(P=0.092).Conclusion:The pestle needle therapy was effective for relieving pain,reducing anxiety and improving bowel function after hemorrhoidectomy,and it is worthy of clinical application.展开更多
文摘Background:Polycystic ovary syndrome(PCOS)is an endocrine disorder that occurs in women of child-bearing age.Moreover,PCOS patients have decreased pregnancy rates and clomiphene citrate resistance.The traditional Chinese medicine formula Kun-Tai-1S(KT1S),consisting of the seahorse species hippocampus,has been reported to elicit therapeutic effects in patients with PCOS.However,given the limited resources and global demand for wild hippocampus,whether KT1S with or without hippocampus can elicit similar therapeutic effects has not been confirmed.Methods:KT1S and Kun-Tai-1A(KT1A,KT1S without dry hippocampus)were used to treat a letrozole-induced rat model of PCOS with an established disease.The serum levels of testosterone,luteinizing hormone,anti-Müllerian hormone,and estradiol were determined,the luteinizing hormone/follicle-stimulating hormone ratio was determined,and the ovarian pathology was evaluated.Results:Similar to the therapeutic effects of cyproterone acetate,both the KT1S and KT1A treatments reduced the body weight and ovarian and uterine indices in the rats with PCOS.The serum levels of testosterone,anti-Müllerian hormone,and luteinizing hormone and the luteinizing hormone/follicle-stimulating hormone ratio were significantly lower in the KT1S and KT1A treatment groups compared to the model group(P<0.01 and P<0.05,respectively).Moreover,the histopathological assessment results suggested that both the KT1S and KT1A treatments significantly ameliorated the PCOS pathology in the rats with an established disease,with a reduced number of cystic and atretic follicles and an increased number of corpora lutea being observed in the ovaries.Notably,there was no obvious difference in the disease outcomes between the KT1S and KT1A-treated groups.Network pharmacology analysis revealed that 4’,7-dihydroxyflavanone,sinpemine A,quercetin,8-isopentenyl-kaempferol,and luteolin in KT1A may promote estrogen signaling;furthermore,the nitric oxide regulation pathway is also closely involved.Conclusion:KT1A and KT1S treatments both significantly ameliorated the PCOS-related pathology in rats,suggesting that the hippocampus component is dispensable for KT1S-mediated amelioration.Given the limited resources and global demand for wild hippocampus for use in complementary medicines,our findings may help conserve this species.Together,our results suggest that KT1A is a promising approach for treating PCOS.
基金supported by grant from Shanghai Municipal Health Commission,China (No. 2018MSB-12). The sponsor provided financial support in the case observation,the collection,analysis of data,and the decision to submit the article for publication。
文摘Background:Hemorrhoids are one of the most common conditions that lead to surgery,and until now surgical hemorrhoidectomy has been the major effective treatment.Post-operative pain from hemorrhoidectomy has been experienced by thousands of patients and remains a major inconvenience of the operation.Objective:This study evaluates the clinical efficacy of the pestle needle therapy,an acupoint stimulation method,for relief of post-hemorrhoidectomy pain.Design,setting,participants and interventions:This was a single-center,patient-assessor-blinded and randomized controlled trial with 154 patients receiving Milligan hemorrhoidectomy surgery.Eligible patients were randomly assigned to either a treatment group or a control group at a ratio of 1:1.The treatment group received the pestle needle therapy,with manual stimulation at Yaoshu(DU2),Mingmen(DU4),Changqiang(DU1),Chengshan(BL57),Erbai(EX-UE2)and the perianal points(1,3,5,7,9,and 11 o’clock around the lesion);while the control group received a sham treatment with very light pressure.Three sessions of treatment were performed at 30 min,4 h and 12 h after the surgery,and each lasted for 15 min.Main outcome measures:The primary outcome was post-operative pain measured with the visual analogue scale(VAS)at 12 h after surgery.The secondary outcomes included the VAS scores measured at0.5,2,4,6,8,24 and 48 h after surgery,the analgesic dose,the time and the VAS score of the patients’first defecation after surgery,as well as the Hamilton Rating Scale for Anxiety(HAMA)evaluated before discharge.Results:The mean pain score of the treatment group was significantly lower than that of the control group(3.10±1.27 vs 4.82±1.29;P<0.001)at 12 h after surgery.Compared with the control group,patients in the treatment group needed a smaller dose of analgesic within the first 24 hours after surgery(P=0.002);and their HAMA scores before discharge were lower(4.07±2.40 vs 5.10±2.45,P=0.009).Compared to the treatment group,patients in the control group had a greater time to the first defecation after surgery([52.34±15.72]h vs[27.08±13.68]h;P<0.001),but there was no difference in their VAS scores at the first defecation(P=0.092).Conclusion:The pestle needle therapy was effective for relieving pain,reducing anxiety and improving bowel function after hemorrhoidectomy,and it is worthy of clinical application.
