Dydrogesterone treatment for menstrual-cycle regularization in abnormal uterine bleeding-ovulation dysfunction patients

BACKGROUND Dydrogesterone has shown significant efficacy in treatment of irregular menstrual cycle due to abnormal uterine bleeding-ovulation dysfunction(AUB-O),but there were few relevant studies.This observational study was designed to evaluate the effectiveness of dydrogesterone for the treatment of Chinese patients with AUB-O.AIM To evaluate the effects of dydrogesterone on menstrual-cycle(MC)regularization and metabolism in the patients with AUB-O.METHODS A prospective,non-interventional,single-arm,post-marketing observational study was conducted.Chinese women aged 16 years or above with AUB-O who had been prescribed dydrogesterone were enrolled.The patients were treated with dydrogesterone 10 mg from day 16 to day 25 of each cycle,consecutively for at least 3 cycles.The main outcome was defined as the percentage of patients whose MCs returned to normal(defined as 21 d<menstrual cycle≤35 d)after three cycles of dydrogesterone treatment.RESULTS One hundred and fourteen women with AUB-O were enrolled in the present study.Of 89 patients who completed treatment,72(80.9%)achieved a regular MC at the end of the 3rd circle.The level of androgen,including testosterone and dehydroepiandrosterone sulfate,declined significantly(P=0.01 and 0.031,respectively),whereas other hormone levels remained steady.During the treatment,44/80(55.0%)subjects in the per-protocol set had reported biphasic basal body temperature.CONCLUSION Dydrogesterone therapy was effective in achieving MC regularization for Chinese patients with AUB-O.

Evaluation of Basal Serum Adrenocorticotropic Hormone and Cortisol Levels and Their Relationship with Nonalcoholic Fatty Liver Disease in Male Patients with Idiopathic Hypogonadotropic Hypogonadism

Background： Prolonged gonadal hormone deficiency in patients with idiopathic hypogonadotropic hypogonadism （IHH） may produce adverse effects on the endocrine homeostasis and metabolism. This study aimed to compare basal serum adrenocorticotropic hormone （ACTH） and cortisol levels between male IHH patients and healthy controls. Moreover, this study compared the basal hypothalamic-pituitary-adrenal （HPA） axis in patients with and without nonalcoholic fatty liver disease （NAFLD）, and also evaluated the relationship between basal HPA axis and NAFLD in male IHH patients. Methods： This was a retrospective case-control study involving 75 Chinese male IHH patients （mean age 21.4 ± 3.8 years, range 17 30 years） and 135 healthy controls after matching tbr gender and age. All subjects underwent physical examination and blood testing for serum testosterone, luteinizing hormone, follicle-stimulating hormone. ACTH, and cortisol and biochemical tests. Results： Higher basal serum ACTH levels （8.25 ±3.78 pmol/L vs. 6.97 ±2.81 pmol/L） and lower cortisol levels （366.70 ±142.48 nmol/L vs. 452.82 ± 141.53 nmol/L） were observed ill male IHH patients than healthy subjects （all P 〈 0.05）. IHH patients also showed higher metabolism parameters and higher prevalence rate of NAFLD （34.9% vs. 4.4%） than the controls （all P 〈 0.05）. Basal serum ACTH （9.91 ±4.98 pmol/L vs. 7.60 ±2.96 pmol/L） and dehydroepiandrosterone sulfate （2123.7 ±925.8 μg/L vs. 1417.1 ±498.4 μg/L） levels were significantly higher in IHH patients with NAFLD than those without NAFLD （all P 〈 0.05）. We also found that basal serum ACTH levels were positively correlated with NAFLD （r = 0.289, P 〈 0.05） and triglyceride levels （r - 0.268, P 〈 0.05） in male IHH patients. Furthermore, NAFLD was independently associated with ACTH levels in male IHH patients by multiple linear regression analysis. Conclusions： The male IHH patients showed higher basal serum ACTH levels and lower cortisol levels than matched healthy controls. NAFLD was an independent associated factor for ACTH levels in male IHH patients. These preliminary findings provided evidence of the relationship between basal serum ACTH and NAFLD in male IHH patients.

Components of the human-specific,p53-mediated“kill switch”tumor suppression mechanism are usurped by human tumors,creating the possibility of therapeutic exploitation

We recently reported our detection of an anthropoid primate-specific,adrenal androgen-dependent,“kill switch”tumor suppression mechanism that is triggered by the inactivation of the p53 tumor suppressor.This mechanism reached its highest expression only in humans as a result of the human-specific harnessing of fire,which resulted in an extraordinary increase in exposure to polycyclic aromatic hydrocarbons.This“kill switch”becomes inoperative in modern humans once they exceed the primitive human lifespan of 25-30 years,because lifespan has more than tripled in modern times,but the secretion curve for dehydroepiandrosterone sulfate remains fixed at the level required for the primitive human lifespan.Components of this“kill switch”are consequently usurped by human tumors,and these are already targets for inhibition in cancer chemotherapy.Here,we suggest a different strategy:using the usurped components of the kill switch to activate prodrugs,rather than as targets for inhibition.This strategy is in its infancy,but has the potential to enable more tumor-specific cytotoxicity,which the inhibition strategy generally cannot achieve.Detection of the usurpation of kill switch elements in liquid biopsy analyses enables the collection of information relevant to this new class of tumor biomarkers without the necessity of invasive tissue biopsy.

Mechanism of the Effect of Guzhen Recipe (固真方) on Regulating Immune Function in Senile Rats

Objective: To explore the effect of Guzhen recipe (固真方, GZR) on mRNA expression of interleukin-2 (IL-2) and interleukin-6 (IL-6) in senile rats as well as the relationship between dehydroepiandrosterone (DHEA) and its sulfate (DHEAS) and the immune function regulation of GZR. Methods: Northern Blot and reverse transcriptase-polymerase chain reaction (RT-PCR) were used to detect the mRNA expression of IL-2 and IL-6, meanwhile coating-antibody-counting method was used to detect DHEA(S) level in serum. Results: Compared with the young group, the splenocyte mRNA expression of IL-2 in senile rats was lowered and that of IL-6 was increased along with the decrease of serum DHEA(S) level. GZR, however, could improve the above indices in the senile rats. Conclusion: GZR might regulate the immune function of aged rats through increasing the serum level of DHEA(S).