Massive secondary postpartum haemorrhage from rupture of thrombosed uterine artery following lower segment caesarean section

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Audit of abdominal hysterectomy for benign disease: Indications and complications

A retrospective study was conducted to evaluate the indications and complications of abdominal hysterectomy for non-malignant gynaecological conditions performed between 1st July 1992 and 30th June 1993. A total of 167 women underwent total abdominal hysterectomy during this period, of whom 127 (76%) were indicated for non-malignant conditions. The main indications were uterine leiomyomata (47.2%), pelvic endometriosis (15.7%) and benign ovarian tumours (15%). Oophorectomy was performed in 61.5% of patients. There was no mortality. The overall short-term complication rate was 59%, with febrile morbidity (33.9%) and haemorrhage requiring blood transfusion (17.3%) the most common complications. It was found that postoperative bladder drainage with Foley catheterisation in situ was associated with a significant increase in urinary tract infection. Prophylactic antibiotics and a vaginal drain did not decrease the febrile morbidity rate. The redivac drain was effective in reducing the wound complication rate. However, due to the small sample size and heterogeneous management, further study is required to clarify the validity of these observations.link_to_subscribed_fulltex

Differential effects of anti-metastatic mechanism of Tian-Xian liquid (TXL) and its bioactive fractions on human colorectal cancer models

Aim of study: This study aimed to elucidate and compare the anti-metastatic mechanism of Tian-Xian liquid (TXL) and its bioactive components namely butanol (BU), ethyl-acetate (EA) and aqueous (WA) fractions on human colorectal cancer in vitro (HT-29 cancer cells) and in vivo (nude mouse xenografts). Materials and methods: The anti-proliferative effects of TXL and its bioactive components in HT-29 cells were determined by MTT assay. Their modulations on the potential angiogenic and metastatic marker expressions on HT-29 cells and xenografts were investigated by real-time PCR and Western blot at transcriptional and translational levels, respectively. For the in vitro study, migration abilities of HT-29 cells were determined using wound healing assay. For the in vivo study, daily measurements of the tumor size and volume of the xenografts were also performed. Results: TXL, BU, EA and WA effectively inhibited the proliferation of HT-29 cells in a dose- and time-dependent manner. The IC 50 value of TXL on HT-29 cells was obtained after incubation with 1% (v/v) TXL for 4 h; whereas IC 50 values were obtained for the following bioactive components: BU at 1.25% (v/v); EA at 5% (v/v); and WA at 0.3125% (v/v). It was found that 1% (v/v) TXL significantly down-regulated MMP2 and MMP7 expression at both transcriptional and translational levels and it reduced MMP9 and VEGF protein expression in vitro. TXL decreased the metastatic ability of HT-29 cells as demonstrated by wound healing assay. TXL and its bioactive fractions caused no significant changes in the body weight indicating lack of toxicity to the xenografts. Conclusions: In summary, TXL multi-targeted to down-regulate the metastatic markers in both in vitro and in vivo models. However, the effects of its bioactive fractions were not obvious. This study profoundly elucidated the anti-proliferative mechanism of TXL, which is vital for the development of future anti-cancer regime in Chinese medicinal formulations. © 2011 Elsevier Ireland Ltd All rights reserved.link_to_subscribed_fulltex

The concurrent and predictive validity of symptomatic remission criteria on psychopathology, functioning, and quality of life in schizophrenic patients

Poster A. Schizophrenia and Psychotic Disorder

Pharmacological effects of Erxian Decoction, a Chinese medicinal formula, in relieving menopausal syndrome

BACKGROUND: Ovarian aging is an inevitable event since the birth of women. Ovarian aging, together with the senescence of the reproductive axis, will eventually lead women to a transit into menopause, which is defined "after 12 months of amenorrhea following the final menstrual period", according to the STRAW staging system (1). The decrease in ovarian estrogen production is though to related to various menopausal symptoms including hot flash (2), osteoporosis (3), increased risk of cardiovascular diseases (4). Although menopausal syndrome can be relieved by conventional hormone replacement therapy, concerns about the cancer incidence (5) herald a safer yet effective alternative therapy. Erxian Decoction (EXD) has been used for relieving menopausal symptoms for more than fifty years. It is composed of six herbs namely Curculigo orchioides (Hypoxidaceae, rhizome), Epimedium brevicornum (Berberidaceae, whole herb), Morinda officinalis How (Rubiaceae, root), Angelica sinensis (Umbelliferae, root), Phellodendron chinense (Rutaceae bark) and Anemarrhena asphodeloides (Anthericaceae, rhizome). To elucidate the science behind its medical efficacy, intensive effort has been spent by our research group. In this abstract, various pharmacological effects of EXD displayed in vivo or in vitro are discussed. Stimulatory effect of EXD on ovarian estrogen biosynthesis It is found that EXD can increase circulating estrogen level through activation of ovarian aromatase, and thus stimulating ovarian estrogen biosynthesis. Currently, the molecular mechanism of EXD is also being studied on rat ovarian granulosa cell. It is also demonstrated that EXD could also stimulate secretion of estradiol from rat ovarian granulosa cell culture. In twelve-month old female SD-rat fed with EXD, the mRNA level of ovarian aromatase (CYP19) increased significantly, while the serum estradiol level were also significantly elevated, suggesting the stimulatory effect of EXD on, at least, ovarian estrogen biosynthesis (6). Effect of EXD on serum lipid profile In another experiment, the effect of EXD on serum lipid profile has been evaluated. It was demonstrated that EXD could significantly decrease the serum total cholesterol level and serum LDL-cholesterol level. Immunoblotting study revealed that the beneficial effect of EXD on serum lipid profile is at least through up-regulation of hepatic LDL-receptor, a protein responsible for clearance of LDL-cholesterol, and down-regulation of HMG-CoA reductase, a key enzyme for cholesterol synthesis (7) Anti-osteoporotic effect of EXD It is known that the incidence of osteoporosis increased after menopause where circulating estrogen level declines. In our recent study, the anti-osteoporotic effect of EXD has been studied in vitro. It was found that EXD could significantly inhibit the proliferation of RAW264.7, the precursor of osteoclast. On the other hand, EXD could also significantly stimulate the proliferation of hFOB1.19, the human fetal osteoblast cell line. Our results revealed that EXD could increase bone formation and reduce bone resorption through regulating the respective cell proliferation. Results from TRAP staining of RAW264.7 also revealed that EXD could inhibit osteoclastogenesis through inhibition of RAW264.7 differentiation. EXD could also increase the trabecular material bone mineral density at the L2 mid-vertebral body in 12-month old female SD-rat, as revealed by microcomputed tomography, suggesting its anti-osteoporotic property in vivo (8). Anti-oxidative effect of EXD EXD also possess anti-oxidative properties, as revealed by the mRNA level of hepatic anti-oxidative enzymes SOD, CAT and GPx-1 (6). Since aging is thought to relate with oxidative stress, the stimulatory effect of EXD on anti-oxidative enzymes suggests the general anti-aging properties of EXD and merits further study. CONCLUSION: The research of diverse pharmacological effects of EXD in vivo and in vitro has been discussed. With the stimulatory effect of EXD on ovarian estrogen biosynthesis, beneficial effects of EXD on serum lipid profile, anti-osteoporotic properties together with the anti-oxidative effects, it is promising that EXD could be an effective alternative for relieving menopausal syndromes.The 13th World Congress on Menopause (IMS Roma 2011), Rome, Italy, 8-11 June 2011

Aspectual asymmetries in the mental representation of events: Role of lexical and grammatical aspect

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Regulation of p21, MMP-1, and MDR-1 expression in human colon carcinoma HT29 cells by Tian Xian liquid, a Chinese medicinal formula, in vitro and in vivo

Ethnopharmacological relevance. Tian-Xian liquid (TXL), a commercially available Chinese medicine decoction, has been used as an anticancer dietary agent for more than 10 years without reported side effects. Aim of the study. The safety and quality consistency of TXL and its mechanisms of action on antiproliferation, antimetastasis, and reversion of multidrug resistance (MDR) regimens were explored. Materials and methods. In this study, an atomic absorption spectrophotometer and reversed phase high performance liquid chromatography with photodiode array detection (HPLC-DAD) were used to evaluate the main toxic elements and the quality consistency among different batches of TXL extracts, respectively. HT29 human colon cancer cell line and tumor-bearing nude mice were used. TXL was provided by China-Japan Feida Union Company Limited. The effect of TXL on in vitro proliferation of HT29 human colon cancer cell line was examined. The percentages of treated cells distributed in different phases of the cell cycles were analyzed by flow cytometry. Antiproliferative effect after treatment with TXL was assessed by determination of the protein levels of p21, cyclinD1, PCNA, and cdk-2, which are the key regulators for cell cycle progression. Meanwhile, the protein levels of MMP-1 and MDR-1 (multidrug resistance protein-1) were also determined to assess the effect of TXL on antimetastasis and reversion of MDR regimen, respectively. Results. The contents of main toxic elements were lower in TXL extract compared with the standard set by the Department of Health of the Government of Hong Kong Special Administrative Region (SAR). Our HPLC results showed that the relative standard deviations of the amount of the 5 standards were less than 5% in different batches of TXL. Immunoblotting analysis revealed a dramatic induction of cyclin kinase inhibitor p21 as well as an inhibition of cyclinD1, PCNA, and cdk-2 in the TXL-treated in vitro models, thereby, impeding cell progression from G1/S phase. Results obtained from the in vivo study also demonstrated that TXL upregulated the protein level of p21 and downregulated the protein levels of MMP-1 and MDR-1. Conclusions. Results obtained from the present investigation not only demonstrate the safety and quality of TXL extract but also demonstrate that TXL possesses antiproliferative and antimetastatic activities and brings about reversion of MDR on HT29 cell and on xenografted tissue in tumor-implanted nude mice. © The Author(s) 2011.link_to_subscribed_fulltex