The use of a noninvasive and nondestructive method, microcomputed tomography, to evaluate the anti-osteoporotic activity of erxian decoction, a Chinese medicinal formula, in a rat model of menopausal osteoporosis

Aim of the study: The anti-osteoporotic activity of Erxian Decoction, a Chinese medicinal formula, in a rat model of menopausal osteoporosis was evaluated by microcomputed tomography (microCT). Materials and methods: Menopause causes a decline in both endocrine function and bone mineral density in human. In this study, 20-month-old female Sprague-Dawley-rats (SD-rats) with a low serum estradiol level and bone mineral density were employed. The anti-osteoporotic activity of EXD was assessed by the determination of trabecular material bone mineral density at the L2 mid-vertebral body after treatment. Serum estrogen levels were also determined to assess the effect of EXD on the endocrine status. Results: Results revealed a significant elevation in serum estradiol level and trabecular bone mineral density at the L2 mid-vertebral body in the EXD-treated menopausal rat model. Conclusions: The results obtained from the present investigation revealed that the EXD had anti-osteoporotic activity as evidenced by an increase of serum estradiol level and bone mineral density. ©2009 IEEE.published_or_final_versionProceedings of the 2009 2nd International Conference On Biomedical Engineering And Informatics (BMEI 2009), Tianjin, China, 17-19 October 2009, v. 1 p. 47-49, article number 530482

Effects of Erxian decoction, a Chinese medicinal formulation, on serum lipid profile in a rat model of menopause

<p>Abstract</p> <p>Background</p> <p>The prevalence and risk of cardiovascular disease increase after menopause in correlation with the progression of abnormality in the serum lipid profile and the deprivation of estrogen. <it>Erxian </it>decoction (EXD), a Chinese medicinal formulation for treating menopausal syndrome, stimulates ovarian estrogen biosynthesis. This study investigates whether EXD improves the serum lipid profile in a menopausal rat model.</p> <p>Methods</p> <p>Twenty-month-old female Sprague Dawley rats were treated with EXD and its constituent fractions. Premarin was administered for comparison. After eight weeks of treatment, rats were sacrificed and the serum levels of total cholesterol, triglyceride, high-density-lipoprotein cholesterol and low-density-lipoprotein cholesterol were determined. The hepatic protein levels of 3-hydroxy-3-methyl-glutaryl-CoA reductase and low-density-lipoprotein receptor were assessed with Western blot.</p> <p>Results</p> <p>The serum levels of total cholesterol and low-density-lipoprotein cholesterol were significantly lower in the EXD-treated group than in the constituent fractions of EXD or premarin groups. However, the serum levels of triglyceride and high-density-lipoprotein cholesterol were not significantly different from the control groups. Results from Western blot suggest that EXD significantly down-regulated the protein level of 3-hydroxy-3-methyl-glutaryl-CoA reductase and up-regulated low-density-lipoprotein receptor. <b>Conclusion </b>EXD improves serum lipid profile in a menopausal rat model through the suppression of the serum levels of total cholesterol and low-density-lipoprotein cholesterol, possibly through the down-regulation of the 3-hydroxy-3-methyl-glutaryl-CoA and up-regulation of the low-density-lipoprotein receptor.</p

Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

Aims: To identify risk factors for major Adverse Events (AEs) and to develop a nomogram to predict the probability of such AEs in individual patients who have surgery for apparent early stage endometrial cancer. Methods: We used data from 753 patients who were randomized to either total laparoscopic hysterectomy or total abdominal hysterectomy in the LACE trial. Serious adverse events that prolonged hospital stay or postoperative adverse events (using common terminology criteria 3+, CTCAE V3) were considered major AEs. We analyzed pre-surgical characteristics that were associated with the risk of developing major AEs by multivariate logistic regression. We identified a parsimonious model by backward stepwise logistic regression. The six most significant or clinically important variables were included in the nomogram to predict the risk of major AEs within 6 weeks of surgery and the nomogram was internally validated. Results: Overall, 132 (17.5%) patients had at least one major AE. An open surgical approach (laparotomy), higher Charlson’s medical co-morbidities score, moderately differentiated tumours on curettings, higher baseline ECOG score, higher body mass index and low haemoglobin levels were associated with AE and were used in the nomogram. The bootstrap corrected concordance index of the nomogram was 0.63 and it showed good calibration. Conclusions: Six pre-surgical factors independently predicted the risk of major AEs. This research might form the basis to develop risk reduction strategies to minimize the risk of AEs among patients undergoing surgery for apparent early stage endometrial cancer

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

Section 5-11: Anticancer Drug Discovery (Part II

Regulation of p21, MMP-1 and MDR-1 expression in Human colon carcinoma HT29 by Tian Xian Liquid, a Chinese Medicine Formula, in vitro and in vivo

The 16th Hong Kong International Cancer Congress and 6th Annual Meeting Centre for Cancer Research, Hong Kong, 4-6 November 2009

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

Improved surgical safety after laparoscopic compared to open surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

AIM: To compare Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH) with regard to surgical safety. METHODS: Between October 2005 and June 2010, 760 patients with apparent early stage endometrial cancer were enroled in a multicentre, randomised clinical trial (LACE) comparing outcomes following TLH or TAH. The main study end points for this analysis were surgical adverse events (AE), hospital length of stay, conversion from laparoscopy to laparotomy, including 753 patients who completed at least 6 weeks of follow-up. Postoperative AEs were graded according to Common Toxicity Criteria (V3), and those immediately life-threatening, requiring inpatient hospitalisation or prolonged hospitalisation, or resulting in persistent or significant disability/incapacity were regarded as serious AEs. RESULTS: The incidence of intra-operative AEs was comparable in either group. The incidence of post-operative AE CTC grade 3+ (18.6% in TAH, 12.9% in TLH, p 0.03) and serious AE (14.3% in TAH, 8.2% in TLH, p 0.007) was significantly higher in the TAH group compared to the TLH group. Mean operating time was 132 and 107 min, and median length of hospital stay was 2 and 5 days in the TLH and TAH group, respectively (p<0.0001). The decline of haemoglobin from baseline to day 1 postoperatively was 2g/L less in the TLH group (p 0.006). CONCLUSIONS: Compared to TAH, TLH is associated with a significantly decreased risk of major surgical AEs. A laparoscopic surgical approach to early stage endometrial cancer is safe