CNKI, PubMed and other databases were retrieved to extract eligible randomized controlled trial(RCT) about modified Xuefu Zhuyu Decoction(MXZD) combined with Western medicine(trial group) versus Western medicine alone(control group) in the treatment of leiomyoma. Therefore, a total of 25 RCTs were included, involving 2 328 patients. Bias risk evaluation tool in Cochrane Handbook 5.1.0 was used for evaluating the quality of these RCTs. Meta-analysis was performed for the reported indicators, including total efficiency, serum hormone level [progesterone(P), luteinizing hormone(LH), estradiol(E_2), follicle stimulating hormone(FSH)], uterine size, fibroids size and adverse reactions by using Stata 14.0 software. Meta-analysis showed that the total efficiency(RR=1.21,95%CI[1.17,1.25],P<0.05) of trial group was better than that of control group. Serum hormone level(WMD_P=-3.86,95%CI[-4.31,-3.41],P<0.05; WMD_(LH)=-3.64,95%CI[-4.47,-2.82],P<0.05; WMD_(E_2)=-39.99,95%CI[-53.45,-26.52],P<0.05; WMD_(FSH)=-3.79,95%CI[-4.86,-2.72],P<0.05), uterine size(WMD=-50.02,95%CI[-55.98,-44.06],P<0.05), fibroids size(WMD=-15.79,95%CI[-18.11,-13.46],P<0.05) and adverse reactions(RR=0.65,95%CI[0.48,0.88],P<0.05) of trial group were all lower than those of control group, with statistical significances. Trial sequential analysis(TSA) was performed by using TSA 0.9 software, and showed a reliable therapeutic effect of the experimental group. In short, our study indicated that modified Xuefu Zhuyu Decoction combined with Western medicine had a better therapeutic effect on leiomyoma than Western medicine alone, but more high-quality studies are needed to verify this conclusion in the future.
Drugs, Chinese Herbal ; Humans ; Leiomyoma/drug therapy* ; Medicine

Uterine leiomyosarcoma is a rare malignant tumor, and distant metastasis to skull bone is very uncommon. We experienced a case of parietal skull bone metastasis from uterine leiomyosarcoma in a 52-year-old woman who had undergone simple total hysterectomy and bilateral salpingoophorectomy with the diagnosis of uterine myoma. We treated this patient with combination chemotherapy using cisplatin and adriamycin and radiotherapy after craniectomy. She is alive now without particular symptoms. We report this case with a brief review of some literatures.
Cisplatin ; Diagnosis ; Doxorubicin ; Drug Therapy, Combination ; Female ; Humans ; Hysterectomy ; Leiomyoma ; Leiomyosarcoma* ; Middle Aged ; Neoplasm Metastasis* ; Rabeprazole ; Radiotherapy ; Skull*

It is to observe the therapeutic action of Guizhi Fuling capsule and the combination of active ingredients on model rats with uterine leiomyoma. The hysteromyoma rats models was established in rats by loading eatrogen, to observe the effect on pathological condition of uterus, uterus wet weight, the content of estradiol and progesterone. Guizhi Fuling capsule and the combination of active ingredients remarkably decreased uterus weight, restrained the excess proliferation of the smooth muscle of uterus, decreased the estraiol and progesterone in blood serum. Guizhi Fuling capsule and the combination of active ingredients can restrain the formation of hysteromyoma in a dose-dependent manner. Perhaps the combination of active ingredients is the material foundation of antihysteromyoma.
Animals ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; blood ; Female ; Leiomyoma ; blood ; drug therapy ; pathology ; Progesterone ; blood ; Rats ; Rats, Wistar ; Uterine Neoplasms ; blood ; drug therapy ; pathology

A 50-year-old peri-menopausal woman presented with hard palpable mass on her lower abdomen and anemia from heavy menstrual bleeding. Ultrasonography showed a 13x12 cm sized hypoechoic solid mass in pelvis and a 2.5x2 cm hypoechoic cystic mass in uterine endometrium. Abdomino-pelvic computed tomography revealed a hypodense pelvic mass without enhancement, suggesting a leiomyoma of intraligamentary type or sex cord tumor of right ovary with submucosal myoma of uterus. Laparoscopy revealed a large Sertoli-Leydig cell tumor of right ovary with a very rare entity of intra-endometrial uterine leiomyoma accompanied by adenomyosis. The final diagnosis of ovarian sex-cord tumor (Sertoli-Leydig cell), stage Ia with intra-endometrial leiomyoma with adenomyosis, was made. Considering the large size of the tumor and poorly differentiated nature, 6 cycles of chemotherapy with Taxol and Carboplatin regimen were administered. There is neither evidence of major complications nor recurrence during 20 months' follow-up.
Adenomyosis/*diagnosis/drug therapy ; Carboplatin/therapeutic use ; Female ; Humans ; Laparoscopy ; Leiomyoma/*diagnosis/drug therapy ; Male ; Menorrhagia ; Middle Aged ; Neoplasm Recurrence, Local ; Paclitaxel/therapeutic use ; Sertoli-Leydig Cell Tumor/*diagnosis/drug therapy ; Treatment Outcome ; Uterine Neoplasms/*diagnosis/drug therapy

In this study, the active components and potential molecular .mechanism of Guizhi Fuling formula in treatment on dysmenorrhea, pelvic inflammation, and hysteromyoma were investigated using network pharmacological methods. Sterols and pentacyclic triterpenes, with high moleculal network degree, revealed promising effects on anti-inflammatory, analgesic, anti-tumor, and immune-regulation, according to D-T network analysis. On the other hand, the targets with high degree were involved in inflammatory, coagulation, angiopoiesis, smooth muscle contraction, and cell reproduction, which showed the novel function in anti-dysmenorrhea, pelvic inflammation, and hysteromyoma. Furthermore, the formula was indicated to play a key role in smooth muscle proliferation, inhibition of new vessels, circulation improvement, reduction of hormone secretion, alleviation of smooth muscle, block of arachidonic acid metabolism, and inflammation in uterus. Thus, the main mechanism of Guizhi Fuling formula was summarized. In conclusion, Guizhi Fuling formula was proven to alleviated dysmenorrhea, pelvic inflammation, and hysteromyoma by acting on multiple targets through several bioactive compounds, regulating 21 biological pathways.
Drugs, Chinese Herbal ; therapeutic use ; Dysmenorrhea ; drug therapy ; genetics ; metabolism ; Female ; Gene Regulatory Networks ; drug effects ; Humans ; Leiomyoma ; drug therapy ; genetics ; metabolism ; Pelvic Inflammatory Disease ; drug therapy ; genetics ; metabolism

BACKGROUNDRosiglitazone is known as the most potent and specific peroxisome proliferators-activated receptor gamma (PPAR-gamma) ligand. It has potentially far-reaching effects on pathophysiological processes, from cancer to atherosclerosis and diabetes. However, it is not clear whether rosiglitazone affects the protein expression of transforming growth factor beta3 (TGF-beta3) and the cell proliferation in human uterine leiomyoma cells in vitro.

METHODSHuman uterine leiomyoma tissues were dissected and cultured. Cells were divided into 5 groups: one control group and other four groups with different concentrations of rosiglitazone (10(-7), 10(-8), 10(-9) and 10(-10) mol/L). Cells were cultured for 72 hours in serum-free Dulbecco's modified Eagle's medium. MTT reduction assay was used to detect the cell proliferation. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the mRNA expression of PPAR-gamma and TGF-beta3. Immunofluorescence staining was used to detect the expressions of PPAR-gamma and TGF-beta3 proteins.

RESULTSMTT reduction assay indicated that the treatment with rosiglitazone (from 10(-7) to 10(-9) mol/L) resulted in an inhibition of the cell growths after 72 hours (P < 0.01). RT-PCR analysis revealed that 10(-7) mol/L rosiglitazone significantly affected the gene expression at 72-hour: PPAR-gamma mRNA expression was up-regulated and TGF-beta3 mRNA was down-regulated and rosiglitazone at the concentration of 10(-7) mol/L affected these most effectively (P < 0.01). Immunofluorescence staining demonstrated that treatment with 10(-7) mol/L rosiglitazone resulted in the significant changes of PPAR-gamma and TGF-beta3 protein expressions compared with the other treatment groups and the control group at 72-hour (P < 0.01). All the effects of rosiglitazone on uterine leiomyoma cells were dose- and time-dependent in vitro.

CONCLUSIONSThe present study demonstrates that the PPAR-gamma activator, rosiglitazone, inhibits the cell proliferation partly through the regulations of PPAR-gamma and TGF-beta3 expressions. The cross-talk between the signal pathways of PPAR-gamma and TGF-beta3 may be involved in the process.

Cell Line, Tumor ; Cell Proliferation ; drug effects ; Female ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Leiomyoma ; drug therapy ; pathology ; PPAR gamma ; agonists ; analysis ; genetics ; RNA, Messenger ; analysis ; Thiazolidinediones ; pharmacology ; Transforming Growth Factor beta3 ; analysis ; genetics ; Uterine Neoplasms ; drug therapy ; pathology

Uterine leiomyomas (myomas or fibroids) are the most common benign pelvic tumors in reproductive aged women occurring in 25% to 40%. They may cause symptoms of heavy or prolonged menstrual bleeding, pelvic pressure symptoms and pain, subfertility, adverse pregnancy outcomes. Therapeutic methods are variable and include expectant management, medical treatment (GnRH agonist, levonorgestrel-releasing intrauterine system, and progesterone receptor modulator), surgical treatment (myomectomy, hysterectomy, and endometrial ablation), myolysis, and uterine artery embolization. Most women who are asymptomatic or have mild symptoms can be followed without intervention. In cases with significant symptoms, the clinicians should understand many factors including age, parity, proximity to menopause, desire for fertility preservation, size, location and number of myomas, severity of symptoms and possibility of malignancy for the choice of treatment modality. The type and timing of the intervention should be individualized after considering and discussing treatment benefit and risk.
Drug Therapy ; Female ; Fertility Preservation ; Hemorrhage ; Humans ; Hysterectomy ; Infertility ; Leiomyoma* ; Menopause ; Myoma ; Parity ; Pregnancy ; Pregnancy Outcome ; Receptors, Progesterone ; Uterine Artery Embolization ; Uterine Myomectomy

A clinical observation was made on the patients with bladder tumor admitted to the Department of Urology, Seoul Adventist Hospital during the periods from January 1978 to December 1981. The following results were obtained. 1. During the periods, 930 patients were hospitalized, and there were 36 cases of bladder tumor giving an incidence rate of 3.9%. 2. There were 25 males and 11 females with a ratio of 2.3:1. 3. Age distribution was between 23 and 77 years, the highest incidence rate was in the age group of 60-69years. 4. The clinical manifestation included gross hematuria (88.9%), frequency (69.4%), dysuria (44.4%) and the others. 5. On I.V.P. findings, 29 cases (80.6%) revealed normal upper tract, 6 cases (16.7%) were unilateral hydronephrosis, and 31 cases (86.1%) revealed filling defect in the bladder. 6. The tumors were located mainly at the lateral wall and trigonal area of bladder (50.0%). 7. Of 36 cases of bladder tumor, 30 cases (83.3%) were transitional cell carcinoma, 3 cases (8.3%) squamouscell carcinoma, and each 1 case (2.8%) adenocarcinoma, metastatic carcinoma and leiomyoma. 8. Among 36 cases, T.U.R. was performed in 17 cases, and intravesiCal chemotherapy in 11 cases. 9. Of 11 patients who received intravesical chemotherapy, 6 were recurred within 1 year showing a recurrencerate of 54.5%.
Adenocarcinoma ; Age Distribution ; Carcinoma, Transitional Cell ; Drug Therapy ; Dysuria ; Female ; Hematuria ; Humans ; Hydronephrosis ; Incidence ; Leiomyoma ; Male ; Seoul ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urology

OBJECTIVETo explore the clinical efficacy of Gengxueting (GXT) in treating hysteromyoma and its effects on estrogen receptor (ER) and progesterone receptor (PR).

METHODSSixty-four hysteromyoma patients with surgical indication were equally assigned to the treated group and the control group. Patients in the treated group were treated with GXT one capsule every day for 90 consecutive days before surgical operation, while those in the control group were treated with surgery alone. Serum levels of reproductive hormones were determined in the follicular phase before medication and one day before operation by RIA, and colored Doppler ultrasound examination was conducted for measuring the size of uterus and myoma. Moreover the protein expressions of ER and PR in tumor and uterine muscular tissues were detected by immunohistochemistry assay with streptomycin avidin-biotin peroxidase complex method.

RESULTSIn the treated group after medication, the serum level of estradiol was (167.0 +/- 85.9) pmol/L, progesterone (1.9 +/- 1.0) nmol/L, follicle-stimulating hormone (10.4 +/- 2.1) IU/L, and luteinizing (12.0 +/- 9. 8) IU/L, all reached the levels of early follicular phase, with the maximal size of myoma significantly decreased from (380.4 +/- 21.0) cm3 to (162.3 +/- 14. 8) cm3 (P < 0.01); and the ER and PR expressions in tumor tissue were significantly lower than those in the control group respectively (P < 0.01).

CONCLUSIONExpressions of ER and PR in hysteromyoma tissue could be significantly reduced by medication of GXT, which leads to significant shrinkage of tumor size and improvement of clinical symptoms.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunohistochemistry ; Leiomyoma ; drug therapy ; metabolism ; Middle Aged ; Phytotherapy ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Treatment Outcome ; Tumor Burden ; drug effects ; Uterine Neoplasms ; drug therapy ; metabolism ; pathology

Extract of Tripterygium wilfordi (TW) has obvious effects on anti-inflammation, anti-tumor, anti-fertility and immuno-regulation, and it is broadly applied in various clinical departments. Referred to the gynecologic diseases, clinical therapeutic trials of TW on endometriosis, leiomyoma uteri, dysfunctional uterine bleeding and some tumors of women have been carried out, and it can be proved an effective new drug for the treatment of gynecologic diseases.
Anti-Inflammatory Agents ; therapeutic use ; Antineoplastic Agents ; therapeutic use ; Contraceptive Agents, Female ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Endometriosis ; drug therapy ; Female ; Genital Diseases, Female ; drug therapy ; Genital Neoplasms, Female ; drug therapy ; Humans ; Immunologic Factors ; therapeutic use ; Leiomyoma ; drug therapy ; Metrorrhagia ; drug therapy ; Tripterygium