Neurological diseases include a variety of neurodegenerative diseases and other brain damage diseases.The treatment schemes for neurological diseases are still in research.The existing clinical and basic studies have confirmed that traditional estrogen therapy has certain protective effect on the nervous system,while it increases the risk of breast or endometrial cancer.The emergence of the selective estrogen receptor modulators (SERMs) can avoid the above mentioned problems.The available studies have confirmed the protective effect of tamoxifen as a SERM on the nervous system.This paper reviews the role and functioning mechanisms of tamoxifen in the nervous system and cognitive function,aiming to provide guidance for the future application of tamoxifen in the treatment of neurological diseases and the improvement of cognitive function.
Tamoxifen/therapeutic use* ; Selective Estrogen Receptor Modulators/therapeutic use* ; Cognition ; Nervous System

Objective: To explore the feasibility, safety and clinical effect of mid-frequency transcutaneous electrical acupoint stimulation (TEAS) combined with oral tamoxifen (TAM) in the treatment of oligoasthenozoospermia. METHODS: We randomly and equally assigned 120 patients with idiopathic oligoasthenozoospermia to receive oral TAM, mid-frequency TEAS, or TAM+TEAS, all for 8 weeks. Before and after treatment, we recorded the semen volume, total sperm count, sperm concentration, sperm motility, percentage of progressively motile sperm (PMS), and the levels of follicle-stimulating hormone (FSH), luteotrophic hormone (LH) and testosterone (T) in the peripheral serum and compared these parameters among the three groups of patients. RESULTS: Compared with the baseline, none of the patients showed significant improvement in the semen volume (P >0.05) but all exhibited remarkably elevated levels of serum FSH, LH and T after treatment (P <0.05); TAM significantly improved the total sperm count (［25.16 ± 2.05］ vs ［42.65 ± 5.78］ ×106, P <0.05) and sperm concentration (［12.15 ± 2.51］ vs ［24.31 ± 2.59］ ×10⁶/ml, P <0.05), but not total sperm motility (［21.78 ± 8.81］ vs ［22.61 ± 5.75］ %, P >0.05) or PMS (［15.87 ± 7.81］ vs ［16.76 ± 5.86］ %, P >0.05); TEAS markedly increased total sperm motility (［24.81 ± 8.27］ vs ［32.43 ± 4.97］ %, P <0.05) and PMS (［19.71 ± 9.15］ vs ［27.17 ± 5.09］%, P <0.05), but not the total sperm count (［23.23 ± 3.14］ vs ［25.87 ± 4.96］ ×106, P >0.05) or sperm concentration (［11.27 ± 2.24］ vs ［14.12 ± 2.47］ ×10⁶/ml, P >0.05); TAM+TEAS, however, improved not only the total sperm count (［26.17 ± 5.05］ vs ［ 51.14 ± 3.69］×106, P <0.05) and sperm concentration (［12.78 ± 2.41］ vs ［27.28 ± 1.98］ ×10⁶/ml, P <0.05), but also total sperm motility (［23.89 ± 9.05］ vs ［37.12 ± 5.33］%, P <0.05) and PMS (［17.14 ± 8.04］ vs ［31.09 ± 7.12］%, P <0.05). The total effectiveness rate was significantly higher in the TAM+TEAS group than in the TAM and TEAS groups (97.5% vs 72.5% and 75.0%, P <0.05). CONCLUSIONS Mid-frequency TEAS combined with tamoxifen can significantly improve semen quality and increase sex hormone levels in patients with idiopathic oligoasthenozoospermia.
Acupuncture Points ; Antineoplastic Agents, Hormonal ; administration & dosage ; therapeutic use ; Asthenozoospermia ; blood ; therapy ; Combined Modality Therapy ; methods ; Electroacupuncture ; methods ; Feasibility Studies ; Follicle Stimulating Hormone ; blood ; Humans ; Male ; Oligospermia ; blood ; therapy ; Prolactin ; blood ; Semen Analysis ; Sperm Count ; Sperm Motility ; Tamoxifen ; administration & dosage ; therapeutic use ; Testosterone ; blood

Objective: To investigate the effect of alpha-lipoic acid (α-LA) combined with tamoxifen citrate (TC) in the treatment of oligoasthenospermia. METHODS: From June to November 2016, we treated 60 patients with oligoasthenospermia in our Department of Andrology, 30 (the trial group) with oral α-LA (0.6 g, qd) + TC (20 mg, qd) and the other 30 (the control group) with oral L-carnitine (1g, bid) + TC (20 mg, qd). Before and after 3 months of medication, we examined the semen parameters of the patients and the levels of their seminal oxidative stress biomarkers, including methylenedioxyamphetamine (MDA) and total antioxidant capacity (TAC) in the seminal plasma. We also compared the pregnancy rate and adverse reactions between the two groups. RESULTS: Totally, 57 of the patients completed the treatment, 28 in the trial group and 29 in the control. Compared with the baseline, the patients of the trial group showed significant improvement after 3 months of medication in the semen volume (［2.50 ± 0.71］ vs ［3.37 ± 0.70］ ml, P <0.05), sperm concentration (［12.00 ± 1.65］ vs ［19.34 ± 2.04］ ×10⁶/ml, P <0.05), percentage of progressively motile sperm (PMS) (［18.01 ± 3.01］% vs ［35.41 ± 6.49］%, P<0.05), MDA level (［14.96 ± 2.76］ vs ［10.04 ± 1.04］ nmol/ml, P <0.05), and TAC in the seminal plasma (［9.83 ± 1.02］ vs ［12.25 ± 1.11］ U/ml, P <0.05), and so did the controls in the semen volume (［2.76 ± 0.67］ vs ［3.36 ± 0.93］ ml, P <0.05), sperm concentration (［11.47 ± 1.10］ vs ［17.77 ± 3.56］ ×10⁶/ml, P <0.05), percentage of PMS (［19.22 ± 1.41］ vs ［36.01 ± 5.22］ %, P <0.05), MDA level (［14.66 ± 2.75］ vs ［10.14 ± 1.01］ nmol/ml, P <0.05), and TAC in the seminal plasma (［9.84 ± 0.90］ vs ［11.14 ± 0.84］ U/ml, P <0.05). There were no statistically significant differences in the above post-medication parameters between the trial and control groups (P >0.05) except in TAC, which was markedly more improved in the former than in the latter (P <0.05), nor in the percentage of morphologically normal sperm before and after treatment in either of the two groups (P >0.05). After 3 months of treatment, 3 pregnancies were achieved in the trial group and 1 in the control (10.7% vs 3.45%, P >0.05). No obvious adverse events occurred during the treatment. CONCLUSIONS Alpha-lipoic acid combined with tamoxifen citrate can evidently improve semen parameters in oligoasthenospermia patients by relieving oxidative stress injury.
Antioxidants ; Asthenozoospermia ; drug therapy ; Biomarkers ; analysis ; Carnitine ; therapeutic use ; Drug Therapy, Combination ; Female ; Humans ; Male ; Oligospermia ; drug therapy ; Oxidative Stress ; Pregnancy ; Pregnancy Rate ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; drug effects ; Tamoxifen ; therapeutic use ; Thioctic Acid ; therapeutic use

Tamoxifen is an antagonist of the estrogen receptor and currently used for the treatment of breast cancer. The current treatment of cutaneous leishmaniasis with pentavalent antimony compounds is not satisfactory. Therefore, in this study, due to its antileishmanial activity, effects of tamoxifen on the growth of promastigotes and amastigotes of Leishmania major Iranian strain were evaluated in vitro. Promastigotes and amastigotes were treated with different concentrations (1, 5, 10, 20, and 50 µg/ml) and time periods (24, 48, and 72 hr) of tamoxifen. After tamoxifen treatment, MTT assay (3-[4,5-dimethylthiazol-2-yl]-2,5 biphenyl tetrazolium bromide assay) was used to determine the percentage of live parasites and Graph Pad Prism software to calculate IC50. Flow cytometry was applied to investigate the induction of tamoxifen-induced apoptosis in promastigotes. The half maximal inhibitory concentration (IC50) of tamoxifen on promastigotes was 2.6 µg/ml after 24 hr treatment. Flow cytometry analysis showed that tamoxifen induced early and late apoptosis in Leishmania promastigotes. While after 48 hr in control group the apoptosis was 2.0%, the 50 µg/L concentration of tamoxifen increased it to 59.7%. Based on the in vitro antileishmanial effect, tamoxifen might be used for leishmaniasis treatment; however, further researches on in vivo effects of tamoxifen in animal models are needed.
Animals ; Antiprotozoal Agents/pharmacology/therapeutic use ; Apoptosis/*drug effects ; Cells, Cultured ; Inhibitory Concentration 50 ; Leishmania major/*drug effects ; Leishmaniasis, Cutaneous/drug therapy ; Macrophages/parasitology ; Mice ; Tamoxifen/*pharmacology/therapeutic use

Endometrial hyperplasia (EH) comprises a spectrum of changes in the endometrium ranging from a slightly disordered pattern that exaggerates the alterations seen in the late proliferative phase of the menstrual cycle to irregular, hyperchromatic lesions that are similar to endometrioid adenocarcinoma. Generally, EH is caused by continuous exposure of estrogen unopposed by progesterone, polycystic ovary syndrome, tamoxifen, or hormone replacement therapy. Since it can progress, or often occur coincidentally with endometrial carcinoma, EH is of clinical importance, and the reversion of hyperplasia to normal endometrium represents the key conservative treatment for prevention of the development of adenocarcinoma. Presently, cyclic progestin or hysterectomy constitutes the major treatment option for EH without or with atypia, respectively. However, clinical trials of hormonal therapies and definitive standard treatments remain to be established for the management of EH. Moreover, therapeutic options for EH patients who wish to preserve fertility are challenging and require nonsurgical management. Therefore, future studies should focus on evaluation of new treatment strategies and novel compounds that could simultaneously target pathways involved in the pathogenesis of estradiol-induced EH. Novel therapeutic agents precisely targeting the inhibition of estrogen receptor, growth factor receptors, and signal transduction pathways are likely to constitute an optimal approach for treatment of EH.
Antineoplastic Agents, Hormonal/adverse effects ; Disease Management ; Disease Progression ; Endometrial Hyperplasia/classification/etiology/*therapy ; Female ; Gonadotropin-Releasing Hormone/therapeutic use ; Humans ; Hysterectomy ; Molecular Targeted Therapy/methods ; Progesterone Congeners/therapeutic use ; Risk Factors ; Tamoxifen/adverse effects

No abstract available.
Breast Neoplasms/*drug therapy ; Consent Forms/*statistics & numerical data ; Endometrial Neoplasms/*chemically induced ; Female ; Humans ; Patient Education as Topic/*statistics & numerical data ; Tamoxifen/*adverse effects/*therapeutic use

No abstract available.
Breast Neoplasms/*drug therapy ; Consent Forms/*statistics & numerical data ; Endometrial Neoplasms/*chemically induced ; Female ; Humans ; Patient Education as Topic/*statistics & numerical data ; Tamoxifen/*adverse effects/*therapeutic use

Breast cancer is the most common type of female cancer. Tamoxifen, a selective estrogen receptor modulator, is widely used to decrease breast cancer recurrence and mortality among patients. However, it also increases the risk of endometrial cancer. This study aimed to assess knowledge and decisional conflict regarding tamoxifen use. Between June and October 2014, breast cancer patients using tamoxifen were consecutively screened and requested to complete a survey including the EQ-5D, Satisfaction with Decision Scale (SWD), Decisional Conflict Scale (DCS), and a self-developed, 15-item questionnaire measuring tamoxifen-related knowledge. The study sample comprised 299 patients. The mean total knowledge score was 63.4 of a possible 100.0 (range, 13.3-93.3). While 73.9% of the participants knew that tamoxifen reduces the risk of breast cancer recurrence, only 57.9% knew that the drug increases endometrial cancer risk. A higher education level (> or =college) was associated with a higher, total knowledge score (beta = 4.291; P = 0.017). A higher knowledge score was associated with a decreased DCS score (beta = -0.366; P < 0.001). A higher SWD score was also associated with decreased decisional conflict (beta = -0.178; P < 0.001). In conclusion, the breast cancer patients with higher levels of tamoxifen-related knowledge showed lower levels of decisional conflict regarding tamoxifen use. Clinicians should provide the exact information about tamoxifen treatment to patients, based on knowledge assessment results, so as to aid patients' decision-making with minimal conflict.
Adult ; Aged ; Antineoplastic Agents, Hormonal/adverse effects/therapeutic use ; Breast Neoplasms/*drug therapy/epidemiology ; Consent Forms/*statistics & numerical data ; Decision Making ; Endometrial Neoplasms/*chemically induced/epidemiology/prevention & control ; Female ; Health Knowledge, Attitudes, Practice ; Health Surveys ; Humans ; Middle Aged ; Patient Education as Topic/*statistics & numerical data ; Patient Participation/statistics & numerical data ; Prevalence ; Republic of Korea ; Risk Assessment ; Tamoxifen/*adverse effects/*therapeutic use

BACKGROUNDRetroperitoneal fibrosis (RPF) is an uncommon disease that is characterized by development of fibrosclerotic tissues involving retroperitoneal structures. This study aimed to investigate the clinical features of 30 patients with RPF in a single center in Beijing in a 10-year period.

METHODSWe retrospectively analyzed clinical data on demographic characteristics, clinical manifestations, laboratory findings, radiological findings, modalities of treatments, outcomes and prognosis of 30 patients with RPF. Patients were treated in Beijing Chao-Yang Hospital between January 2003 and December 2013.

RESULTSThe mean age of patients with RPF was 56.7 ± 14.4 years. Twenty-three patients were men and seven patients were women. Acute phase reactants were elevated in most patients. Rheumatic factor was positive in 4/25 (16.0%) patients, and antinuclear antibody was positive in 6/22 (27.3%) patients. Elevation of IgG4 was observed in 9/22 (40.9%) patients. The most common type was I + III (n = 13), followed by I + II + III (n = 12). Five patients undertook an 18 F-fluoro-deoxy-D-glucose positron emission tomography examination and increased uptake was detected in four patients. Eight patients received combination therapy with glucocorticoids and tamoxifen. Surgical intervention treatments included intraureteral double-J stent implantation (n = 26), percutaneous nephrostomy (n = 2), open ureterolysis and intraperitonealization of the ureters (n = 5) and laparoscopic ureterolysis and intraperitonealization of the ureters (n = 5). Three patients underwent hemodialysis because of renal failure.

CONCLUSIONSClinical characteristics of RPF patients in our study are similar to those previously reported. Steroids and immunosuppressive therapy combined with ureterolysis could be a viable choice of treatment for RPF. More prospective, multi-center studies with a longer follow-up are warranted.

Adult ; Aged ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Immunoglobulin G ; blood ; Male ; Middle Aged ; Retroperitoneal Fibrosis ; blood ; diagnosis ; drug therapy ; surgery ; Retrospective Studies ; Tamoxifen ; therapeutic use ; Treatment Outcome

Primary endocrine therapy (PET) is often included as a treatment option in elderly women with operable breast cancer. Elderly women tend to have pre-existing comorbidities and are often reluctant to undergo surgery. The benefit of surgery needs to be weighed against a relatively higher potential for operative morbidity and mortality, and a limited life expectancy. But while PET can provide relatively good locoregional control, it is not curative in nature and the possibility of local complications and metastasis remains. We retrospectively reviewed the outcome of PET in a series of 19 elderly women, older than 70 years of age, who had presented with operable non-metastatic breast cancer. Only about a third of these women were deemed medically unfit for surgery; the rest had declined surgery. Compliance was an issue, with almost half of these patients defaulting treatment and follow-up. Local control was achieved in most patients, but disease progression did occur in 5 patients. Three of these patients received additional treatment; which included surgery in 1 patient. PET should therefore not be considered an equivalent alternative to surgery in elderly women who were fi t to undergo surgery. However, having observed that only 1 of the 6 deaths in our study was related to breast cancer, PET does have a role in women whose life expectancy is more likely to be limited by coexisting morbidities than the breast cancer itself.
Aged ; Aged, 80 and over ; Antineoplastic Agents, Hormonal ; therapeutic use ; Breast Neoplasms ; drug therapy ; Drug Therapy ; utilization ; Female ; Humans ; Retrospective Studies ; Tamoxifen ; therapeutic use