Objective: To compare the clinical efficacy of Cassia Twig Tuckahoe capsule (Chinese Medicine) and Mifepristone combined with laparoscopic surgery for the treatment of endometriosis. Designs: Prospective cohort study....Objective: To compare the clinical efficacy of Cassia Twig Tuckahoe capsule (Chinese Medicine) and Mifepristone combined with laparoscopic surgery for the treatment of endometriosis. Designs: Prospective cohort study. Setting: Gynecology and Obstetrics Department, Jingzhou Central Hospital, affiliated to Yangtze University. Methods: We selected 67 patients suspected with endometriosis and divided randomly into 2 groups on patient choice. Outcome Measures: Treatment efficacy, side effects, recurrence rate and pregnancy rate. Results: Comparing the effect of treatment between the two groups, the success rate was almost same (P > 0.5). However, the disappearance of pain was faster in Cassia twig Tuckahoe group (P Conclusion: After analysis of the result, Cassia twig Tuckahoe capsule combined with Laparoscopy is superior to the Mifepristone combined with Laparoscopy. Cassia twig Tuckahoe capsule is a very propitious medicine for treating endometriosis for long term benefits.展开更多
Objective To study the effect of single and low dose of RU486 on endometrial receptivity of healthy women. Methods A total of 5 healthy women were followed for one control and one treatment cycle. In the treatment cyc...Objective To study the effect of single and low dose of RU486 on endometrial receptivity of healthy women. Methods A total of 5 healthy women were followed for one control and one treatment cycle. In the treatment cycle, a dose of 10 mg RU486 was administered on day luteinizing hormone (LH)-2. In both the control and treatment cycle, an endometrial biopsy was obtained on LH+7. These biopsies were assessed by immunohistochemical analysis to find the difference in expression of integrins and progesterone receptor (PR) between the control and treatment cycle. Results The treatment with RU486 increased the expression of α 1 and α 4 subunits of integrin in glandular epithelial cells, but did not influence β 3 subunit. Moreover, the normal down regulation of PR in epitherial cell nuclei was inhibited by 10 mg RU486. Conclusion Single dose of 10 mg RU486 impairs the establishment of endometrial receptivity on time.展开更多
Objective In order to gain further information about the mechanism of emergency contraception, during the peri-implantation period the effect of single and low dose of Mifepristone on the expression of integrin level ...Objective In order to gain further information about the mechanism of emergency contraception, during the peri-implantation period the effect of single and low dose of Mifepristone on the expression of integrin level in endometrium of healthy women were observed Materials ＆ Methods Eleven healthy women, proven fertility, were randomly divided into two groups: group LH-2 (n = 5) and LH+ 2 (n = 6). During the control and treatment cycle, placebo or 10 mg Mifepristone were given orally to group LH- 2 on cycle day LH- 2 or to group LH + 2 on cycle day LH - 2, respectively. One endometrial tissue specimen was obtained in both the control and the treatment cycle on cycle day LH+ 7.In this study, the endometrial specimens were assessed by immunohistochemistry analysis to measure the change of integrin α1, α4 and β3 subunits expression on the endometrium after using Mifepristone.Results Mifepristone increased the expression of α1 and α4 subunit in glandular epithelium only in group LH- 2. The expression of β3 integrin subunit remain the same in our experiments.Conclusion Treatment with Mifepristone interferes with integrin distribution during the implantation period, which may imply that the contraceptive effect of Mi fepristone is primarily due to impaired endometrial receptivity.展开更多
Objective: To compare the efficacy and side effects of levonorgestrel and low dose mifepristone in emergency contraception. Method: The study is a randomized double--blind multicenter comparative trial. A total of 1, ...Objective: To compare the efficacy and side effects of levonorgestrel and low dose mifepristone in emergency contraception. Method: The study is a randomized double--blind multicenter comparative trial. A total of 1, 276 women with unprotected intercourse within 72 hours were allocated to one of the two study groups. In the levonorgestrel (LNG) group, 0. 75 mg LNG was taken twice, 12 hours apart, whereas in the mifepristone (Mife) group, a single dose of 10 mg mifepristone was taken and a placebo 12 hours after. Follow--up visit was paid on the seventh day of the expected next menstruation to evaluate the contraceptive efficacy and side effects. Contraceptive efficacy was calculated by Dixon’s method. Result:In the LNG group 20 pregnancies occurred among 643 women, while in the Mife group 9 pregnancies occurred among 633 women. The pregnancy rates were 3. 10% and 1. 43% respectively. Contraceptive efficacy rate of preventing pregnancy was 59. 16% and 79. 73%, the difference was statistically significant (P<O. 05). The incidence of various side effects, which were mild, was less than 10%. There was no statistical difference between the two groups. The percentage of subjects who had their next menstruation 3 days earlier or later than their expected menstruation in LNG group and Mife group was 77. 7% and 78. 5% respectively. Conclusion: Use of levonorgestrel or low dose mifepristone for emergency contraception is effective and safe.展开更多
To provide the theoretical fundation for the further clinical application of mifepristone and anordrin compound. Materials & Methods Ribonuclease protection assay was used for the detection and quantitation of est...To provide the theoretical fundation for the further clinical application of mifepristone and anordrin compound. Materials & Methods Ribonuclease protection assay was used for the detection and quantitation of estrogen and progesterone receptor mRNAs in human decidua from the termination of early pregnancy.Three groups, each of which had 6～8 cases, were studied. Results Compared to the normal control group, estrogen and progesterone receptor mRNAs increased significantly (P<0.05) in the mifepristone group, whereas the changes in the group administrated mifepristone compound which contains anordrin were not obvious. Conclusions The result suggests that with the similar clinical effect, mifepristone compound has less side effect on the patients, thus being more suitable for the anti early pregnancy drug.展开更多
A prospective randomized, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy. Author: Dr Roopa Malik, Assistant Professor, ...A prospective randomized, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy. Author: Dr Roopa Malik, Assistant Professor, Obstetrics and gynaecology department Pt BDS PGIMS Rohtak BACKGROUND: Vaginal misoprostol has been shown to be an effective single agent for medical agent for medical abortion. This randomized, placebo controlled trial compared a regimen of mefipristone and misoprostol with misoprostol alone for termination of early pregnancy. METHODS: 200 women with gestation <56 days were randomized by a random number table to receive either 200 mg mifepristone orally or placebo followed 48 h later by 800 ug vaginal misoprostol. Abortion success was defined as complete abortion without the use of surgical aspiration. RESULTS: Successful medical abortions occurred in 96 out of 100 subjects (96%) after mifepristone followed by vaginal misoprostol. In all, 79 out of 100 subjects (79%) successfully aborted after placebo and vaginal misoprostol. The higher success rate of complete abortion with mifepristone and misoprostol regimen was statistically significant compared with the placebo and misoprostol regimen (p < 0.05). CONCLUSION: A regimen of mifepristone and misoprostol was significantly more effective for termination of pregnancies <56 days than misoprostol alone. The misoprostol alone regimen for termination of early pregnancy is not a very good method for medical abortion but 79% efficacy obtained with vaginal misoprostol alone may clinically acceptable when mifepristone is not available.展开更多
The objective of this study was to investigate the clinical efficacy of carboprost tromethamine combined with mifepristone in the treatment of uterine fibroids.A total of 66 patients with uterine fibroids admitted to ...The objective of this study was to investigate the clinical efficacy of carboprost tromethamine combined with mifepristone in the treatment of uterine fibroids.A total of 66 patients with uterine fibroids admitted to our hospital between April 2018 and January 2019 were selected as subjects.According to the two different treatment methods,patients were divided equally:The observation group and the control group,each group of 33 people.The oxytocin drug treatment was medicated to the control group,and the prostaglandin tromethamine combined with mifepristone was medicated to the observation group.The treatment effect,adverse reaction,operation,and uterine muscle before and after surgery were observed in these two groups:Tumor tissue progesterone receptor and estrogen receptor levels.The clinical treatment effect of the observation group was 93.94%,and the clinical treatment effect of the control group was 60.61%.The clinical treatment effect of the observation group was significantly higher than that of the control group;furthermore,the incidence of adverse reactions in the observation group in terms of rash,fatigue,nausea,and vomiting was much lower than the control group and could observe a significant difference.Finally,in observation group,the amount of intraoperative blood loss,operation time,and hospitalization time was better than those of the control group.The progesterone receptor and estrogen receptor levels in the uterine fibroid tissue after surgery should also be better than the control group,and it is worth to make a further comparison.Carboprost tromethamine combined with mifepristone is effective in the treatment of uterine fibroids and can be further developed.展开更多
Objective: To study the effect of mifepristone on invasion gene and apoptosis gene expression in ectopic endometrial tissue of patients with endometriosis. Methods: Patients with endometriosis who were treated in Peop...Objective: To study the effect of mifepristone on invasion gene and apoptosis gene expression in ectopic endometrial tissue of patients with endometriosis. Methods: Patients with endometriosis who were treated in People's Hospital of Dongxihu District Wuhan City between March 2015 and June 2017 were selected as the research subjects and randomly divided into two groups, mifepristone group received mifepristone therapy 3 months before surgery, and control group received no special treatment. The endometriosis lesions were collected after surgical resection to determine the expression of invasion and apoptosis genes. Results: β-catenin, GSK3β, uPA, NK-kB p65, OPN, Ki-67, c-IAP1, Bcl-2, Livin and Id-1 protein expression in endometriosis lesions of mifepristone group were significantly lower than those of control group while PTEN, Smac, Bax and Fas protein expression were significantly higher than those of control group. Conclusion: Preoperative mifepristone therapy can inhibit cell invasion and promote cell apoptosis in endometriosis lesion.展开更多
Objective:To study the effect of mifepristone intervention on the inflammatory factor as well as invasion and apoptosis gene expression in endometriosis lesions of endometriosis model rats.Method:SD female rats were s...Objective:To study the effect of mifepristone intervention on the inflammatory factor as well as invasion and apoptosis gene expression in endometriosis lesions of endometriosis model rats.Method:SD female rats were selected as experimental animals, divided into model group (EMs group) and mifepristone group (RU486 group) and made into endometriosis models, then the EMs group received saline intervention and RU486 group received 2.6 mg/kg/d RU486 intervention. 4 weeks after intervention, endometriosis lesions were anatomized to determine the expression of inflammatory factors (COX-2, PGE2, TNF-α, IL-1β and IL-6), invasion genes (OPN, MMP2, MMP9, uPA and S100A6) as well as apoptosis genes (Bcl-2, Livin, Smac and PTEN).Results: COX-2, PGE2, TNF-α, IL-1β, IL-6, OPN, MMP2, MMP9, uPA, S100A6, Bcl-2 and Livin protein expression in endometriosis lesions of Ru486 group were significantly lower than those of EMs group while Smac and PTEN protein expression were higher than those of EMs group.Conclusion: Mifepristone for endometriosis model rats can inhibit the expression of inflammatory factors, invasion genes and anti-apoptosis genes, and increase the expression of pro-apoptosis genes.展开更多
Objective: Mifepristone, as a type of well-accepted emergency contraceptive drugs, is an optional progesterone receptor mod-ulator and widely used clinically. However, the effect of mifepristone on sperms is poorly st...Objective: Mifepristone, as a type of well-accepted emergency contraceptive drugs, is an optional progesterone receptor mod-ulator and widely used clinically. However, the effect of mifepristone on sperms is poorly studied. This research is intended to investigate the biological effect of mifepristone on human sperm function in vitro. Methods: Spermatozoa were incubated in the culture medium containing 0.04 μM, 0.4 μM, 4 μM and 40 μM of mifepristone for one hour after capacitation. It was required to measure sperm motility, viability, DNA integrity, acrosomal reaction, sperm hyperactivation, and the concentration of free calcium ions in spermatozoa. Results: After treating sperms with different concentrations of mifepristone in vitro, sperm viability, motility, morphology and DNA integrity were measured. The differences between the control group and the experimental group were of no statistical significance (p > .05). When the concentration of mifepristone was higher than 0.4 μM, the proportion of sperm hyperactivation was significantly reduced (p < .01). According to further examination on the rate of acrosomal reaction (AR rate) and the con-centration of free calcium ions in sperms, it was found that acrosomal reaction was significantly inhibited with the concentration of free calcium ions in sperms decreased when the concentration of mifepristone was higher than 0.4 μM. Conclusions: The in-vitro spermicidal mechanism of mifepristone is realized by inhibiting acrosomal reaction, hyperactivation and decreasing the concentration of free calcium ions.展开更多
Objective:To compare the clinical efficacy of Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone,Guizhi Fuling Capsule(桂枝茯苓胶囊)combined with mifepristone,and single mifepristone in the treatment of uterine...Objective:To compare the clinical efficacy of Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone,Guizhi Fuling Capsule(桂枝茯苓胶囊)combined with mifepristone,and single mifepristone in the treatment of uterine fibroids.Methods:Retrospective analysis was performed on 307 patients with uterine fibroids receiving drug treatment in our hospital.All 307 patients has been divided into three groups according to the different drug delivery scheme,GLM group of 125 patients taking Gongliuqing Capsule and mifepristone,GFM group of 113 patients taking Guizhi Fuling Capsule(桂枝茯苓胶囊)and mifepristone,SM group of 69 patients only taking mifepristone.Comparison of the cure rate and effective rate,volume of menstruation,menstrual period and uterine fibroids,level of estrogen and the incidence of adverse reaction of the patients of the 3 groups.Results:After 90days of treatment,the efficiency of GLM and GFM group were higher than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).The cure rate of GLM group was higher than that of the other two groups,and the difference was statistically significant(P<0.05).The menstrual volume and period length,uterine fibroids volume of GLM and GFM group was smaller than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P<0.05).The P and E2 level of GLM and GFM group was lower than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).There was no significant difference in the incidence of other sex hormone level and adverse reactions(P>0.05).Conclusions:Compared with the SM to treat uterine fibroids,the integrative medicine therapy were better.Among them,Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone has the highest cure rate.展开更多
Objective To explore the effects of mifepristone on the growth of human gastric cancer cell line MKN-45 and its possible mechanisms. Methods In situ hybridization was used to detect the expression of progesterone rece...Objective To explore the effects of mifepristone on the growth of human gastric cancer cell line MKN-45 and its possible mechanisms. Methods In situ hybridization was used to detect the expression of progesterone receptor (PR) mRNA in MKN-45 cells. Proliferation, cell cycle distribution, and the expression of Bcl-xL and vascular endothelial growth factor (VEGF) of MKN-45 cells incubated with various concentrations of mifepristone (1, 5, 10, and 20 μmol/L) were analyzed using MTT reduction assay, flow cytometry, reverse transcription-polymerase chain reaction (RT-PCR), and enzyme-linked immunoab-sorbent assay (ELISA), respectively. After transplantation of MKN-45 cells underneath the skin of athymic mice, mifepristone was administrated with the dose of 50 mg/(kg·d) for 6 weeks to evaluate the tumor growth. Apoptosis and the expression of proliferating cell nuclear antigen (PCNA) in xenografted tumors were detected using transmission electron microscopy and immunohistochemical staining, respectively. Results PR mRNA was highly expressed in cultured MKN-45 cell. Mifepristone dose-dependently inhibited the pr-oliferation of MKN-45 cells, and the inhibitory rate was dramatically increased from 7.21% to 47.23%. The inhibitory effect was accompanied by a dose-dependent increase in the percentage of cells in G 0 /G 1 phase, and with a concurrent decrease in the proportion of S- and G 2 /M-phase cells and the proliferative index from 57.65% to 24.54%. Meanwhile, mifepristone down-regulated the expression of Bcl-xL and VEGF in a dose-dependent manner. In vivo, mifepristone effectively inhibited the growth of xenografted tumors in nude mice (55.14% for inhibitory rate), induced apoptosis, and down-regulated PCNA expression in gastric cancer. Conclusion Mifepristone exerts significant growth inhibitory effects on PR-positive human MKN-45 gastric cancer cells via multiple mechanisms, and may be a beneficial agent against the tumor.展开更多
To explore the reversal effect of mifepristone on multidrug resistance (MDR) in drug-resistant human breast cancer cell line MCF7/ADR and its mechanisms. Methods: Expression of MDR1 and MDR-associated protein(MRP) mRN...To explore the reversal effect of mifepristone on multidrug resistance (MDR) in drug-resistant human breast cancer cell line MCF7/ADR and its mechanisms. Methods: Expression of MDR1 and MDR-associated protein(MRP) mRNA in MCF7/ADR cells was detected using reverse transcription- polymerase chain reaction(RT-PCR). Western blotting was used to assay the protein levels of P-glycoprotein (P-gp) and MRP. Intracellular rhodamine 123 retention and [3H]vincristine (VCR) accumulation were measured by flow cytometry and liquid scintillation counter, respectively. MTT reduction assay was used to determine the sensitivity of cells to the anticancer agent, adriamycin (ADR). Additionally, a MCF7/ADR cell xenograft model was established to assess the reversal effect of mifeprisone on MDR in MCF7/ADR cells in vivo. Results: Miferpristone dose-dependently down- regulated the expression of MDR1 and MRP mRNA in MCF7/ADR cells, accompanied by a significant decrease in the protein levels of P-gp and MRP. After exposure to 5, 10, and 20 mmol/L mifepristone, MCF7/ADR cells showed a 3.87-, 5.81-, and 7.40-fold increase in the accumulation of intracellular VCR(a known substrate of MRP), and a 2.14-, 4.39-, and 5.53-fold increase in the retention of intracellular rhodamine 123(an indicator of P-gp function), respectively. MTT analysis showed that the sensitivity of MCF7/ADR cells to ADR was enhanced by 7.23-, 13.62-, and 20.96-fold after incubation with mifepristone as above-mentioned doses for 96 h. In vivo, mifepristone effectively restored the chemosensitivity of MCF7/ADR cells to ADR. After 8 weeks of administration with ADR(2 mg穔g-1穌-1) alone or in combination with mifepristone(50 mg穔g-1穌-1), the growth inhibitory rate of xenografted tumors in nude mice was 8.08% and 37.25%, respectively. Conclusion: Mifepristone exerts potent reversal effects on MDR in MCF7/ADR cells in vitro and in vivo through down- regulation of MDR1/P-gp and MRP expression and inhibition of P-gp- and MRP-dependent drug efflux, thus increasing the sensitivity to anticancer drug.展开更多
Objective To investigate telomerase activity in chorion and decidua from abortion induced by mifepristone incorporated with misoprostol at early pregnancy Methods TRAP-SYBR Green assay was used to detect the expressio...Objective To investigate telomerase activity in chorion and decidua from abortion induced by mifepristone incorporated with misoprostol at early pregnancy Methods TRAP-SYBR Green assay was used to detect the expression of telomerase. Forty specimen were obtained from medicinal abortion (experiment group) and forty were from normal induced abortion (control group). Results Positive expression of chorion telomerase was significantly different between the experimental group (28%, 11/40) and the control group (73%, 29/40) (P<0.05). While in decidua, the positive rate was 28% (11/40) in the experimental group and 20% (9/40) in the control group, there was no significant difference (P>0.05). Conclusion It is suggested that miferistone may significantly decrease the telomerase activity in chorion but not in decidua.展开更多
Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostot.Subjects and Methods A total...Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostot.Subjects and Methods A total of 213 pregnant women with amenorrhea of 34-69d after caesarian section who asked for medical abortion were recruited,including 63 cases undergoing their second medical abortion.A total amount of mi feprisstone of 150 mg given in separate doses(25 mg×4 and 50 mg at the first time)was administered orally within 3d, followed by misoprostot of 0.6 mg orally in the morning of d 3.Results The complete abortion rate was 92.5%,incomplete abortion was 4.7% and failure was 2.8%.Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section histo-ry.Its efficacy was similar to that for ordinary population.Its safety and effec-tiveness were satisfactory.展开更多
Objective To compare the effects of 2 dosage-forms (granular and decoction) of Arnebia euchroma (royle) Johnst (Arnebia EJ in short below) on medical abortion with that of mifepristone combined with misoprostol Method...Objective To compare the effects of 2 dosage-forms (granular and decoction) of Arnebia euchroma (royle) Johnst (Arnebia EJ in short below) on medical abortion with that of mifepristone combined with misoprostol Methods Totally 648 women, who had pregnancy of 38-45 d and were willing to terminate pregnancy with mifepristone and misoprostol, were randomly divided into 3 groups, each of which was respectively given granular of Arnebia EJ, placebo granular, or decoction of Arnebia EJ besides mifepristone and misoprostol. The abortion results, bleeding duration, menstruation recovery and side-effects were observed. Results Neither complete abortion rates nor average bleeding durations of the granular group and the decoction group were significantly different (P>0.05). The complete abortion rate and bleeding duration of the two groups were respectively higher and shorter than those of the placebo group (P<0.05). However, the menstruation recov- ery was not significantly different among the three groups (P>0.05). The decoction of Arnebia EJ caused significantly more nausea and vomiting than the other groups (P<0.05). Conclusion The granular form did not have the odor of Arnebia EJ, and caused much less nausea and vomiting compared with the decoction form. The granular and decoc- tion forms were equally effective in improving the results of medical abortion. There- fore it is necessary to conduct further studies on the granular form of Arnebia EJ.展开更多
To compare the effectiveness and side effects of various low dose of Mifepristone in combination with Misoprostol and low doses Mifepristone alone in emergency contraception Materials & Methods This is a multi cen...To compare the effectiveness and side effects of various low dose of Mifepristone in combination with Misoprostol and low doses Mifepristone alone in emergency contraception Materials & Methods This is a multi center double blind randomized controlled clinical trial. A total of 899 healthy women were allocated into this study and were randomly divided into 3 groups. They were orally administrated with different emergency contraceptives with 120 h after unprotected intercourse. Group I (n=300) was given 25 mg Mifepristone plus 0.2 mg Misoprostol after 24 h. Group II (n=299) was given 10 mg Mifepristone plus 0.2 mg Misoprostol after 24 h. Group III (n=300) was administrated with 10 mg Mifepristone alone. The effective rates in different groups were calculated with Dixon method. Results Altogether 11 pregnancies occurred, among which 2 cases were in Group I, 2 cases in Group II, and 7 cases were in Group III. After correction with method failure, there was only one case in Group I, 0 case in Group II, and 5 cases in Group III. The contraceptive effectiveness in these groups was 95.5%, 100% and 76.9% respectively. The pregnancy rate was significantly lower in Group I and Group II than that of Group III (P<0.01). The side effects were slight and tolerable, and there was no significant difference between different groups (P>0.05). Conclusion Use of low dose Mifepristone (25 mg or 10 mg) in combination with 0.2 mg Misoprostol was an effective, low side effects and safe treatment regimen for emergency contraception.展开更多
文摘Objective: To compare the clinical efficacy of Cassia Twig Tuckahoe capsule (Chinese Medicine) and Mifepristone combined with laparoscopic surgery for the treatment of endometriosis. Designs: Prospective cohort study. Setting: Gynecology and Obstetrics Department, Jingzhou Central Hospital, affiliated to Yangtze University. Methods: We selected 67 patients suspected with endometriosis and divided randomly into 2 groups on patient choice. Outcome Measures: Treatment efficacy, side effects, recurrence rate and pregnancy rate. Results: Comparing the effect of treatment between the two groups, the success rate was almost same (P > 0.5). However, the disappearance of pain was faster in Cassia twig Tuckahoe group (P Conclusion: After analysis of the result, Cassia twig Tuckahoe capsule combined with Laparoscopy is superior to the Mifepristone combined with Laparoscopy. Cassia twig Tuckahoe capsule is a very propitious medicine for treating endometriosis for long term benefits.
文摘Objective To study the effect of single and low dose of RU486 on endometrial receptivity of healthy women. Methods A total of 5 healthy women were followed for one control and one treatment cycle. In the treatment cycle, a dose of 10 mg RU486 was administered on day luteinizing hormone (LH)-2. In both the control and treatment cycle, an endometrial biopsy was obtained on LH+7. These biopsies were assessed by immunohistochemical analysis to find the difference in expression of integrins and progesterone receptor (PR) between the control and treatment cycle. Results The treatment with RU486 increased the expression of α 1 and α 4 subunits of integrin in glandular epithelial cells, but did not influence β 3 subunit. Moreover, the normal down regulation of PR in epitherial cell nuclei was inhibited by 10 mg RU486. Conclusion Single dose of 10 mg RU486 impairs the establishment of endometrial receptivity on time.
文摘Objective In order to gain further information about the mechanism of emergency contraception, during the peri-implantation period the effect of single and low dose of Mifepristone on the expression of integrin level in endometrium of healthy women were observed Materials ＆ Methods Eleven healthy women, proven fertility, were randomly divided into two groups: group LH-2 (n = 5) and LH+ 2 (n = 6). During the control and treatment cycle, placebo or 10 mg Mifepristone were given orally to group LH- 2 on cycle day LH- 2 or to group LH + 2 on cycle day LH - 2, respectively. One endometrial tissue specimen was obtained in both the control and the treatment cycle on cycle day LH+ 7.In this study, the endometrial specimens were assessed by immunohistochemistry analysis to measure the change of integrin α1, α4 and β3 subunits expression on the endometrium after using Mifepristone.Results Mifepristone increased the expression of α1 and α4 subunit in glandular epithelium only in group LH- 2. The expression of β3 integrin subunit remain the same in our experiments.Conclusion Treatment with Mifepristone interferes with integrin distribution during the implantation period, which may imply that the contraceptive effect of Mi fepristone is primarily due to impaired endometrial receptivity.
文摘Objective: To compare the efficacy and side effects of levonorgestrel and low dose mifepristone in emergency contraception. Method: The study is a randomized double--blind multicenter comparative trial. A total of 1, 276 women with unprotected intercourse within 72 hours were allocated to one of the two study groups. In the levonorgestrel (LNG) group, 0. 75 mg LNG was taken twice, 12 hours apart, whereas in the mifepristone (Mife) group, a single dose of 10 mg mifepristone was taken and a placebo 12 hours after. Follow--up visit was paid on the seventh day of the expected next menstruation to evaluate the contraceptive efficacy and side effects. Contraceptive efficacy was calculated by Dixon’s method. Result:In the LNG group 20 pregnancies occurred among 643 women, while in the Mife group 9 pregnancies occurred among 633 women. The pregnancy rates were 3. 10% and 1. 43% respectively. Contraceptive efficacy rate of preventing pregnancy was 59. 16% and 79. 73%, the difference was statistically significant (P<O. 05). The incidence of various side effects, which were mild, was less than 10%. There was no statistical difference between the two groups. The percentage of subjects who had their next menstruation 3 days earlier or later than their expected menstruation in LNG group and Mife group was 77. 7% and 78. 5% respectively. Conclusion: Use of levonorgestrel or low dose mifepristone for emergency contraception is effective and safe.
基金This work was supported by a grant from the National Laboratory of Contraceptives and Devices Research of China
文摘To provide the theoretical fundation for the further clinical application of mifepristone and anordrin compound. Materials & Methods Ribonuclease protection assay was used for the detection and quantitation of estrogen and progesterone receptor mRNAs in human decidua from the termination of early pregnancy.Three groups, each of which had 6～8 cases, were studied. Results Compared to the normal control group, estrogen and progesterone receptor mRNAs increased significantly (P<0.05) in the mifepristone group, whereas the changes in the group administrated mifepristone compound which contains anordrin were not obvious. Conclusions The result suggests that with the similar clinical effect, mifepristone compound has less side effect on the patients, thus being more suitable for the anti early pregnancy drug.
文摘A prospective randomized, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy. Author: Dr Roopa Malik, Assistant Professor, Obstetrics and gynaecology department Pt BDS PGIMS Rohtak BACKGROUND: Vaginal misoprostol has been shown to be an effective single agent for medical agent for medical abortion. This randomized, placebo controlled trial compared a regimen of mefipristone and misoprostol with misoprostol alone for termination of early pregnancy. METHODS: 200 women with gestation <56 days were randomized by a random number table to receive either 200 mg mifepristone orally or placebo followed 48 h later by 800 ug vaginal misoprostol. Abortion success was defined as complete abortion without the use of surgical aspiration. RESULTS: Successful medical abortions occurred in 96 out of 100 subjects (96%) after mifepristone followed by vaginal misoprostol. In all, 79 out of 100 subjects (79%) successfully aborted after placebo and vaginal misoprostol. The higher success rate of complete abortion with mifepristone and misoprostol regimen was statistically significant compared with the placebo and misoprostol regimen (p < 0.05). CONCLUSION: A regimen of mifepristone and misoprostol was significantly more effective for termination of pregnancies <56 days than misoprostol alone. The misoprostol alone regimen for termination of early pregnancy is not a very good method for medical abortion but 79% efficacy obtained with vaginal misoprostol alone may clinically acceptable when mifepristone is not available.
文摘The objective of this study was to investigate the clinical efficacy of carboprost tromethamine combined with mifepristone in the treatment of uterine fibroids.A total of 66 patients with uterine fibroids admitted to our hospital between April 2018 and January 2019 were selected as subjects.According to the two different treatment methods,patients were divided equally:The observation group and the control group,each group of 33 people.The oxytocin drug treatment was medicated to the control group,and the prostaglandin tromethamine combined with mifepristone was medicated to the observation group.The treatment effect,adverse reaction,operation,and uterine muscle before and after surgery were observed in these two groups:Tumor tissue progesterone receptor and estrogen receptor levels.The clinical treatment effect of the observation group was 93.94%,and the clinical treatment effect of the control group was 60.61%.The clinical treatment effect of the observation group was significantly higher than that of the control group;furthermore,the incidence of adverse reactions in the observation group in terms of rash,fatigue,nausea,and vomiting was much lower than the control group and could observe a significant difference.Finally,in observation group,the amount of intraoperative blood loss,operation time,and hospitalization time was better than those of the control group.The progesterone receptor and estrogen receptor levels in the uterine fibroid tissue after surgery should also be better than the control group,and it is worth to make a further comparison.Carboprost tromethamine combined with mifepristone is effective in the treatment of uterine fibroids and can be further developed.
文摘Objective: To study the effect of mifepristone on invasion gene and apoptosis gene expression in ectopic endometrial tissue of patients with endometriosis. Methods: Patients with endometriosis who were treated in People's Hospital of Dongxihu District Wuhan City between March 2015 and June 2017 were selected as the research subjects and randomly divided into two groups, mifepristone group received mifepristone therapy 3 months before surgery, and control group received no special treatment. The endometriosis lesions were collected after surgical resection to determine the expression of invasion and apoptosis genes. Results: β-catenin, GSK3β, uPA, NK-kB p65, OPN, Ki-67, c-IAP1, Bcl-2, Livin and Id-1 protein expression in endometriosis lesions of mifepristone group were significantly lower than those of control group while PTEN, Smac, Bax and Fas protein expression were significantly higher than those of control group. Conclusion: Preoperative mifepristone therapy can inhibit cell invasion and promote cell apoptosis in endometriosis lesion.
文摘Objective:To study the effect of mifepristone intervention on the inflammatory factor as well as invasion and apoptosis gene expression in endometriosis lesions of endometriosis model rats.Method:SD female rats were selected as experimental animals, divided into model group (EMs group) and mifepristone group (RU486 group) and made into endometriosis models, then the EMs group received saline intervention and RU486 group received 2.6 mg/kg/d RU486 intervention. 4 weeks after intervention, endometriosis lesions were anatomized to determine the expression of inflammatory factors (COX-2, PGE2, TNF-α, IL-1β and IL-6), invasion genes (OPN, MMP2, MMP9, uPA and S100A6) as well as apoptosis genes (Bcl-2, Livin, Smac and PTEN).Results: COX-2, PGE2, TNF-α, IL-1β, IL-6, OPN, MMP2, MMP9, uPA, S100A6, Bcl-2 and Livin protein expression in endometriosis lesions of Ru486 group were significantly lower than those of EMs group while Smac and PTEN protein expression were higher than those of EMs group.Conclusion: Mifepristone for endometriosis model rats can inhibit the expression of inflammatory factors, invasion genes and anti-apoptosis genes, and increase the expression of pro-apoptosis genes.
文摘Objective: Mifepristone, as a type of well-accepted emergency contraceptive drugs, is an optional progesterone receptor mod-ulator and widely used clinically. However, the effect of mifepristone on sperms is poorly studied. This research is intended to investigate the biological effect of mifepristone on human sperm function in vitro. Methods: Spermatozoa were incubated in the culture medium containing 0.04 μM, 0.4 μM, 4 μM and 40 μM of mifepristone for one hour after capacitation. It was required to measure sperm motility, viability, DNA integrity, acrosomal reaction, sperm hyperactivation, and the concentration of free calcium ions in spermatozoa. Results: After treating sperms with different concentrations of mifepristone in vitro, sperm viability, motility, morphology and DNA integrity were measured. The differences between the control group and the experimental group were of no statistical significance (p > .05). When the concentration of mifepristone was higher than 0.4 μM, the proportion of sperm hyperactivation was significantly reduced (p < .01). According to further examination on the rate of acrosomal reaction (AR rate) and the con-centration of free calcium ions in sperms, it was found that acrosomal reaction was significantly inhibited with the concentration of free calcium ions in sperms decreased when the concentration of mifepristone was higher than 0.4 μM. Conclusions: The in-vitro spermicidal mechanism of mifepristone is realized by inhibiting acrosomal reaction, hyperactivation and decreasing the concentration of free calcium ions.
文摘Objective:To compare the clinical efficacy of Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone,Guizhi Fuling Capsule(桂枝茯苓胶囊)combined with mifepristone,and single mifepristone in the treatment of uterine fibroids.Methods:Retrospective analysis was performed on 307 patients with uterine fibroids receiving drug treatment in our hospital.All 307 patients has been divided into three groups according to the different drug delivery scheme,GLM group of 125 patients taking Gongliuqing Capsule and mifepristone,GFM group of 113 patients taking Guizhi Fuling Capsule(桂枝茯苓胶囊)and mifepristone,SM group of 69 patients only taking mifepristone.Comparison of the cure rate and effective rate,volume of menstruation,menstrual period and uterine fibroids,level of estrogen and the incidence of adverse reaction of the patients of the 3 groups.Results:After 90days of treatment,the efficiency of GLM and GFM group were higher than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).The cure rate of GLM group was higher than that of the other two groups,and the difference was statistically significant(P<0.05).The menstrual volume and period length,uterine fibroids volume of GLM and GFM group was smaller than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P<0.05).The P and E2 level of GLM and GFM group was lower than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).There was no significant difference in the incidence of other sex hormone level and adverse reactions(P>0.05).Conclusions:Compared with the SM to treat uterine fibroids,the integrative medicine therapy were better.Among them,Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone has the highest cure rate.
文摘Objective To explore the effects of mifepristone on the growth of human gastric cancer cell line MKN-45 and its possible mechanisms. Methods In situ hybridization was used to detect the expression of progesterone receptor (PR) mRNA in MKN-45 cells. Proliferation, cell cycle distribution, and the expression of Bcl-xL and vascular endothelial growth factor (VEGF) of MKN-45 cells incubated with various concentrations of mifepristone (1, 5, 10, and 20 μmol/L) were analyzed using MTT reduction assay, flow cytometry, reverse transcription-polymerase chain reaction (RT-PCR), and enzyme-linked immunoab-sorbent assay (ELISA), respectively. After transplantation of MKN-45 cells underneath the skin of athymic mice, mifepristone was administrated with the dose of 50 mg/(kg·d) for 6 weeks to evaluate the tumor growth. Apoptosis and the expression of proliferating cell nuclear antigen (PCNA) in xenografted tumors were detected using transmission electron microscopy and immunohistochemical staining, respectively. Results PR mRNA was highly expressed in cultured MKN-45 cell. Mifepristone dose-dependently inhibited the pr-oliferation of MKN-45 cells, and the inhibitory rate was dramatically increased from 7.21% to 47.23%. The inhibitory effect was accompanied by a dose-dependent increase in the percentage of cells in G 0 /G 1 phase, and with a concurrent decrease in the proportion of S- and G 2 /M-phase cells and the proliferative index from 57.65% to 24.54%. Meanwhile, mifepristone down-regulated the expression of Bcl-xL and VEGF in a dose-dependent manner. In vivo, mifepristone effectively inhibited the growth of xenografted tumors in nude mice (55.14% for inhibitory rate), induced apoptosis, and down-regulated PCNA expression in gastric cancer. Conclusion Mifepristone exerts significant growth inhibitory effects on PR-positive human MKN-45 gastric cancer cells via multiple mechanisms, and may be a beneficial agent against the tumor.
文摘To explore the reversal effect of mifepristone on multidrug resistance (MDR) in drug-resistant human breast cancer cell line MCF7/ADR and its mechanisms. Methods: Expression of MDR1 and MDR-associated protein(MRP) mRNA in MCF7/ADR cells was detected using reverse transcription- polymerase chain reaction(RT-PCR). Western blotting was used to assay the protein levels of P-glycoprotein (P-gp) and MRP. Intracellular rhodamine 123 retention and [3H]vincristine (VCR) accumulation were measured by flow cytometry and liquid scintillation counter, respectively. MTT reduction assay was used to determine the sensitivity of cells to the anticancer agent, adriamycin (ADR). Additionally, a MCF7/ADR cell xenograft model was established to assess the reversal effect of mifeprisone on MDR in MCF7/ADR cells in vivo. Results: Miferpristone dose-dependently down- regulated the expression of MDR1 and MRP mRNA in MCF7/ADR cells, accompanied by a significant decrease in the protein levels of P-gp and MRP. After exposure to 5, 10, and 20 mmol/L mifepristone, MCF7/ADR cells showed a 3.87-, 5.81-, and 7.40-fold increase in the accumulation of intracellular VCR(a known substrate of MRP), and a 2.14-, 4.39-, and 5.53-fold increase in the retention of intracellular rhodamine 123(an indicator of P-gp function), respectively. MTT analysis showed that the sensitivity of MCF7/ADR cells to ADR was enhanced by 7.23-, 13.62-, and 20.96-fold after incubation with mifepristone as above-mentioned doses for 96 h. In vivo, mifepristone effectively restored the chemosensitivity of MCF7/ADR cells to ADR. After 8 weeks of administration with ADR(2 mg穔g-1穌-1) alone or in combination with mifepristone(50 mg穔g-1穌-1), the growth inhibitory rate of xenografted tumors in nude mice was 8.08% and 37.25%, respectively. Conclusion: Mifepristone exerts potent reversal effects on MDR in MCF7/ADR cells in vitro and in vivo through down- regulation of MDR1/P-gp and MRP expression and inhibition of P-gp- and MRP-dependent drug efflux, thus increasing the sensitivity to anticancer drug.
文摘Objective To investigate telomerase activity in chorion and decidua from abortion induced by mifepristone incorporated with misoprostol at early pregnancy Methods TRAP-SYBR Green assay was used to detect the expression of telomerase. Forty specimen were obtained from medicinal abortion (experiment group) and forty were from normal induced abortion (control group). Results Positive expression of chorion telomerase was significantly different between the experimental group (28%, 11/40) and the control group (73%, 29/40) (P<0.05). While in decidua, the positive rate was 28% (11/40) in the experimental group and 20% (9/40) in the control group, there was no significant difference (P>0.05). Conclusion It is suggested that miferistone may significantly decrease the telomerase activity in chorion but not in decidua.
文摘Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostot.Subjects and Methods A total of 213 pregnant women with amenorrhea of 34-69d after caesarian section who asked for medical abortion were recruited,including 63 cases undergoing their second medical abortion.A total amount of mi feprisstone of 150 mg given in separate doses(25 mg×4 and 50 mg at the first time)was administered orally within 3d, followed by misoprostot of 0.6 mg orally in the morning of d 3.Results The complete abortion rate was 92.5%,incomplete abortion was 4.7% and failure was 2.8%.Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section histo-ry.Its efficacy was similar to that for ordinary population.Its safety and effec-tiveness were satisfactory.
文摘Objective To compare the effects of 2 dosage-forms (granular and decoction) of Arnebia euchroma (royle) Johnst (Arnebia EJ in short below) on medical abortion with that of mifepristone combined with misoprostol Methods Totally 648 women, who had pregnancy of 38-45 d and were willing to terminate pregnancy with mifepristone and misoprostol, were randomly divided into 3 groups, each of which was respectively given granular of Arnebia EJ, placebo granular, or decoction of Arnebia EJ besides mifepristone and misoprostol. The abortion results, bleeding duration, menstruation recovery and side-effects were observed. Results Neither complete abortion rates nor average bleeding durations of the granular group and the decoction group were significantly different (P>0.05). The complete abortion rate and bleeding duration of the two groups were respectively higher and shorter than those of the placebo group (P<0.05). However, the menstruation recov- ery was not significantly different among the three groups (P>0.05). The decoction of Arnebia EJ caused significantly more nausea and vomiting than the other groups (P<0.05). Conclusion The granular form did not have the odor of Arnebia EJ, and caused much less nausea and vomiting compared with the decoction form. The granular and decoc- tion forms were equally effective in improving the results of medical abortion. There- fore it is necessary to conduct further studies on the granular form of Arnebia EJ.
文摘To compare the effectiveness and side effects of various low dose of Mifepristone in combination with Misoprostol and low doses Mifepristone alone in emergency contraception Materials & Methods This is a multi center double blind randomized controlled clinical trial. A total of 899 healthy women were allocated into this study and were randomly divided into 3 groups. They were orally administrated with different emergency contraceptives with 120 h after unprotected intercourse. Group I (n=300) was given 25 mg Mifepristone plus 0.2 mg Misoprostol after 24 h. Group II (n=299) was given 10 mg Mifepristone plus 0.2 mg Misoprostol after 24 h. Group III (n=300) was administrated with 10 mg Mifepristone alone. The effective rates in different groups were calculated with Dixon method. Results Altogether 11 pregnancies occurred, among which 2 cases were in Group I, 2 cases in Group II, and 7 cases were in Group III. After correction with method failure, there was only one case in Group I, 0 case in Group II, and 5 cases in Group III. The contraceptive effectiveness in these groups was 95.5%, 100% and 76.9% respectively. The pregnancy rate was significantly lower in Group I and Group II than that of Group III (P<0.01). The side effects were slight and tolerable, and there was no significant difference between different groups (P>0.05). Conclusion Use of low dose Mifepristone (25 mg or 10 mg) in combination with 0.2 mg Misoprostol was an effective, low side effects and safe treatment regimen for emergency contraception.
