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Objective: To analyze the applied condition of ovary function suppression (OFS) before and after joint analysis of TEXT and SOFT trials and SOFT trial, and to identify the relevant factors of OFS usage., Methods: The analysis was performed in premenopausal women with hormone receptor (HR) positive breast cancer receiving surgical treatment from Apr 2013 to Oct 2015 in Ruijin Hospital, Shanghai Jiaotong University School of Medicine. Adjuvant treatment strategy was made in the multidisciplinary team (MDT) meetings. We analyzed the applied condition of OFS before and after joint analysis, SOFT trial and its relevant factors., Results: Among 454 patients, 114 (25.1%) patients received OFS. Before the results of joint analysis came out, all the patients (38/38) received OFS together with tamoxifen (TAM); after the results came out, clinicians began to put OFS with exemestane into practice, among 76 patients, 41(53.9%) patients received OFS with exemestane while 35 (46.1%) patients received OFS together with TAM. Before the results of SOFT trial came out, 71 out of 310 (22.9%) patients received OFS while 43 out of 144 (29.9%) patients received OFS after that. No significant difference was found between the proportion of patients receiving OFS before and after the results of SOFT trial came out (P=0.112). Age, histological grade, pN status, Ki-67 status, molecular subtype and acceptance of chemotherapy were correlated with OFS treatment (P<0.05). Age, tumor grade and pN were independent significant predictors of OFS usage., Conclusions: After the results of joint analysis came out, clinicians began to apply OFS with exemestane to premenopausal women with HR positive breast cancer. There is no significant difference between the proportion of patients receiving OFS before and after SOFT trial. Age, tumor grade and pN status are independent significant predictors of OFS treatment. Patients younger than 40, with histological grade Ⅱ or Ⅲ tumor and with pN1 or pN2 status are prone to receive OFS.

Objective: To evaluate the role and efficacy of preventing bone mineral loss in patients with endometriosis treated by gonadotrophin-releasing hormone analogues (GnRH-a) combined with add-back therapy., Methods: Prospective, randomized controlled studies of the use of GnRHa with add-back therapy in treatment of endometriosis were enrolled in this study from Medline, Embase, Cochrane library, China National Knowledge Internet (CNKI), Chinese Biological Medicine Disk (CBM) and Data Base of Wanfang.After quality assessment and data extraction, meta-analysis were conducted in the change of BMD, reproductive hormone (E2) and visual pain score(VAS) by Stata 11.0 software., Results: A total of 785 patients from 13 randomized controlled trail (RCT) studies enrolled in this study after exclude no following up, poor quality and repeat published studies.377 patients were in group of GnRH-a with add-back treatment and 408 patients were in group of GnRna alone.The findinds were showed in meta-analysis: (1) there was a significant difference in percentage change of bone mineral density (BMD) between two groups, the add-back therapy was more effective in prevention of bone loss which was (SMD = 0.223, 95%CI:0.003 to 0.443, P = 0.047). (2) There was no significant difference in the level of reproductive hormone between two groups (SMD = -0.053, 95% CI:-0.479 to 0.373, P = 0.807). (3) There was also no significant difference in the visual pain score between the two groups (SMD = -0.157, 95% CI: -0.474 to 0.160, P = 0.332)., Conclusions: GnRH-a with add-back therapy have been shown to be more effective in preventing loss of BMD than GnRH-a treatment alone.However, the long term effect of preventing BMD should be studied.

Objective: To determine the effect of raloxifene hydrochloride (RLX) on the lumbar spine and total hip bone mineral density (BMD), bone metabolism and serum lipids in Chinese postmenopausal women with osteoporosis., Methods: 204 Chinese postmenopausal women with osteoporosis from 3 hospitals in Beijing and Shanghai were randomly divided into 2 groups of 102 women: RLX group (RLX of the dosage of 60 mg/day was given for 12 months) and placebo group. In addition, 500 mg of elemental calcium and 200 units of vitamin D were given daily to all women. BMD, serum bone markers and lipids were measured before and after drug administration. The BMD of lumber spine and hip was measured by dual-energy X-ray absorptiometry (DEXA). Serum bone gamma-carboxyglutamic acid-containing protein (BGP) and C-teloppeptide were analyzed by one-step ELISA. Serum lipids were measured by enzymatic method., Results: By the end of the 12-month study period, the lumbar spine BMD was increased by 3.3% +/- 4.8% in the RLX group and 1.0% +/- 4.9% in the placebo group (P < 0.001); the hip BMD was increased by 1.4% +/- 4.8%in the RLX group and decreased by 0.9% +/- 5.0% in the placebo group (P < 0.01). New vertebral fracture occurred in none of the subjects in the RLX group and in 5 subjects of the placebo group (P = 0.059). The serum BGP and CTX decreased by 41.7% and 61.5% respectively in the RLX group, both significantly more than those in the placebo group (10.6% and 35.6% respectively, both P < 0.001). Both the total cholesterol and low-density lipoprotein cholesterol were significantly lower in the RLX group than in the placebo group (both P < 0.001), however, there were no significant differences in high-density lipoprotein cholesterol and triglycerides between these two groups. One subject in the RLX group and 5 subjects in the placebo group discontinued the study due to adverse events. There were no differences in the number of subjects with hot flushes (3 in the RLX group and 1 in the placebo group) and the number of subjects with leg cramps (9 in the RLX group and 4 in the placebo group). No venous thromboembolic event was reported., Conclusion: RLX of the dosage of 60 mg/day for 12 months significantly increases the lumbar spine and total hip bone BMD, significantly decreases bone turnover and has favorable effects on serum lipids in Chinese postmenopausal women with osteoporosis.

Objective: To compare the effects of one year treatment of estrogen and tamoxifen, either alone or combined with fluoride on bone metabolism in ovariectomized rats., Methods: One hundred and forty two virgin female Sprague-Dawley rats were ovariectomized (OVX) or sham operated at 6 months of age, and randomly divided into 7 groups (19 - 21 rats each): (1) sham-operated controls; (2) OVX vehicle controls; (3) estrogen group; (4) fluoride group; (5) tamoxifen group; (6) fluoride plus estrogen; (7) fluoride plus tamoxifen. The treatments lasted for one year. Bone mineral density (BMD) measurement, bone histomorphometry analysis (lumbar vertebrae) and biomechanical test (3-point-bending test on right femur) were performed before and after treatment. The histological change of uterus were also determined at the same time., Results: (1) Twelve months of ovariectomy, the OVX group had significantly lower total body (279 mg/cm(2)), lumbar vertebra (232 mg/cm(2)) than all other groups (total body 286 - 298 mg/cm(2), lumber 251 - 266 mg/cm(2), P < 0.05). Estrogen group (216 mg/cm(2)) had higher BMD than tamoxifene group (195 mg/cm(2)) in midshaft of femur. (2) After 4 months of ovariectomy, only the two combination groups kept the maximum load (145 N) of right femur over the level of OVX group (118 N); after 12 months of treatment, the maximum load of OVX group [(108 +/- 13) N] was significantly different from all other groups (132 - 155 N); both maximum load and elastic load of estrogen group were significantly higher than that of tamoxifen group. (3) No evidence of dysmineralization was found by bone histomorphometry., Conclusions: Estrogen has more potent effects on keeping bone mass and bone strength as compared with tamoxifene. The combined therapy (estrogen + fluoride or tamoxifen + fluoride) resulted in better bone strength than the single ones.

Objective: To asses the efficacy of adjuvant endocrine therapy in ER-positive breast cancer patients after radical mastectomy., Methods: 369 estrogen receptor (ER)-positive breast cancer patients were divided into two groups after radical mastectomy: 1. Endocrine group (N-194). The postmenopausal patients in this group received oral tamoxifen (TAM) for five years and the premenopausal patients were first treated with bilateral ovary ablation and, then, given TAM for five years. 2. The chemotherapy group patients (N-175) received CTX + MTX + 5-Fu + VCR + DXM) (CMFVP) or CTX + MTX + 5-Fu (CMF) multi-drug chemotherapy., Results: Postmenopausal patients in the endocrine and chemotherapy groups gave disease-free survival rates (DFSR) of 78.4% and 45.4% (P < 0.01). Their overall survival rates were 83.3% and 52.9% (P < 0.05). The premenopausal patients gave DFSR of 72.8% and 35.7% (P < 0.01), and their overall survival rates were 80.7% and 60.6% (P < 0.05). But, no significant difference was observed in the stage I patients and those having > or = 8 axillary lymph node metastases (P > 0.05)., Conclusion: For ER-positive breast cancer patients, the adjuvant endocrine therapy gives results superior or equal to multi-drug chemotherapy after radical mastectomy.

Objective: To explore the mechanism of treating endometriosis by tonifying Kidney and removing blood stasis with Neiyixiao Recipe (NYXR)., Methods: One hundred and three patients of endometriosis were divided randomly into the NYXR group (58 cases, treated with NYXR) and the control group (45 cases, treated with danazol) and were reviewed for the improvement of clinical symptoms, serum level of FSH, LH, PRL, E2, P and T, humoral and cellular immunity (C3, C4, CD3, CD4, CD8), and plasma prostaglandin after treatment., Results: There was no significant difference in effect between the NYXR group and the control group in relief of dysmenorrhea and degradation of elevated plasma prostaglandin (chi 2 = 0.71, P > 0.05). But there was significant difference between the two groups in curing infertility (chi 2 = 14.77, P < 0.01), and the effect of NYXR in regulating endocrine and immunity was significantly better than that of danazol., Conclusion: By tonifying Kidney and removing blood stasis, NYXR is multi-effective and being one of effective methods in clinical practice for treatment of endometriosis.

Using metabolic balance test, bone mineral density measurement, animal models of osteoporosis, bone cell culture, we investigated the relationship between osteoporosis and the metabolism of calcium and bone. We found that the calcium intake was rather low in 20 healthy adults (480 mg per day); the average intestinal net absorption rate(%) of calcium in 124 healthy adult volunteers was 28.9(%), which increased gradually in recent 20 years (from 17.1% in 1978 to 40.6% in 1977), owing to improvement of dietetic structure. We conclude that the insufficiency of sex hormone and calcium are the main causes of osteoporosis. In bone cell culture, the whole process of bone remodelling was observed for 35 days continuously. Calcitonin damaging osteoclast was also investigated. Thus, we suggest new concept of bone remodelling coupling.

Objective: To study the therapeutic effects of gestrinone on experimental endometriosis in rabbits., Methods: Mature female rabbits were laparotomized under sterile condition and three or four segments of endometrium (7 mm x 7 mm) were sutured to the mesentery of uterus. Seven weeks after operation these animals were divided into 5 groups: control; treated with danazol 20mg/kg; gestrinone 0.06, 0.12, 0.24 mg/kg for 4 weeks respectively. At the end treatment they were laparotomized again. The ectopic endometrial implants were weighted and their morphologic features were analysed quantitatively by semi-automatic image analysis system, meanwhile serum follicular stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and progesterone (P) concentrations were determined by radioimmunoassay., Results: Decreased weight and atrophy of ectopic endometrial implants were shown in all experimental groups, except for control and 0.06 mg/kg gestrinone treated-group. In 0.12, 0.24 mg/kg gestrinone treated-group, except for P serum FSH, LH and E2, concentrations decreased significantly. The degree of inhibition on ectopic lesions of 0.12 mg gestrinone group was similar to that of danazol group., Conclusions: Gestrinone inhibits the growth of ectopic endometrial implants in a dose-dependent manner and showed a significant therapeutic effects on experimental endometriosis in rabbits.