[The clinical efficacy of the stratification medical treatment based on the risk estimation of motor complications in Parkinson's disease]

Objectives: To evaluate the clinical efficacy of the stratification medical treatment based on the motor complications risk estimation in improving the quality of life, motor symptoms and delaying the motor complications in Parkinson's patients. Methods: Outpatients and inpatients from Xinhua Hospital, Shanghai Jiao Tong University, were recruited between November 2019 and June 2020. The participants were all clinically diagnosed with PD and treated with anti-PD medications, but had no history of motor complications, with the 8-item Parkinson's disease questionnaire summary index (PDQ-8 SI)>18.59. At baseline, the demographic characteristics, PD medical history, levodopa dosage (LD) and levodopa equivalent dosage (LED) were collected, and the evaluation of PDQ-8, Unified Parkinson's disease rating scale (UPDRS)-Ⅱ and Ⅲ, Hoehn and Yahr (H&Y) grade, Hamilton anxiety scale-14 (HAMA-14), Hamilton depression scale-24 (HAMD-24), mini-mental state examination (MMSE), Pittsburgh sleep quality index (PSQI), and Epworth sleepiness scale (ESS) tools was accomplished in all participants. Meanwhile, a Parkinson's disease risk estimation scale for motor complications was used to assess patients' risk of motor complications, and thus the medication was stratified in PD patients accordingly. During the 6-month and 12-month follow-ups, the evaluation of the above-mentioned parameters was repeated in all participants. At the 3-month and 9-month follow-ups, the information of anti-PD medications, the occurrence of motor complications (motor fluctuations and dyskinesia) and adverse drug reactions were recorded, and PDQ-8 was also evaluated. Results: Two hundred and fifty-one patients completed the 1-year follow-up, with 135 males and 116 females. At baseline, the median age of the patients was 66 (60, 71) years and the median PDQ-8 SI was 31.2 (21.9, 40.6). Additionally, 15.9% (40/251) of the patients were at high risk of motor fluctuation, and 7.2% (18/251) were at high risk of dyskinesia. There were significant differences in the age of onset, disease duration, PD treatment duration, the scores of UPDRS-Ⅱ and Ⅲ, H&Y Grade, and PDQ-8 SI among PD patients of different risk groups (all P<0.05). In the 12th month, the median of PDQ-8 SI, Δ PDQ-8 SI and Δ UPDRS-Ⅲ was 12.5 (9.4, 18.8), -15.6 (-21.9, -9.4) and -9(-16, -4), respectively, which was statistically different from that of baseline (all P<0.05). The change of UPDRS-Ⅱ scores in the group with high risk of motor fluctuation was statistically different from that in the groups with low and moderate risk (P<0.05). The changes of PSQI score, LD and LED in the group with high risk of dyskinesia was statistically different from those in the groups with low and moderate risk (all P<0.05). During the follow-up, the incidence of motor fluctuation and dyskinesia was 9.56% (24/251) and 5.97% (15/251), respectively. Conclusion: The stratification medical treatment might have a positive intervention effect on promoting a better quality of life, improving motor symptoms and delaying motor complications in PD patients.

[The preventive and curative action of fish oil compound on early atherosclerotic lesions in the aortic of diabetic rats]

250-320g male Wistar rats were divided randomly into three groups: normal control, diabetes mellitus (DM) control and fish oil compound (FOC) treatment groups. The latter two groups were induced diabetic by streptozotocin injection. At the end of the third week after injection, the treatment group was fed FOC for 9 weeks. The results showed that FOC could decrease the plasma total cholesterol, triglycerides, low density lipoprotein-cholesterol and very low density lipoprotein cholesterol levels significantly; restrain platelet aggregation; decrease blood pressure and increase atrial natriuretic polypeptide-mRNA content. It was found that the aorta in DM rats had more serious lesions than those in the FOC group. Our study found that FOC could prevent the development of atherosclerosis in DM rats.

A follow-up study of the efficacy and safety of injectable microencapsulated megestrol acetate and a discussion on its contraceptive mechanism

A monthly injectable microencapsulated contraceptive was developed by the researchers of the School of Pharmacy of Sichuan Medical College, and a comparative clinical study was undertaken by the Sichuan Cooperative Research Group. It has been found that the microencapsulated compound consisting of 15 mg megestrol acetate and 5 mg estradiol valerate is associated with the lowest incidences of menstrual disturbances and other side effects. This is a follow-up report on the 434 women who used this 'optional' dosage of compound by before-and-after comparisons and by comparisons with two other groups of women: 41 women who were given the compound with the same dosage combination but with microencapsular coat dissolved, and 20-30 women who were using a non-steroidal contraceptive method such as IUDs, barrier or rhythm methods. The microencapsulated compound was highly effective in preventing accidental pregnancies. All except two of the 119 women who discontinued the medication experienced normal menstruation within 3 months. The study did not show changes in blood pressure, liver function, glucose tolerance level and plasma concentration of cholesterol in women using the compound. Cervical smears and breast examination also showed no evidence of epithelial abnormality or breast tumors. This new delivery system of microencapsulated injections affects the cervical mucus function, and inhibits ovulation as well as implantation of fertilized ovum.

Clinical evaluation of intramuscular injection of microencapsulated compound megestrol acetate

A comparative clinical study was undertaken by the Sichuan Cooperative Research Group for Microencapsulated Contraceptives to assess the efficacy of intramuscular microencapsulated megestrol compound as a long-acting contraceptive and to find the optimal dosage as regards efficacy, side effects and menstrual irregularities. Eight hundred twenty eight women were divided into four groups and injected monthly with four different dosage combinations that consisted of megestrol acetate and estradiol valerate. In all, 5298 dosage cycles were observed. The investigation indicated that microencapsulation effectively prolonged contraceptive effect of the short-acting agents, reduced the required dosage and lowered the incidence of side effects. A combination of 15 mg megestrol acetate and 5 mg estradiol valerate, as compared to the other three regimens, was found to be clinically most acceptable because of the lower incidence of menstrual irregularities.