The prevalence of AGA in Chinese men and women was lower than in Caucasians and similar to that in Koreans.
Esophageal leiomyoma is the most common benign esophageal tumor. Thoracoscopic enucleation is currently a preferred approach to most of these lesions. We present our experiences of enucleation of these tumors using thoracoscopic approach. A retrospective review of 40 patients who underwent enucleation of esophageal leiomyoma from 1997 to 2007 in our institute was conducted. Presenting symptoms, operative approach, tumor size, tumor shape, outcomes, and indication for this approach were analyzed. Forty patients were identified. Postoperative histopathology confirmed the leiomyoma in all patients. The thoracoscopic enucleation was completed in 34 cases, and the operation was converted to open procedure in six cases. Reasons for conversion included too small tumors to be visualized in two cases, thoracic cavity adhesion in one case, and the too large tumors in three cases. The median operating time was 70 min (50 to 210 min). Mean tumor size was 3.7 cm (0.5-10 cm). There were no major postoperative complications. Symptoms especially dysphasia were relieved postoperatively. Short- and long-term follow-up was satisfactory with none of the patients having tumor recurrences or other problems. Thoracoscopic enucleation of esophageal leiomyoma is technically safe and effective. It is currently the best choice for management of esophageal leiomyoma 1 to 5 cm in diameter. It can also be tried on a tumor larger than 5 cm, although the possibility of conversion to thoracotomy increases along with tumor growing and surrounding the esophagus.
The study was aim to assess the impact of biochanin A on the oral bioavailability and pharmacokinetics (PK) of saquinavir (SQV), a substrate of P-glycoprotein (P-gp), in rats. 10 male rats were randomized into 2 groups of equal size, and administered orally 30 mg/kg SQV with or without 20 mg/kg biochanin A. The PK of SQV was assessed using non-compartmental analysis. Results revealed that the area under the plasma concentration-time curve of SQV from time zero to time infinity (AUC) was reduced by 51.39% by biochanin A (=0.038); while the apparent systemic clearance (CL/F) was increased by 87.62% (=0.028). Double peak phenomenon was observed in the plasma SQV profiles. Biochanin A increased the first peak, yet decreased the second peak of plasma SQV levels. Our study demonstrates that biochanin A can significantly reduce SQV oral bioavailability and alter SQV PK profiles in rats. Findings in this study suggest a precaution in the clinic when SQV is administered with dietary/herbal supplements that contain biochanin A.
BackgroundBiological disease modifying antirheumatic drugs (bDMARDs) are frequently used in combination with other drugs. Very limited data are available on concomitant therapy with bDMARDs in China.ObjectivesTo investigate the usage patterns and safety of concomitant drugs in Chinese RA patients receiving bDMARDs.MethodsPatients from 15 Chinese hospitals were recruited in this cross-sectional study. Consenting patients (aged ≥18 years) diagnosed with RA receiving bDMARDs were included.ResultsData collected from 802 patients with a mean (SD) age of 49.0 (13.9) years (81.3% women) were analyzed. Among these patients, 89.5%, 56.1%, 29.7%, and 19.1% were receiving concomitant conventional DMARDs (cDMARDs), nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids (GC), and drugs for local application (LA drugs), respectively. In total, 718 patients were receiving concomitant cDMARDs. The proportion of patients using 1, 2, and 3 concomitant cDMARDs was 49.3%, 41.2%, and 9.5%, respectively. The most common cDMARDs were methotrexate, hydroxychloroquine, leflunomide, and sulfasalazine; used by 65.9%, 41.8%, 41.5%, and 6.3% patients at a mean (SD) daily dose (mg) of 1.4 (0.4), 340.3 (96.3), 15.4 (5.2), and 1753.3 (693.3), respectively. The respective mean (SD) duration of treatment (days) was 443.7 (845.8), 261.3 (409.4), 413.4 (578.5), and 429.1 (1039.9). Among the 238 patients on concomitant GC, 73.1% and 23.1% patients were receiving oral prednisone and methylprednisolone at a mean (SD) weekly dose (mg) of 57.8 (31.9) and 59.7 (151.6), respectively. In total, 17.6% patients reported at least one GC-associated adverse event (AE) at a mean (SD) duration of treatment (weeks) of 12 (28.3); the most common AEs were moon face (13.9%) and weight gain (4.2%). Among the 450 patients receiving concomitant NSAIDs, 43.1%, 20.2%, and 12.0% patients were receiving celecoxib, meloxicam, and loxoprofen sodium at a mean (SD) daily dose (mg) of 306.2 (100.1), 12.8 (3.5), and 143.9 (45.3), respectively. Most NSAID users were receiving NSAIDs at a dose lower than the daily maximum, except 2 patients using diclofenac acid at higher than daily maximum dose (150 mg). Only 3.6% NSAID users reported at least one AE; the most common AE was gastrointestinal discomfort (3.1%). A total of 153 patients were receiving concomitant LA drugs. The most common LA drugs were ketoprofen, diclofenac acid, and a Chinese herb medicine “Jia Wei Shuang Bai San”, used by 30.1%, 20.9%, and 10.5% patients, respectively. The corresponding mean (SD) treatment duration (weeks) was 2.0 (4.1), 7.8 (26.4), and 16.9 (28.0), respectively. The predominant reason (62.9% patients) for not using LA drugs was the lack of physician-directed prescription.ConclusionsThe usage patterns of concomitant cDMARDs and NSAIDs in Chinese RA patients receiving bDMARDs are similar to those in Western countries. The 17.6% concomitant GC users who reported at least one AE are receiving GC for longer time (12 weeks on average). LA drugs including traditional Chinese medicine offer a broad...
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